Tenant participation newsletter 2017

Health and social care integration

Health and social care integration - what does it mean for housing in Scotland?

The increasing challenges associated with an ageing population means more pressure on our vital services. We're responding to this challenge by better integrating our health and social care services.

Good quality housing plays a key part in this. We know that independent living is key to improving health and wellbeing, so successfully integrating health and social care will ensure that more people are cared for and supported at home or in a homely setting.

Delivering the national health and wellbeing outcomes set out in legislation* involves more than health and social care services. We've made sure that it underpins local planning, with requirements to 'connect' with citizens, communities, service providers, carers and others when strategic planning. Some housing functions are part of local integration arrangements, with the lead responsibility for these shifting to health and social care.

For example, it isn't only about enabling independent living for people, but also about being more effective in preventing admissions to hospital, helping people return home more quickly after hospital admission and contributing to tackling the health inequalities affecting people in Scotland.

Housing organisations have a track record of providing holistic support to tenants, residents and homeless people, so they're well placed to align their services with integrated health and social care services. Examples of housing services which contribute to the achievement of national health and wellbeing outcomes include:

• providing and maintaining modern homes which meet the diverse needs of tenants, including those with particular needs;
• arranging and undertaking adaptations to council and housing association homes, and helping owners and private tenants to fund and undertake adaptations; providing preventative services such as Care and Repair and 'handyperson' schemes;
• repairing and upgrading social rented housing;
• providing technology and telecare to help people manage their lives at home;
• ongoing housing support to those who need help to manage their life in their home; from low-level activity (such as tenancy support) to more intensive support for those with complex needs; and
• advising those facing difficulties with their housing, including those facing increasing frailty and those at risk of homelessness; this can include advice on housing choices, welfare advice, advocacy support, befriending services, and help finding alternative housing.

The national health and wellbeing outcomes set out in the legislation drive change and so each partnership is forming a strategy around the needs of its local population. Locality planning is included in the legislation meaning that each partnership must identify at least two (with some identifying as many as four or five) localities within its area, the needs and priorities for each requiring its own plan to reflect that area and its community. Partnerships and services are starting to form new working relationships across all services and are engaging with local people as never before. Through health and social care integration people will see change that reflects their needs and aspirations and see the benefit of dynamic new partnership working.

Please contact Kate.Cunningham@gov.scot for more information.

* The outcomes are set out in the Public Bodies (Joint Working) (National Health and Wellbeing Outcomes) (Scotland) Regulations 2014.

George McGuinness MBE, Chair of the Glasgow and Western Isles Regional Network, has been involved in housing advocacy for almost 40 years

How do you think health and social care integration can change lives for tenants in Scotland?

I've seen services trying to work together over the years and this really is a new model and people are more focused on its delivery than they ever have been in the past and there is more work going on now. Before, it wasn't joined up. There was hope and promises, but lots of failure and disappointment.

To me housing and health is the key to life. Without warm, safe housing lives would be affected, children would struggle at school, families suffer. Housing officers used to be responsible for up 800 houses. Now that number is closer to 200 meaning they get to know their tenants, they see when someone is starting to struggle long before it is a problem so that changes can be made and support offered to keep people in their home and in their community.

What would you like to see integration achieve in future?

I'd like to see us being more proactive. Health, housing and wellbeing should be our mantra.

The uniqueness of people needs to be appreciated, where one person might need support in one area and respond quickly, another person might take much longer to respond and we need to be plan for this. We all need different types of support at different times and no one solution can ever fit us all. That type of planning is a sticking plaster and can't last.

I witnessed a telecare consultation in the Highlands where an older gent spoke to his doctor online saving him a 60-mile round trip. They spoke about test results, how he was feeling and afterwards he felt better and his doctor felt better knowing that he was well and coping. If I struggle I might only need a hand rail. It might only take widening a doorway to keep me in my home. We have all the solutions right now and I hope we're starting to use them all at last.

George McGuinness MBE.