Last July, myself and a large group of Sitra members, sat listening to one of the Transformation Managers for a London Borough, talk through her responsibilities for the successful implementation of the Care Act 2014. The list of tasks, partnerships, priorities, and plans seemed endless, and the ambition was huge. Around the country, hundreds of staff in Local Authorities have been following the same agenda, and today is the day when plans become realities and policy becomes practice.
So – have you managed to take the opportunity to influence your local authority? Have you got round the table to inform the integrated spend of the Better Care Fund? Have you reframed your services around wellbeing and prevention – key components of the Care Act?
At the national level, there is growing support and understanding of the role housing has in ‘integrated delivery’. A recent blog by Andrea Sutcliffe, Chief Inspector of Adult Social Care, highlights her understanding of the housing role – with a key reminder that ultimately the prize is better services for people, not more efficient processes (because – let’s not be shy – it is possible to get the latter without the former!!). A conference held this time last year, by Placeshapers, brought together public health, NHS England and ministerial support for the role that housing could play in the delivery of community based, integrated, preventative services. Finally, if you are keen to wave a piece of paper to get your point heard – you need reach no further that the long awaited Memorandum of Understanding between Housing and Health, which came out at the very end of 2014. This key document outlines a national commitment and understanding of the role that housing plays across the health spectrum.
So, if nationally there is a growing voice, how does it feel on the ground? ‘Patchy’ seems to be the political phrase of the day! (Oliver Letwin’s words – according to Tony Stacey). Telling, I agree, but not news! I have spent December and January touring round with the LGA hearing about how the integration of health, housing and social care is working on the ground. I know that where it is working, the results are positive, but there is no obvious structure/plan for scaling up. I think that we have that structure now in the form of the Care Act 2014. It seems to me this is the only structure we are going to have for the foreseeable future – and very importantly it is a structure that recognises the potential role for housing.
I am cheered by the way that housing organisations have responded to the opportunities arising as part of Devomanc, and see this type of ‘alliance’ as a critical part of future discussions with health. Whilst I too share the frustration that recent announcements around Vanguard sites and Integration pioneers do not ‘name’ housing, I think that there is really positive work in play that has already influenced national parlance around housing, and will soon support the local shift from ‘implicit’ to ‘explicit’. Just remember – if the local priority is to keep people living as independently as possible, as healthily as possible for as long as possible – they need a home to do it in! #healthbeginsathome