Richard Webb, Executive Director for Communities at Sheffield City Council, reflects on integration, his discussion at the CIH/Tunstall Delivering housing, health and care outcomes summit and shares elements of the Sheffield experience.
The summit discussion was of its time. We have a lot of national policy debate about bringing together issues around housing, health and social care. However, in many ways I think this is also about revisiting our roots, our history and core beliefs and values. Certainly now, I think it’s about making a difference, tackling the root causes of inequality, promoting social justice – prevention rather than the cure. These things really come together when we come to talk about housing, health and care.
I was asked to give a view from the front, so I wanted to share the journey that we are on in Sheffield where we have a population of 0.5m, 1/5 live in social housing and over 40k households live in council housing. We have about 35 RHPs [registered housing providers], a growing private rented sector of about 36k households, and about 10k customers in adult social care sector. We also have the advantage of a single CCG that brings together 80+ GP practices. Here, the key principles that are informing our direction are about affordable services and about becoming more democratic and accountable. We want to find new ways to engage with people and get to a broader agenda of health and social justice. We also wanted to move towards joining up and integrating services across health, housing and social care and making our investment stretch further. In Sheffield we conducted a lot of public engagement sessions, using the potential of the home and partnerships to promote independence, and making the most of our individual and community assets. A pivotal issue is isolation and we know, according to the Marmot Review, that the single biggest predictor of hospital admissions is loneliness – which is something housing services can make a big contribution to solving.
We’ve seen significant changes in the last five years in adult social care and as the money gets tighter we have to challenge ourselves again. Part of this is about technological solutions. Specific issues around these agendas include what I call ‘digital lives’ and part of that is about telecare and telehealth and part of that is about digital inclusion. For example, some of those people most affected by the bedroom tax are the least digitally included. It is also about developing our asset-based approach. Department of Health has asked for integration pioneer bids, bringing together housing, health and social care. Crucially, they are also saying housing and I think that is one of the fundamental differences from previous attempts to try and integrate health and social care. It is not about a structural ‘one size fits all’ solution; it is about what are the most important and relevant things in people’s lives – and particularly for those people who are most frail and vulnerable.
I think the journey that we are all on currently is really about how to make the best of your assets so that, to quote an Icelandic proverb, ‘everything is hay in hard times’.
Read the report Delivering housing, health and care outcomes
Tunstall will be attending the CIH Annual South West Conference from 2-4 April at Palace Hotel, Torquay.