In November 2021, economic analysis estimated that the cost burden to the NHS caused by hazards arising from poor quality homes in England was £1.4bn. Improving the overall health and wellbeing of local populations, particularly mental health, will therefore need to take a cross-sector approach including housing and welfare.
Our research on the cost of living also identified challenges for the NHS workforce in securing affordable housing, with some trusts reporting that the rising housing prices in the vicinity of their sites is leading to recruitment and retention challenges, as well as higher commuting costs for those who live further from work.
Trusts can play a role as part of ICSs, alongside housing partners such as councils, housing associations and the voluntary sector, to take a more joined up approach to supporting people's health, prevent illness, and facilitate holistic recovery for those in their care. A review of housing and mental health examined the evidence on integrating health and housing services and identified ways in which ICSs can better bring together health, housing and housing-related services alongside their system partners. The review recommended that
healthcare providers see housing services as part of each care pathway, and that healthcare providers and commissioners exercise agency in relation to housing for their patients.
Alongside these valuable partnerships, trusts are also increasingly looking at their estates and land use to consider whether they can do more locally to boost the supply of high-quality housing. However, trusts say that it is essential to ensure that any decisions made about housing are in conjunction with the local authority and in consultation with local populations. Capital funding challenges currently present barriers to effectively repurposing land and securing funding to redevelop estates, however, some trusts are building local relationships to ensure existing facilities can be used more fruitfully for social value.
Sussex Partnership NHS Foundation Trust has developed a strategic plan, alongside local government and housing partners, to better coordinate the provision of high-quality housing that meets the needs of mental health patients during their recovery.
Case study
Sussex Partnership NHS Foundation Trust
Sussex Partnership NHS Foundation Trust is working with other health and care organisations as part of Sussex Health and Care (SHC) ICS, to deliver a more joined up approach to housing, including supported housing, for people with mental health needs across Sussex. The provision of support with housing was identified as being essential to recovery and a key determinant of positive physical and mental wellbeing for people using mental health services across the area. In 2020 the trust published a strategic plan for integrating housing and mental health across Sussex. It identified five strategic objectives to form a road map for future mental health services. The objectives were coproduced with local authority partners and a project delivery board oversees progress, with input from housing providers, local authorities, and other partners.
The trust is working with partners to deliver mental health and housing plans for each place in East Sussex, West Sussex and Brighton and Hove. These plans will consider three main strands:
- how to develop a specialised housing placement market with the right quantity and quality of specialist supported housing services
- how to coordinate access to specialist housing placement services, making sure patients, staff and carers can access these services when they need them
- culture change and integration, including transforming how mental health and housing services work together.
Under these strategic objectives, the partnership aims to ensure housing expertise is embedded within the new model for community mental health services being developed across the SHC partnership. This includes developing new housing specialist roles that will sit within mental health teams to identify and respond to patients' housing needs. These new roles are being developed in partnership with local housing authorities; this integration of mental health and housing services has been supported by additional training, co-location of services, and staff shadowing each other's teams to understand their ways of working. Staff recruited by the trust to housing specialist roles receive professional supervision from the local housing authorities.
The trust also has a discharge to assess service, which has been successfully piloted in West Sussex and Brighton for the last two years, delivering supported housing services for people who are ready to leave hospital but need ongoing assessment and support, and who might otherwise be unable to enter into a secure housing placement because of their health needs. These services are now moving from pilot to 'business as usual'. The trust has an ambition to create further integrated models of supported housing for people with multiple and complex needs, in order to reduce out of area hospital placements and residential care.
Sussex Partnership NHS Foundation Trust and SHC are committed to ensuring that housing is a cornerstone for delivering positive mental health outcomes for adults across Sussex. They say that working in partnership with the system has allowed better provision of housing options, helping people live better and more fulfilling lives.