Housing Solutions – an early intervention approach

A new report commissioned by Healthcare Improvement Scotland describes the work carried out in Scotland to improve engagement with people of all ages in our communities, at the earliest stage, around their long term housing needs, recognising housing as being critical to a person’s overall well-being.

Developing learning from the Adapting for Change (AfC) programme, Health Improvement Scotland, Improvement Hub (ihub), under the Place, Home, and Housing portfolio, commissioned the development of a ‘Housing Solutions change programme’. The programme has been designed to ensure a very wide range of practitioners can engage far more effectively at the earliest point, to have person-centred conversations about a person’s housing needs for the long term.

This has delivered a comprehensive national programme, to jointly train multi-agency practitioner trainers from Health and Social Care Partnerships (HSCP’s), Housing and third sector partners, and was rolled out in 2017-18 in 22 of the 31 health & Social Care Integrated Board areas across Scotland (as of June 2019). The programme has also provided mechanisms to support strategic, integrated working to help drive forward whole-system change, including the development of a ‘Joint Protocol’.

A key principle, is to compliment a ‘whole-systems’ approach to the improvement of all aspects of services designed to support people to live safely in their own home.A key principle, is to compliment a ‘whole-systems’ approach to the improvement of all aspects of services designed to support people to live safely in their own home. Working with people in our communities at an earlier stage will help our agencies be more effective and proactive in our strategic thinking and our planning. In a system that often makes people feel that they have little choice, it offers all stakeholders more space to explore integrated health, housing, and social care solutions and options, allowing service users more control and opportunities for self-management.

It also provides the opportunity to provide more accurate evidence of levels and types of needs which are not inflated or distorted by the impact of continual ‘crisis’ responses, and in turn, supports effective reallocation strategies, better planning and inclusive design to support people at various stages of needs, and improved asset management and use of resources.

Key outcomes to date have evidenced:

• Improved joint working between HSCP’s and Housing at strategic and front-line level;
• Increased awareness, ownership and accountability, across a very wide range of professions and services, recognising ‘housing is everyone’s business’;
• Recognition from experienced staff working with housing issues that they have to take a different approach;
• Improved outcomes for people with effective, timely re-housing leading to improvements in quality of life and well-being.

An additional aspect of the programme has been the development of Modules to assist in the training of other, non-Occupational therapy staff, in the assessment of straightforward adaptations. This work fits very well with the new guide, Adaptations without Delay, commissioned by the Royal College of Occupational Therapists from the Housing LIN, which aims to clarify the valuable role of occupational therapist, particularly in relation to more complex needs, but also describes how others can embrace a role in the provision of effective adaptations where needs are more straightforward.

This programme will be of interest to a wide-range of strategic and operational managers leading on Housing, Health & Social Care and relevant to many of the current service drivers and policy developments including, Frailty, Anticipatory Care Planning, Dementia, Hospital Discharge, Mental health, early intervention, prevention and well-being, utilising digital technology, and new models of Housing care. It is also very relevant to services working with children with complex and long-term conditions. We look forward to working with the Housing LIN as it grows its presence in Scotland.