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National Homeless Advice Service

The NHS Long Term Plan - what it means for housing and homelessness

Posted by nicola_marklew January 10, 2019

On Monday 7th January 2018 the NHS Long Term Plan was released, outlining how an additional £20bn, up to 2023, should be spent.

The ambitious plan sets out how the NHS should focus on preventing ill health through various means, including the encouragement of joined up working, with Integrated Care Systems to be rolled out across the country by 2021.

It seeks to make the NHS more joined-up and coordinated in its care, breaking down traditional barriers between care institutions, teams and funding streams; and the plan goes into further detail saying that all Integrated Care Systems will include participation from local authorities, the voluntary and community sector and other partners.

Much of what is set out in the plan is already happening across the country, at varying stages and with varying levels of success. The case studies section of the Long Term Plan website includes good practice from:

The plan itself also directly references the work being done by Pathway to help create teams within hospitals to support homeless people.

Key points from the NHS Long Term Plan in relation to housing and homelessness, and that might be of interest to you:

  • All major national programmes and every local area across England will be required to set out specific measurable goals and mechanisms by which they will contribute to narrowing health inequalities over the next five and ten years. Up to £30 million is to be spent on meeting the mental health needs of rough sleepers.

  • It extends on work already being done on the Five Year Forward View to focus on health conditions such as dementia and cancer, to cardiovascular and respiratory conditions. Conditions that we know are exacerbated or caused by poor quality housing or rough sleeping. There will be targeted investment in this area.

  • The plan doesn’t require changes in the law to be implemented, however there are proposals to amend legislation in order to accelerate progress on service integration, amongst others.

  • Support offered to individuals should be more differentiated; so a ‘one size fits all’ approach is never ok. Tailored prevention based on the needs and wants of a person will increase the changes of engagement, leading to improved access and outcomes.

  • Discharging people from hospital back into their community will get better, by implementing measures such as placing social work teams at the beginning of the acute hospital pathway, and agreeing an expected date of discharge within 14 hours of admission. There is an expectation that all hospitals with a major A&E department will do this in partnership with their local authorities.

  • Over 1,000 trained social prescribing link workers will be in place by 2020/21, working with people to develop tailored plans, connecting them to local services to address issues related to wider determinants of health, such as housing.

  • The blending of health and social care budgets, where councils and Clinical Commissioning Groups agree it makes sense, will be supported. Further proposals for health and social care integration will be set out in the forthcoming Green Paper on adult social care.

  • The Better Care Fund will be reviewed in 2019/2020 by the Department of Health and Social Care and the Ministry of Housing, Communities and Local Government. It will include clear requirements on reducing delayed transfers of care and improve the availability of care packages for patients ready to leave hospital.

  • Social enterprises, local charities and community interest companies who provide support and services to vulnerable and at-risk groups will continue to be commissioned, partnered with and championed by the NHS.

  • To support staff to continue to develop their skills and knowledge, Health Education England has agreed to increase the proportion of its total budget spent on the workforce in the short-term, with a focus on primary care and community settings. The Government’s Spending Review and the Workforce Strategy, due later this year, will further clarify details.

  • Population health management solutions will be deployed in 2019, helping Integrated Care Systems to understand areas of greatest health need and match NHS services to meet them. It’s anticipated that these digital solutions will become increasingly sophisticated, predicting which individuals are most likely to benefit from different health and care interventions, shining a light on health inequalities and helping to reach those who need the most support.

  • Support for the most vulnerable children and young people in, or at risk of being in contact with, the youth justice system, will be invested in.

  • A veteran’s accreditation scheme will be rolled out to GPs across the country over the next five years, to ensure all GPs are equipped to best serve veterans and their families.

  • Through the Healthy New Towns programme, the NHS will continue to play a lead role in setting out principles and practice for Putting Health into Place guidelines – for how local communities should plan and design a healthy built environment. In 2019/20 the NHS will work with government to develop a Standard, awarding places that meet high standards and principles promoting health and wellbeing with a Healthy Homes Quality Mark.

A new operating model is being developed with leaders across the NHS and other partners, based on the principles of co-design and collaboration. Local health systems are expected to work on their local plans, based on this Long Term Plan, to be delivered later this year.

To join in the conversation on social media use #NHSLongTermPlan and to keep up to date with developments go to the NHS Long Term Plan website: https://www.longtermplan.nhs.uk/