Tuesday 29 January 2013

How CCGs can commission to support those in poor housing

How CCGs can commission to support those in poor housing: The statutory duty of CCGs to consider integration of health related services may impact the provision of housing.
From 1 April 2013, strategic health authorities and primary care trusts will be abolished and replaced by the NHS commissioning board and about 200 clinical commissioning groups.
What do these reforms mean for registered providers who currently provide or have an interest in providing housing to those with significant care needs or in poor health?

Whether CCGs will commission new housing to tackle poor health will depend to a large extent on how the greater emphasis on joint working between CCGs and local authorities beds down as the reforms under the Health and Social Care Act are implemented.
In addition, there is a statutory duty on CCGs to consider the integration of health related services and this may also have an impact on the provision of housing.
Taking joint working first, local authorities and partner CCGs have to develop a joint health and wellbeing strategy for the relevant local authority area which they must "have regard" to when carrying out their functions.
In turn, health and wellbeing boards, which local authorities are under a duty to establish under the act will have a degree of influence over the joint health and wellbeing strategy that is agreed by the local authority and CCG to meet identified local needs.
The upshot of all this is that health and wellbeing boards may identify poor housing as a local priority in addressing the poor health of the local population. This could then in turn filter into the joint health and wellbeing strategy for that area.
The local authority and partner CCG could then prioritise funding for a particular housing scheme designed to turn around the health of the residents placed there, ensuring that appropriate arrangements are put in place to manage and drive delivery of the project.
CCGs will continue to have the flexibility that PCTs have to establish pooled funds with local authorities to discharge commissioning arrangements so it may be possible for specific housing schemes to be developed by way of joint working between CCGs and local authorities.
Turning to the integration of health related services, CCGs' duty to commission services to promote integration across health bodies may also open up new opportunities for housing.
Although detailed guidance on how integration will be achieved is not set out in the act, this should lead to much broader, strategic thinking about how services are commissioned and in turn less of a "silo" approach to service provision, especially when it comes to CCGs.
This greater drive towards health provision across a series of health related services could lead to a greater demand for certain types of care and specialised housing if this reduces demand for acute services in hospitals for example.
Published research findings have confirmed that immediate access to housing and support services result in chronically ill homeless individuals utilising fewer hospital resources.
Practical steps for registered providers in this new commissioning environment would be to approach local CCGs, health and wellbeing boards and local authorities so that housing is kept very much at the forefront of their minds when setting strategies for better health outcomes.
David Isaacson is a partner in the commercial and infrastructure team at Bevan Brittan, a public services law firm. Guardian Professional. 

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