If carried forward, the local housing allowance cap could have a catastrophic impact on health and social care services, warns Juliann Hall from the South Yorkshire Housing Association (SYHA).
‘Health’ and ‘housing’ are words we now hear uttered more and more frequently in the same sentence, and for good reason. The NHS Five Year Forward View and its ambition to deliver more healthcare in our homes and neighbourhoods has led to greater awareness of the vast potential of housing associations to support with prevention, transformation and system change.
Housing associations have a long and rich history of providing preventative services. We enable frail older people to remain in their communities. We offer a home and support to those recovering from drug or alcohol dependency, the homeless and young people taking their first step into independence after a life spent in care. And we offer an alternative to residential or institutional care for those with mental health problems and learning disabilities. A recent comprehensive study assessed that the saving to the state delivered by supported housing is in excess of £600m a year.
Buried within the Autumn Statement 2015 was an announcement which could prove to be a fatal blow to supported housing services nationwide. If carried forward, it will have a catastrophic impact on our health and social care services.
Under the plans, due to take effect from 2018, housing benefit for social housing tenants would be capped at the same rate as the local housing allowance (LHA). LHA is the benefit people in the private rented sector can claim, which is limited to the cheapest 30 per cent of local private rents. The Department for Work and Pensions intends to apply the cap to housing benefit for tenants in supported and sheltered housing, despite the fact that rents in supported housing tend to be higher, to reflect the extra facilities and resources involved.
As a result, associations such as ours – which provide housing for older people, people with disabilities and people with mental health needs – could be left with huge shortfalls. The impact would be catastrophic. We would be left with no option but to close the majority of our care and support services, in the face of a total annual loss of £2.83m of rental income. We calculate that 24 of our supported housing schemes across the Sheffield city region would no longer be financially viable and would be at risk of closing.
But this isn’t just a problem for us. The National Housing Federation estimates that the decision puts 150,000 supported housing places at risk of closure nationwide.
So why should this matter to our colleagues in the NHS and social care?
The closure of so much supported housing would leave thousands of vulnerable people without homes or care. The NHS and local authorities would inevitably have to pick up the pieces. Many people would undoubtedly present at A&E and be at far greater risk of admission to hospital. The risk of long-term hospitalisation would rise. And local authority social care services and budgets would come under even greater pressure. GPs would face similarly unmanageable needs.
The physical and mental health of many will decline due to the lack of good housing and support which results from the decision. The impact of mass displacement of our most vulnerable cannot be overstated.
The LHA decision seems a clear case of not joining the dots, making a policy decision in one department which manifests in a set of catastrophic and unintended consequences elsewhere. We must do all we can to prevent our key decision-makers from sleepwalking into this disaster.
Andy Buck, a non-executive director at SYHA and former chief executive in the NHS, adds:
“25 years ago, when working for Sheffield City Council’s social services, I was in the thick of much of the work we did in the city to replace long-stay institutions with homes and support – for people with learning disabilities, physical disabilities and mental ill health, as well as frail older people.
“At times it was a desperate struggle: the services being replaced were often cheap (but very far from cheerful); service users and, rather more frequently, their carers were sometimes deeply sceptical about our intentions. Making the capital and revenue costs stack up, in a very tough financial climate in which responsibility for paying for residential and nursing home care was transferring from the then Department of Health and Social Security to local authorities, sometimes seemed close to impossible.
“But we persevered, and there gradually emerged homes with support that offered people the dignity, respect and comfort everyone deserves.”
“Since then, working for the NHS and now in the voluntary sector, I have witnessed this continuing, with new generations of supported housing emerging. We are all so much better for these changes – as a society, as citizens, as health and care services, as people who need support, and as their families.
“The thought that this huge progress might be undone is deeply shocking. From a human perspective it would be tragic. From an NHS and social care perspective, it would be economically ludicrous. From a political perspective, surely it would be indefensible.
“This feels like one of those moments when the politicians need to say ‘you know what – we’ve listened, we didn’t get this one right, so we’re changing our plans to put it right now’”.
It’s the kind of thing we ask of our staff all the time – listen, reflect, learn and act. Let’s hope the government will follow suit.
Juliann Hall is director of care, health and wellbeing at South Yorkshire Housing Association. Follow her and the organisation on Twitter @hall_juliann @SYorksHA
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