Guidance

Improving health through the home: how to use the checklist

Published 10 November 2016

When to use this checklist

Any local plan for improved health and wellbeing needs to consider the home environment and housing circumstances, because they are one of the wider determinants of health.

This checklist will help to:

• check whether local plans have considered and planned for impact of the home and housing circumstances on health and wellbeing
• inform local conversations that should lead to improved health and wellbeing, by action being taken on the home or housing circumstances, and by working with the housing sector and related professions like home care and occupational therapists

This checklist may be of particular benefit to people with the following interests:

• protecting and improving the public’s health, wealth and wellbeing locally
• reducing health inequalities
• preventing, delaying and reducing the demand for health care and social care services
• ‘homes, health and wealth’: local economic prosperity and growth
• enabling local communities to improve their health, homes, and neighbourhoods

Types of local plans

There are a number of local commissioning or other plans to improve health and wellbeing that this checklist could usefully be applied to. Only some of these are statutory.

NHS and partnership plans

You could apply the checklist to NHS and partnership plans including:

• the Sustainability and Transformation Plan
• the Clinical Commissioning Group business plan
• the Better Care Fund Plan (BCF)
• Delayed Transfer of Care (DTOC) plans – these must be submitted as part of the BCF plan

Local authority and partnership plans

You can also apply the checklist to local authority and partnership plans including:

• the Health and Wellbeing Strategy
• the Director of Public Health annual report
• Care Act 2014 implementation/transformation plans
• social care commissioning plans (for example children and families, adults, older people, or mental health)
• market position statements for social care and related services
• devolution or other locality plans (these may not be specifically for health or care, but for a related topic such as the economy)
• the Local Plan and supporting spatial planning policies
• local housing and homelessness strategies

Support to complete the checklist

Users of this checklist may have little or no prior knowledge of how the home environment or housing circumstances impact on the public’s health and wellbeing, or of the housing sector.

To answer some of the questions you may need to consider the evidence of the impact of housing on health on populations, and review examples of housing interventions that can contribute to improved outcomes.

Ideally, you should make contact with other expert and interested professionals, organisations, individuals or communities of interest to complete the checklist. This checklist was developed with input from the national bodies representing these professions and signatories to Improving health through the home’ national memorandum of understanding.

The process of completing the checklist is as important as the end results, and working with others now will help you to identify potential solutions faster.

Before you use the checklist: searching for keywords

Before you start to use the checklist you might want search for some relevant words within the plan document, to get a sense of how much the home environment and housing circumstances have been considered.

These are useful search terms:

• ‘hous’ [house, housing]
• ‘home’ [home, homes, homeless]
• ‘liv’ [live, living]
• ‘enviro’ [environment]

Why it is important for local plans to consider the home environment

The right home environment is essential to health and wellbeing, at all stages of life.

Home and housing circumstances are one of the wider determinants of health. They can negatively affect:

• a child’s education and life chances
• the contribution that working age adults can make to the economy
• independence and participation in the community in later life

Poor housing is estimated to cost the NHS in England at least £1.4bn each year, with almost half that cost associated with older households.

Single homelessness costs the NHS at least £85.6m each year.

If we are to improve health and wellbeing, and prevent, delay and reduce the demand for health care and social care, then local plans for health, wellbeing and wealth should consider the home and health relationship across the life course.

What we mean by the ‘home environment’ and the ‘housing sector’

The ‘home environment’ means:

• a healthy home: warm, safe, free from hazards
• a suitable home: suitable to size of the household, and the specific needs of household members, including disabled people, and to households whose needs may change, for example as they grow up or age
• a stable, secure, home to call your own: without risk of, or actual, homelessness or other threat, like domestic abuse

The housing sector means all the professions and organisations meeting housing needs and aspirations as either:

• their primary purpose - this includes social landlords, environmental health practitioners, housing information and advice or option services, housing service providers, private developers, private landlords or lettings agents, planners; or
• a major part of their work - this includes welfare advice providers and occupational therapists

There’s a real opportunity for the housing workforce to make every contact count.