17 December 2020

My thoughts on the relationship between health and housing come from the privileged position I have been in as chair of both the Walsall Healthcare NHS Trust and whg housing association.

Taking on both roles was by no means a coincidence – I was drawn to both organisations because their objective is to provide two of the fundamental cornerstones to achieve a happy life: good health and a decent home. There is no doubt that these two foundations of life are intrinsically linked, so holding the chair position for both organisations provided the perfect opportunity to explore the opportunities that could come from the two services working more closely together.

Although it is essential to have a fantastic healthcare system that looks after people when they get ill, the holy grail of health is of course prevention. We know that much of the demand presenting in our medical centres and hospitals is preventable and that the key influences are not all within the control of health services. We also know the road to recovery is often challenged by the circumstances of the patient. If they live alone, if they don’t have the resources to keep themselves well or the right adaptations to their home, recovery can be much more challenging.

I believe there is huge potential in innovative approaches to integrated housing and health, with the potential to improve health and healthcare outcomes, reduce healthcare costs and help manage demand.

In Walsall we have developed ‘Walsall Together’, our integrated care partnership board. We have made sure that whg, as the major housing provider, has a seat at the table.

Our starting point in the partnership is making sure we provide a warm, safe home which provides a stable foundation for our work. We are developing models for social prescribing, which seek to engage with the patient on their road to recovery. By linking housing colleagues with healthcare professionals, we can design more impactful services that develop resilience in the community. By understanding the links between health and impacts of unemployment and poverty, we can design place based, community centred programmes which promote health equity and contribute to the resilient communities’ agenda.

Learning from the pandemic

It has been a very challenging year for both organisations. The pandemic has brought significant stresses to the NHS, and whg have seen the disproportionate impact on poorer communities, where the impact of health inequalities has been compounded by the economic impacts of the national and local lockdowns. Health inequalities are particularly prevalent in Walsall where areas of post-industrial decline and increasingly ethnically diverse populations combine to create significant issues of poverty, lack of opportunity and poor health. These issues are not uniformly distributed across the borough.

The 2020 coronavirus crisis has shone a harsh spotlight on longstanding inequity. The need to address inequalities and work with partners to address the social determinants of health is core to the work of both social housing and the NHS. The issues of poverty, lack of opportunity and poor health in poorer communities have posed greater challenges for managing in a pandemic. Understanding and having close links with specifically challenged groups, like those with mental health needs and those who are already socially isolated means we can plan communication and targeted services in a way that has the greatest impact.

During the pandemic we have also seen some fantastic examples of partnership working, including the alignment of health and social care budgets. These joined up approaches, supported by more connected and resilient communities, will provide a better environment to respond to something like a pandemic in the future.

How should primary care and health commissioners work with housing associations?

Through Walsall Together, our health care partners are starting to understand the ‘added extra’ that housing provides in terms of services that directly benefits health care services further downstream. They can see that housing providers are able to deliver these at relatively small levels of investment. With the help and investment of primary care and health commissioners we could achieve even more.

By working together, we can embed health outcomes within our services and in planned regeneration schemes and by disrupting traditional commissioning protocols and funding housing associations to directly deliver health prevention, using our existing relationships with our customer base, we could see a significant impact on the prevention of poor health in some of our most challenging communities.

Danielle Oum

Danielle is chair of the Walsall Healthcare NHS Trust and whg.

Danielle was appointed Chair at whg in February 2019 after joining the Board in October 2018. She has a professional background in the learning and skills and regeneration sectors and has held senior roles in organisations such as Black Country Consortium, Groundwork UK and the Learning and Skills Council.

In parallel to her professional career, Danielle has also held a number of non-executive roles, including within the housing sector at Optima-Family, WM Group and Wrekin Housing Trust.

Alongside her continued interest in housing, Danielle has held non-executive roles in the NHS. She is Chair of Healthwatch Birmingham, the regional agency for Healthwatch England that advocates on behalf of NHS and social care service users. She is also Chair of Audit for Healthwatch England. She has previously held non-executive/Chair roles at Dudley Primary Care Trust and Dudley and Walsall Mental Health Trust. In 2016, she was asked to become the Chair at Walsall Healthcare NHS Trust, to help turn around this poorly performing Trust.

Danielle holds an MA in Equal Opportunities from Birmingham City University and a BA in Humanities from University of Greenwich.

She is also a Member of the Governance and Remuneration Committee.

Health and housing: a joined-up approach