The Bigger Picture: Policy drivers & implications for

housing & care options services

Sue Adams, CEO, Care & Repair England

Aim

• Understand the wider context within which you are delivering services and hence…..

• Identify the more likely drivers for supporting continuation of services

Policy Backdrop• Massive reductions

in public expenditure

• Reducing role of the state in most areas of public life

• Housing – very radical changes

Government spending as a share of GDP projected to approach its lowest post-war level (around 36%) by the end of the consolidation in 2019-20.

Resolution Foundation (2015) Seven charts that show the changing shape of the state in Britain

Health spending – safer than houses?

• NHS facing massive funding pressures – not a golden goose

• Revealed in Spending Review – tomorrow• BUT• Social care even more squeezed• Housing – role of state ends?• Welfare reform – major reductions

Can you reduce health pressures?• Hospital admission levels,

especially amongst older old, linked to speed of discharge & readmissions

• Costs to GPs – multiple appts/ again hospital costs – both higher for older people / people with multiple LTCs

• [Meet Targets/ Outcomes]

Pressing Other Sectors’ Buttons

Adult social care• Facing major funding

reductions/ rising need• PRIORITIES? Reduce

residential care cost• Reduce social care costs

more generally• Meet Duty / integrate• [Targets/ Outcomes]

Housing • Stock shortage/ build

new homes (with no state funding) is top of agenda

• I&A ‘selling points’– Making best use of stock– Cut waiting lists (social)– Effective use of DFG/

adaptations / repairs

Pressing Other Sectors’ ButtonsPublic Health• Prevent ill health• Reduce inequalities• Meet outcomes/ targets• Key role in H&WBBs/

joint commissioning

DWP• Welfare reform (includes

changes to help with housing costs eg. mortgage/ loan interest

• Self help/ use own resources (incl. Pension pot/ home equity)

• Pension changes have put independent I&A on the policy map

Housing - Big Changes• Housing and Planning Bill• Headline issues around social housing– Rents (1% cut, market rents, pay to stay)– End security of tenure– Extension of Right to Buy to housing association

tenants – incl specialist/ supported– Shrinking supply of social rented homes

• Mainstream housing– Focus on first time buyers (reducing LA powers re

what built eg starter homes, planning changes etc)

Implications for I&A

As yet many unknowns but….

• Need for good, impartial I&A will become greater than ever as income/ pensions/ housing / care costs in later life become ever more intertwined

Imperative – demonstrate value

• Being a ‘good thing’ & clearly improving lives -not enough

• Quantify impact/ value across health, social care, housing, welfare sectors

The Big Challenge• Do more for less

• Do things differently

• Be part of integration agenda

• Evidence, evidence, evidence

• Can’t stand still…………..

Red Queen Syndrome