People
Occupational therapists( OTs), the report argues, are perfectly suited to unite the efforts of the health and housing industries and enhance preventative efforts for both sectors. Their expertise in the relationship between people, their environments and their daily activities, enables them to bridge sectors, design inclusive solutions and deliver integrated, personcentred care. The report references a number of care studies where the use of occupational therapists has resulted in both economic and social benefits for residents and the services that support them. Strategic OT interventions in Wiltshire saved £ 65,000 over the course of three months, and up to £ 1.4 million saved from adaptation budgets in the London Boroughs of Richmond and Wandsworth.
Conclusions and recommendations
The report is concrete in its conclusion: housing is a fundamental human right and a core social determinant of health. Where homes fail to meet people’ s needs, through poor condition, inaccessibility or insecurity of tenure, the consequences ripple outwards – declining health, rising demand for care, deepening inequality and mounting costs for the public purse. This ripple-effect is not inevitable, and the report concludes that the best effort to prevent and counteract it is a joint initiative between the worlds of health, housing and social care.
The report makes a number of recommendations as to how prevention
can become embedded within all three disciplines. One of the concepts key to this is occupational therapy leadership, which involves including senior occupational therapists in decision-making across social care, housing and health, who can act as a strategic voice ensuring that key decisions have prevention at the core, rather than crisis response. This is core for it’ s first recommendation, to strengthen system leadership across housing, health and care, and ensure that each service is aware of and addresses how their services overlap and influence the others.
Shifting funding upstream and prioritising prevention and early intervention is another key recommendation from the report. Preventative action delivers better outcomes and avoids higher health, care and housing costs later on, and addressing housingrelated risks before people reach crisis point maximises safety and independence. The report suggests how this can be achieved across central government, local authorities and system leaders, including reforming and modernising Disabled Facilities Grants to enable earlier, preventative housing interventions at scale.
Embedding accessibility and adaptability in housing at scale is also a major pathway to saving long-term costs. Drawing on expertise from occupational therapist, the report says local housing, planning and regeneration strategies should place health and adaptability as core strategic priorities. All of these recommendations require investment into workforce capacity and expertise. In order to facilitate positive change and adequate prevention, government should recognise occupational therapy as a critical workforce for prevention and integration across housing, health and social care, and support national workforce approaches that embed housing-related capability.
Breaking the cycle
The reports core message is one that much of the sector is already aware of: prevention must come first. Across housing, health and social care, all three industries are currently trapped in a cycle of meeting steadily increasing demand with tighter and fewer resources. Treating the symptoms of an issue will only yield temporary relief, the core issue must be treated in order to truly solve the problem, the core issue in this case being housing. Fewer and less suitable homes will only breed further and more complex health requirements, placing strain on public services. All three industries mut analyse the current status quo and begin to understand how the cycle can be broken in exchange for a system that prevents problems before they occur, as well as treating them at the crisis point.
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