Agenda item

To consider the report.

The committee received the presentation from Public Health on Housing as a determinant of Health and noted it. They discussed the complexity of housing provision and the need for an integrated approach.

Alice Munro, Consultant in Public Health, gave a presentation on the upcoming Annual Report of the Director of Public Health, due to come to Executive Committee in March. The report is an independent and personal view from the Director of Public Health, covering matters outside ‘business as usual’, often about issues whose profile should be raised and where the whole system needs to respond.

The themes for this report are ‘Homes and Health’, highlighting that homes provide a strong essential foundation for good health, and ‘Neighbourhood’, highlighting how resilient communities can support people to live healthy independent lives.

During the discussion, the following points were raised and responded to:

• The report findings have a lot of interconnected thinking in terms of housing and type of housing. What can councillors do to address it? There are recommendations in the report for different audiences, to look at the powers regarding the local plan and the transport plan. The final report will have more detail.
• There are different levels of care in care homes on hospital discharge than there used to be, possibly lower levels. Is that something commonly found with hospital discharge? There is variety in the supported housing model, when someone leaves hospital they have an assessment to see what their needs are and what is available. Work with the individual and looking at what they need, including from the private sector.
• Example of a case where someone was discharged to an unpaid carer, but carer had to work and so they were left without care. What efforts are being made on hospital discharge to support that? There are several different pathways, which can be augmented with Village Agents, Red Cross, and other VCSEs. Pathway 0 has the ward look at whether they are able to go home, Discharge to Assess involves a hub and a multi-agency decision.
• It’s about neighbourhoods and making sure they care for each other.
• Complex Care Team is a great example of the NHS working for older people with a holistic approach, difficult referrals and needs being met in a short amount of time
• How can we get the message out about homes being adapted for older people? Do we as adults need to take more responsibility for preparing for getting older? That would be a question for colleagues in Communications – many people don’t perceive themselves to be vulnerable or anticipate that they might need support in their home or housing adaptations. Need to raise awareness and be pro-active instead of responding to a need.
• How can Adults and Health Scrutiny contribute to this and connect to the broad developments like housing and the local plan? Earlier this week there was a meeting with Housing, Social Care, and Public Health to look at the housing plan in Somerset. May be possible to do this item as a workshop for the scrutiny committee.
• This could be an area that chairs of Scrutiny such as Adults and Health, Communities, and Childrens etc. come together on.
• There is a need to work collaboratively with planning on this.
• There is a need to integrate the processes, looking at transport, housing, and service provision holistically, for example a bus that is under threat that takes people to their nearest surgery.
• The timing involved in updating the local plan is complicated – the Somerset local plan is going to take years to be formed and look at how it is implemented. There is a need to look at the way of influencing current building and planning, and as phosphate mitigations mean more building can take place, need to look at how we influence things now.
• With housing being developed as buses are withdrawn, there is a particular challenge, even in areas with previous local plans. The hope was with unitary that highways and planning would work together.
• Where there isn’t a local plan for areas such as Somerset or South Somerset, there can be neighbourhood plans which take control of the issue at a local level. We should encourage local areas to have their own neighbourhood plan with support from Somerset Council.
• Where there have been issues with transport to healthcare in the past, surgeries, NHS, and local councils have worked together to provide transport like a minibus. That could be an area we look at for rural communities.

Cllr Slocombe (chair) thanked Alice Munro for her presentation and summarised the discussion around intervention and an integrated approach.