The law firm Capsticks and the publication Social Housing recently invited a number of senior housing and health professionals to discuss how they could work together more effectively on capital projects. Understandably, much of the discussion focused on the difficulties of unlocking access to public land, and NHS land in particular.
Susie Rogers, a partner at Capsticks, seems, to me, to nail the issue when she says "once an NHS property has been declared surplus, that organisation is obliged to sell the site to the highest bidder. It is therefore key to act before that. If you can get in with a proposal that has other benefits for the NHS, before the site is declared surplus, then that is something they will talk to you about. For example, an estates rationalisation programme, or a keyworker accommodation scheme".
The trick, then, is in forging closer ties with health. A number of positive examples of health providers and housing associations working together to develop new services were cited by those at the roundtable. They included Southdown’s promotion of the Individual Placement and Support, which has been recognised by the Centre for Mental Health as a full partner in the Individual Placement and Support (IPS) Centre of Excellence Programme.
The Tower Hamlets Crisis Service, a joint service provided by Look Ahead Housing and Care, and the Tower Hamlet Home Treatment Team provides a temporary safe space for people to manage their presenting mental ill health, so they don’t have to be admitted to hospital. Tile House, a joint venture between One Housing Group and Camden and Islington NHS Foundation Trust provide step down accommodation to allow for more effective recovery in the community.
There are a number of examples. The question is how can housing associations work with health providers to unlock access to land?
One participant noted that you need to get into the psyche, and demands and needs of local HNS providers. You need to recognise that they will have difference priorities and drivers than you.
Personally, as someone who spends time in the NHS and with housing associations, I’ve found that when NHS providers talk with housing associations - which in itself doesn’t happen often - their gut reaction tends to be one of suspicion. “All they want us for is our land,” is a typical reaction.
What they fail to see is the potential for the two to come together to solve their problems. To facilitate this collaboration, here are four ways housing can help health providers find common cause:
- be clear about the care pathways you’re discussing, and have a clear service offer to help with the redesign of the healthcare pathway. You can then discover the best way to provide an integrated service, whether as a prime contractor, as a sub-contractor, or, if you have the skills and strength on your balance sheet, to be part of a joint venture.
- understand what your local NHS Trust is seeking to deliver through their service transformation programmes, especially their cost improvement programmes. You can then identify how your current and proposed service could help the Trust to deliver these programmes.
- investigate whether your local NHS Trusts have any plans to declare land surplus to requirements, and try to find out whether they might consider a joint venture, or if they just want to dispose of the land. Trusts are increasingly looking at ways of achieving a capital to revenue transfer, and want to use surplus land to deliver a revenue stream.
- establish your local authority requirements for specialist or designated housing for older people, and develop a proposal that can be used to declare an interest in any site during its 50 day window for disposal.
Above all, try to develop a business case to put in front of the board of your local NHS Trust that will allow them to create value from their assets in the long-term, and not just a simple disposal of land.
Given the considerable financial constraints that both housing and health are experiencing at the moment - and will continue to experience in the next five years - there is a real need for housing to find common cause with health, and to deliver real added value for local people, and the tax payer.
The Capsticks and Social Housing article can be downloaded here - http://www.capsticks.com/assets/Uploads/Social-Housing-magazine-Roundtable.pdf