shoes standing on the concrete floor and white direction sign to go ahead

One direction is better than four

I hear Zayn and Harry are doing well in their solo careers, but the outcome of a band splitting up is always the same. Somebody gets left behind. It’s not a new phenomenon – The Beatles were greater than the sum of their parts. And you might say the same of political parties and their policies. So why are we still hearing piecemeal solutions?

There’s housing. There’s infrastructure. There’s health. And there’s social care. It seems that the latter two will finally come together (a little indulgent nod to the Beatles there). They are finally being viewed as intrinsically linked pieces of the jigsaw. But they are not the whole story.

Sustainable Transformation Plans (or STPs) are evidence of this. Local authorities and health trusts are working together, following a national direction and applying it to their local community needs. But out of all 44 STPs across the country, you can count on one hand the number that have a pot of money set aside for housing.

Why is this important? Well, look at it this way, if we’re going to tackle the health crisis, we need to find appropriate housing for the thousands of individuals who are stuck in acute care due to housing related issues. If we’re going to tackle the health crisis, we need to consider the fact that poor housing costs the NHS on average £1.4 billion per year.

But it goes beyond bricks and mortar.

Isolation is a significant contributor to mental health problems. Communities need to be designed to encourage cohesion, support networks and access.

This is where infrastructure comes in. We must consider transport links to re-balance the economy and ensure everyone has reasonable access to the services and opportunities that they need.

So we need to go further and look beyond these physical communities. Financial pressures and unemployment also contribute to negative health problems. So jobs, training and education have a big part to play as well.

If you fix the medical issue without addressing the cause, the hospital doors will keep revolving and the costs will keep spiralling. A healthy community needs support in all of these areas – but they need to come together and head in one direction (see what I did there?).

If we can design great places that promote integration, that provide access to services and facilities and that encourage aspirations, we can play a role in the prevention of health problems. We need to design places that consider how the wider community interacts, not just the individuals and families within their homes.

And we need to relieve the pressure of red tape on the individuals themselves. Nowadays, if you switch your bank account and move to a new provider, they will often manage the transfer of all your direct debits. It removes a huge administrative headache for the customer. When we are talking about health and social care, the customers in question are often quite vulnerable, so wouldn’t it be helpful if we could remove their administrative burden. So rather than having to consider each of their lifestyle needs individually, they have one coherent health and wellbeing plan that navigates them through the various providers on their behalf.

If the services are integrated, the administrative pressure is also reduced on staff, who only need to respond once. The customer benefits, and so too does the taxpayer.

There’s little point retro-fitting all the pieces of the jigsaw together. Whichever party we elect on 8 June needs to ensure that these conversations are happening at the very start. Let’s get the right people around the table in the first place and only then will we know what the solutions might be and how much they will cost.



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