This week’s leadership message comes from Sarah Roxby, Service Director for Housing at Wakefield District Housing. We also have a blog from Charlotte Goulding, the Partnership's Palliative and End of Life Care Programme Manager.

Hello, my name is Sarah.

I’m the Housing and Health lead for the Improving Population Health Programme in West Yorkshire. I am also the Service Director for Housing at Wakefield District Housing, a large social housing provider based in Wakefield.  As a housing leader, I am passionate about working with others to improve people’s lives through healthy homes.

Octavia Hill is widely recognised as the founder of social housing.  Born in the 1800s, Octavia was an inspirational woman. She was an English social reformer determined to alleviate poverty in the most deprived areas of English cities.  At just 14 years old, she started work to improve the welfare of the poorest in society, people who found themselves trapped in poverty due to ill health or lack of opportunity. In 1864, with the help of an investor, she established the first housing project in the slums of St Marylebone London. Octavia Hill believed that a well-maintained home, which was clean, light and airy would make all the difference to the tenants. This, along with neighbours who looked out for each other, could change slum dwellings into socially responsible communities. Her ethos was to support her tenants, getting to know them personally and helping them live healthily in their homes as well as helping them find opportunities to work. The project was a success and she soon moved on to develop many other healthy housing schemes.

Octavia trained women to manage the projects for her, a type of social support worker, and from here the ‘housing manager’ was created. Octavia had great foresight for the time.  She understood the health impacts of overcrowded houses, poor sanitary conditions, lighting and drainage and a lack of open space.

Octavia was a pioneer and, over 150 years on from Octavia, what have we learnt?

We know that housing is a significant determinant of health. Healthier homes lead to healthier people, which is why in West Yorkshire, housing is a key partner in the health and social care system. Our Housing and Health Programme focuses on some key priorities:

• providing healthy homes for people with learning disabilities, mental health and autism
• preventing homelessness and reducing rough sleeping
• ensuring healthy homes for healthy children
• providing healthy homes to support older people to live independently

Each year, the NHS spends an estimated £1.4 billion on treating illnesses associated with living in cold or damp homes. When wider societal costs are considered, that figure rises to £15.4 billion. The direct impact of housing conditions on health was tragically highlighted in November 2022, following the death of two-year-old Awaab Ishak. The inquest concluded that the toddler died because of a severe respiratory condition caused by prolonged exposure to mould in his housing association home.

Living in a cold home can worsen asthma and other respiratory illnesses and increase the risk of heart disease and cardiac events. It can also worsen musculoskeletal conditions such as arthritis. And it can have a significant impact on mental health, with depression and anxiety more common among people living in these conditions.

In West Yorkshire, we are working together to provide healthy homes to support healthy lives. The West Yorkshire Housing Partnership (WYHP) is made up of 14 members – 12 housing associations and two stock holding local authorities. The WYHP owns or manages over 250,000 homes, two-thirds of which are in West Yorkshire. Following the tragic death of Awaab Ishak, the partnership said:

“Every member of the West Yorkshire Housing Partnership was deeply saddened by the death of Awaab Ishak.  Providing safe, decent homes and ensuring the voice of all customers is heard and acted on are fundamental to what we do as housing providers. It is absolutely vital that we take action whenever we fall short of the standards we expect as a sector. A commitment to working collaboratively and learning from each other is at the heart of the WYHP.” 

The WYHP has agreed on the priorities to collectively ensure that people living in social housing in our region do not experience ill-health because of condensation, damp and mould.  The priorities are centred on having the right processes to respond to reports of mould and damp, having clear customer communication and sharing knowledge and good practice. This includes trialling new technology as well as ensuring that all employees have the right skills and training.

The £1million winter warmth funding investment to local authorities will support people to stay warm at home, for less.  This will be achieved by improving home energy efficiency ratings, offering advice on reducing energy bills and helping people to access the support they are entitled to. Together, we have also produced an affordable warmth webpage and affordable warmth advice leaflets. These leaflets offer information about the support services people can access and information about the different benefits and grants available to help people heat their home and experience better health. The ‘affordable warmth for children leaflet’ also contains some top tips for keeping warm and highlights that living in a cold damp home increases the risk of breathing problems particularly in children.

The housing and health work across the partnership has also created resources on the West Yorkshire Healthier Together website.  This includes content on indoor air quality and asthma triggers, keeping your home warm, damp and mould free, and information on housing to support families and healthcare professionals know what advice to give and what services are available locally.

The System Leadership Executive and Children, Young People and Families Board made a commitment that no child or young person in West Yorkshire should suffer severe or uncontrolled asthma symptoms due to fuel poverty or poor housing conditions. In response, questions relating to indoor air quality, were added to primary care clinical templates for asthma, making sure that these things are considered at every opportunity. To ensure the impact of living conditions on health are highlighted, Wakefield will begin a trial to introduce healthy homes coaches. The coaches will help families with young children to tackle mould and damp issues and improve living conditions. They will also help families to access financial and employment support. The team of coaches will work closely with health visitors to follow up on any issues identified as part of a home environment assessment.

Supporting tenants to live healthy lives is fundamental to successful tenancies. As a housing officer it is important to understand how to help your tenants. We’ve worked across West Yorkshire to provide trauma informed practice training to over 300 front line housing officers. The training has been a great success with officers sharing positive feedback and examples of how they have discreetly changed their approach to supporting tenants as a result.

The National Housing Federation (NHF) recently launched its research into the supported housing sector’s impact on homelessness prevention, health and wellbeing. The report highlights that supported housing plays a critical role in reducing homelessness and relieving pressures on the social care, health, criminal justice and housing sectors. Without it, there would be an increase in core homelessness of around 41,000 people, with a further 30,000 people at significant risk of future homelessness. Our housing and health work in West Yorkshire features in the report as an area of good practice.

Of course, it’s not just about supporting young people and families.  As I’ve already mentioned, we have a commitment to supporting older people to live independently and, working with the WYHP and the West Yorkshire Combined Authority, we will soon launch our ‘right size’ campaign.  The campaign will highlight the housing options for older people across our region. The aim is to encourage more older people to consider moving to a home that provides safety, support and is the ‘right size’ to help meet their needs and maintain independence in their own home for longer.

Working together we can support people to live happy, healthy lives in healthy homes and continue the great work started by Octavia Hill.

"You cannot deal with the people and their houses separately."

- Octavia Hill 

Have a good weekend all.

Sarah