An Integrated Public Health / Housing Systems

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An Integrated Public Health / Housing Systems by Mind Map: An Integrated Public Health / Housing Systems

1. Avoid hospital admissions related to poor housing

1.1. Asthma

1.2. Stroke

1.3. COPD

1.4. CHD

1.5. Mental Health

1.5.1. HonOS Pbr system - contribution of housing

1.6. Admissions associated with old-age

2. Reduce emergency admissions and GP referrels

2.1. More efficient referral pathways - Treatment at home

3. Maximise technology like telecare: Patients of the future

3.1. COPD / Diabetes

3.2. Blood pressure and cholesterol levels

3.3. New digital technologies to help vulnerable people, such as the elderly and dementia patients at home

3.4. Comprehensive monitoring technology coupled with telephone support is allowing the local authority and NHS to benefit through a reduction in costly ambulance call-outs and hospital admissions

4. Help older people to recover their independence after illness, stroke, injury or trauma

5. Contribution to QIPP programme

5.1. Cost/Savings

5.2. Innovation

5.3. Productivity

6. Social Workers unaware of clients medical needs -

7. Reduce number of bed days / avoid bed costly bed blocking - when support from social care or district nursing is not available in the community for vulnerable patients.

7.1. The NHS and social care must work together to ensure people have the support they need on leaving hospital


7.3. Lack of communication between acute and community services

8. Home from hospital: a partnership approach

9. Work with Housing Associations

9.1. Influence on health outcomes

9.2. Work in most deprived areas - people most likely to present at a later stage of their illness - and increased chance of readmissions

9.2.1. Higher Mortality

9.3. £315 Million saved form investments in health and social care budgets

9.4. Offer preventative services

10. An integrated health and social care IT system - Although not new -See the Torbay Trust - HSJ article

10.1. Barriers - Linking the datsets

10.1.1. The divide between primary and secondary care in the NHS, and also that between health and social care.

10.1.2. NHS management culture often talks about innovation yet demonstrates a fundamentally 'permission-based' and ‘risk averse’ approach

10.1.3. The absence of a robust shared electronic patient record

10.1.4. Policy barriers to integrated care

10.1.5. Are Social Services and Housing integrated (I think no) - See article

10.2. Data Sources - See notes

10.3. Shining a light on the lack of current capacity and capability in community services to deliver care co-ordination and more intensive care in the home environment.

10.4. Innovative approaches are needed to sharing data together with a commitment to developing shared clinical records.

11. Facilitating Hospitals Discharge

12. Providing independent living - Improved Psychology welfare

13. Integrated Care Pathways

14. Excess winter deaths - Highest in Europe

14.1. Fuel Poverty

14.2. Healthy Life Expectancy and Preventable Mortality

15. Need for information regarding the interactions between social care, housing and health

15.1. Improved analytical evidence to improve delivery of social care