Life-support safety net is our vision for residents
Jas Bains, chief executive of Hafod, shares his ideals on transforming health, care and housing for tenants in Wales
LAST year I made a momentous decision to move to Wales, and I am so glad I did. I forged my career in public services in the West Midlands, with a track record in local government and housing associations. Over the years I have seen how a fragmented system can let down those who need our support most.
I could see that the divergent Welsh policy, and a forward-thinking government, might provide the right conditions for transforming our public services. So I took the plunge and became chief executive at Hafod in July 2017, and have not looked back – except perhaps to maintain cross-border excursions and keep an eye on Wolverhampton Wanderers.
Hafod supports 16,000 people across south Wales. With 5,000 homes, we are more than a housing association, we also provide a network of nursing homes, supported housing and extra care. This unique offer means that we could see people falling through the gaps, but that we could also be in a position to deliver change.
We’ve transformed how we work by dismantling internal silos and have consulted our customer base, staff, stakeholders and partners to design a new way of working within our neighbourhoods. As a result, we will meet more people, more regularly, and make sure we get them the help and support they need to prevent a crisis, and improve their wellbeing.
I often use the example of “Mary” to explain our plans.
Mary is a real-life example and reflects how people drop through the gaps of our public services. As a housing tenant with no rent arrears, and no repairs required, we may have little interaction with Mary, and believe her to be content, and not requiring support. But over time she became increasingly lonely and isolated, and then experienced a fall which led to a hospital admission. She became a number listed as “delayed transfer of care” – stuck in a hospital bed only because she could not go home, which led to muscle wastage and further loss of confidence. Eventually she ended up in residential care, and was no longer one of our tenants.
How could we have better supported Mary? If our team had more opportunities to interact with Mary, and we measured and managed our work differently, and how we collaborated with our partners in primary care, social services, and the third sector, then we could have supported Mary as her life changed. That different way of working could have helped Mary maintain her independence and happiness, as well as saving the public purse a considerable amount of money.
Our perspective is shifting, and with all the ingredients for collaboration in place in Wales, and with housing associations like Hafod able to provide a pivotal role at scale, we have turned our attention to working with our partners to see how we could share this model.
But we don’t just want to tweak the current provision, we want to help transform the whole system of healthcare, social support and wellbeing.
We all agree in Wales that we need better integration of health and social services – the Welsh Government, NHS Wales and our local authorities are all keen to see more joined-up work. Our plan is to take this a step further, using this opportunity of transformational change to fully integrate housing provision into the new health and care models, based on neighbourhoods and communities.
Imagine if we could commission the well-being of entire neighbourhoods.
We want to move away from service provision at the point of crisis, to a universal model of preventative commissioning based on neighbourhood-level outcomes rather than individual-level services.
We are calling this the Hafod Neighbourhood Model. To make this work, we will reach out to our partners as we will all need to work differently, embrace new technologies, develop new cultures, and change traditional service silos.
I think we can also learn from disruptive service models such as AirBnB and we are hosting a change laboratory this week to “hack the system” – bringing the innovation of the tech industry to redesign public services.
It will be vital to bring with us our residents and communities, but also the crucial public servants who are the backbone of our caring society. The way we commission services will also need to be reinvented.
The silo between housing and health leads to a mismatch where the silo that bears the cost does not receive the benefit.
This is not just a solution to social housing needs, with additional care support.
It’s a model that can consider age, poverty, obesity, climate change and inequality, and provide a local framework focused on long-term wellbeing.
We have all the elements in place in Wales to do this, and I am excited that Hafod plans to step up to the plate to help deliver change for our future generations.
However, we can’t achieve this alone, and invite our colleagues across the public sector to join us in transforming health, care and housing for the people of Wales.
■ Jas Bains MBE, is chief executive of Hafod @jasbains #caringforthefuture