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    Value Generation

    Value Generation is a term we’ve developed to inform a new way of assessing the impact that services for people with additional needs have. It’s not complicated. The words “Value Generation” aren’t new, the 3 principles that sit behind those words aren’t new either; however, what is new is the intention of Value Generation to change the values (in another seanse) that sit behind the way that services for people with additional needs are commissioned, funded and reviewed.

    For far too long services for people with additional needs have been commissioned within a system of segmented commissioning and a focus on cost control. Segmented commissioning and cost control are the prime movers in a situation where the NHS, social care & other commissioners engage in a negative competition to NOT fund peoples’ additional needs in order to protect “their” budgets. If we had unified commissioning and a pooled budget, we’d have made progress but not enough progress because commissioning and funding would still be based primarily on cost control: who has the lowest unit cost, not who generates the most value.

    So we need unified commissioning, a pooled budget and a change of values. We need a move to Value Generation, which is 3 things:

    1. What are the outcomes for people?
    2. What is the cost-benefit to the public purse?
    3. What is the wider community benefit?

    The need to save money is understood. The practice of cost control in this context does the opposite. A failure to invest in preventative, enabling services such as supported housing inevitably leads to a need to fund otherwise avoidable emergency interventions as a consequence. Prevention has always been cheaper than “cure”, and a lot less humanly painful. The second of the three Value Generation principles asks “what is the cost-benefit?” (of the services that are seeking to be commissioned and funded) so it’s not as if money isn’t an object. It’s just that cost control is a crude and simplistic approach that’s caused huge damage to publicly funded services.

    Any methodology that includes the three Value Generation principles should avoid the temptation to measure the first and third principles (outcomes for people and wider community benefit) in financial terms. To do so would be to give in to the cost control paradigm. These are qualitative outcomes, not quantitative outcomes. We should certainly measure the second principle (cost-benefit to the public purse) in financial terms though.

    The UK Government is currently thinking about the future shape and funding supported housing. We urge everyone involved in this to think about using Value Generation principles as a means of commissioning and funding supported housing services.

    September 05, 2018 by Support Solutions

    Intensive Housing Management

    Many of you will have heard about Intensive Housing Management, some of you will be working with housing providers that have claimed enhanced Housing Benefit in order to fund Intensive Housing Management services to tenants/licensees with additional needs. This will often be people who live in supported housing and sheltered housing (Exempt Accommodation and Specified Accommodation), but also tenants in so-called “general needs” housing many of whom also have additional needs and need tenancy sustainment services in order to remain independent in their accommodation.

    Support Solutions reintroduced Intensive Housing Management in 2005 as a response to the retrenchment of Supporting People funding. Put simply, Intensive Housing Management is a series of Housing Benefit eligible tasks that go beyond normal housing management functions because some tenants in social housing have greater needs. The Housing Benefit eligible tasks are listed in a Support Solutions Briefing from 2015: Exempt Accommodation, Specified Accommodation & Intensive Housing Managerment.

    When Support Solutions first identified the technical/regulatory basis for enhanced Housing Benefit, which funds Intensive Housing Management in Exempt Accommodation and Specified Accommodation, it was greeted with scepticism and in some cases suspicion. Some people thought it was somehow “dodgy”, or that it was too good to be true that there existed (and still exists) a genuine regulatory basis for claiming additional revenue to meet peoples’ additional housing needs. History has since shown that not only is Intensive Housing Management a legitimate and proper way to meet otherwise unfunded housing needs but that it has also led to the creation of an annual revenue stream of £2.1bn that would otherwise have been lost to the system.

    The recent UK Government announcement (August 2018) on the future funding of supported housing has confirmed that the additional housing costs of social tenants with additional needs will continue to be met from within the welfare benefits system, i.e. through enhanced Housing Benefit. You can see the detail of this in our recent Briefing New Arrangements for Funding Supported Housing. For Support Solutions and for those supported housing and sheltered housing providers who have gone down the Intensive Housing Management route this is an absolute vindication of this process. For those social providers who have yet to do so we urge you to contact us to help you navigate what is a technically complex process. We have seen an upsurge in interest from providers recently and we have invested in more staff resources to meet this demand.

    You can also visit the Intensive Housing Management page and the Briefing page on our website for more information.

    Michael Patterson August 29th 2018

    August 29, 2018 by Support Solutions

    Funding Supported Housing

    As you may have heard the UK Government announced recently (August 2018) that is has effectively withdrawn the key principles of its 2017 Consultations on the future funding of supported housing. This, we hope, puts an end to 3 years of uncertainty around funding.

    The key points from the UK Government’s 24 page statement are as follows:

    • The proposal to devolve a ring-fenced sum of money to English local authorities to fund so-called Short-Term Supported Housing has been dropped. We assume that the UK Government will not now devolve sums of money to national governments as proposed
    • The idea of Sheltered Rent has been dropped
    • All forms of supported and sheltered housing will have their additional housing costs met from within the welfare system
    • The UK Government wants to see a “robust oversight regime” for supported housing
    • The UK Government wants to review “housing related support” and the relationship between eligible service charges and support

    We think that all of these points are positives but we also think that the UK Government needs to frame and consult on revised approaches. These should include:

    • Ensuring that supported housing costs are funded fully through the welfare system by a “Supported Housing Rent”. This would take the form of an enhanced housing component of Universal Credit and Pension Credit within which the variable costs of both housing and additional needs are reflected in a simple banded system that matches needs with resources
    • Revised definitions of different types of supported housing. The “Sheltered & Extracare” definition should remain but “Short-Term” and “Long-Term” supported housing definitions should be replaced by “Immediate Access Accommodation”, “Intermediate Needs” and “Intensive Needs” supported housing. Supported housing should not be defined by timescale but by intensity of need.
    • Any oversight regime should be underpinned by Value Generation principles (outcomes for people, cost-benefit to the public purse and wider community benefit) and not by a crude “cost control” approach, which has been very destructive (and expensive) for supported housing. Furthermore, people who make judgements about the cost and quality of supported housing should be separate from people who commission supported housing
    • Any review of “housing related support” should be undertaken in the context of an integrated approach to supported housing, social care and healthcare and it should be undertaken with a recognition that funding for “support” has effectively disappeared in most parts of the UK.

    The £2.1bn of annual revenue to fund Intensive Housing Management that has been injected into the welfare system, largely as a consequence of the work that Support Solutions has done since 2005, is a good basis for funding supported housing going forward but there remains a funding gap where HB ineligible support tasks are no longer funded. Any new funding system must acknowledge this. The easiest way to do so is to ensure that an enhanced housing component of Universal/Pension Credit has sufficient scope to meet both Intensive Housing Management and support costs.

    You can read more about this in our latest Briefing: “New Arrangements for Funding Supported Housing“.

    August 24, 2018 by Support Solutions

    The head of the NHS in England, Simon Stevens is set to use controversial claims used by Vote Leave, to put the case for cash boost in a speech later, according to reports by The BBC.

    The speech by Mr Stevens at the NHS Providers’ annual conference of health managers is being made at the time when three reputable health think-thanks- the Health Foundation, the King’s Fund and the Nuffield Trush- publish a joint report calling for the health sector to be given an extra £4bn in 2018.

    This cash boost was also promised during the EU referendum whereby it was claimed that £350m was given to the EU and it would be better spent on the NHS; some have however argued that this proved very significant in the result of the referendum.

    Simon Stevens will say this to delegates in Birmingham:

    “… Rather than our criticising these clear Brexit funding commitments to NHS patients- promises entered into by cabinet ministers and my MPs -the public want to see them honoured…”

    According to a Department of Health spokesman:

    “Research shows spending on the NHS is in line with most other European countries, and the public can be reassured that the government is committed to continued investment in the health service.”

    Chris Hopson, NHS Providers chief executive also supports giving extra money:

    “The Budget is an important opportunity, at the beginning of this Parliament, to protect care quality for patients and service users and help the NHS break out of the downward spiral in which it is currently trapped.”

    What do you think?

    Please tweet comments @suppsolutions.

    November 08, 2017 by Abimbola Duro-David

    Labour obtained figures through Freedom Of Information (FOI) requests which show that the NHS has been “pushed to the brink”.

    Reports by The Guardian shows details from the FOI requests which found that:

    • The number of patients waiting an hour or more to be transferred from an ambulance into an NHS A&E ward has doubled in England over the past two years
    • There were 111,524 people who waited at least 60 minutes in an ambulance in 2016-17, up from 51,115 in 2014-15
    • South Western ambulance service was the only one of the 10 English ambulance trusts to record a decline in waits of an hour or more between 2014-15 and 2016-17
    • There was also an increase by – three-quarters, to 509,062 in patients waiting 30 minutes or longer for admission to an emergency ward
    • Every trust recorded a rise from 2014-15, except West Midlands ambulance service, which did not provide the relevant statistics on half-hour wait
    • Secamb showed the biggest increase for patients waiting an hour or more
    • The next biggest rises were recorded by Yorkshire ambulance service and the North West ambulance service

    According to the shadow health secretary, Jon Ashworth:

    “These figures show an ambulance service pushed to the brink by years of Tory underinvestment. It’s clear that NHS services last year were operating at the absolute limit of what they could with.

    “There is no excuse for the government to allow another crisis on this scale to develop this year. They’ve been well warned and they should take action to sort it out.”

    Ashworth also said:

    “Theresa May has a choice in the budget: give the NHS the money it needs to deliver a decent standard of care or leave NHS patients stranded in pain in the back of ambulances because the hospitals are just too full to cope.”

    Earlier this year, NHS Improvement (NHSI) said:

    “Tolerating ambulance handover delays is tolerating significant risk of harm to patients.”

    What do you think?

    Please tweet comments @suppsolutions.

    November 03, 2017 by Abimbola Duro-David

    The Office for National Statistics (ONS) are making necessary measures to alter their plans to make housing associations public bodies.

    According to reports by 24 Housing, the ONS said the following:

    • If the proposed legislation comes into force as envisaged, local authority, central government influence and the existence of nomination agreements would not be a part of public sector control
    • English PRPs would be regrouped as Private Non-Financial Corporations
    • Once the secondary legislation has been enacted, ONS will be happy to review the classification

    Gavin Smart, Chartered Institute of Housing’s deputy chief executive also said:

    “Although we have been expecting this decision for some time, it is welcome news.

    “It is important that housing associations retain their independent status, not least because it means they can secure significant amounts of private finance to bolster public investment in housing”.

    He also hopes that this proposed legislation is confirmed when legislation is passed by Parliament.

    What do you think?

    Please tweet comments @suppsolutions.

    November 02, 2017 by Abimbola Duro-David

    The government’s Help to Buy scheme has added to the inflation of house prices according to a recent analysis, Inside Housing reports.

    The analysis of the Help to Buy Scheme revealed the following:

    • There was clarity from the start that demand-side subsidy of this kind would lead to a price and supply response
    • The number of subsidies that would cause price increases and developer profits was unknown
    • The Government’s problem with this scheme is whether it offers value for money and storing up risks for the market and tax payer
    • Someone in the treasury is devising a way of slowly winding down the scheme

    The chief executive of Paradigm Housing Group, Matthew Bailes, said:

    ” … clearly, it worked well for developers, and for providers, it was largely neutral, and part of the game if you wanted to buy new stock.

    “Arguably, it suited the Housing Corporation too, by helping it to achieve its targets while claiming to have squeezed grant rates.

    “The only losers were the taxpayers and the people who would have been housed had the wasted grant funding been used to fund additional units. Unfortunately, they didn’t have much visibility of what was going on.”

    What do you think?

    Please tweet comments @suppsolutions.

    For more details, visit Inside Housing.

    August 30, 2017 by Abimbola Duro-David

    Flintshire Council, North Wales will use chalets in Prestatyn to put locals up in an emergency, The Sun reports.

    The north Wales Council revealed their waiting list for new homes has reached “breaking point”.

    According to Clare Budden, Flintshire Council’s community enterprise chief officer said:

    “There are currently just over 1,600 people on Flintshire County Council’s waiting list for housing.

    “This compares with just over 1,200 at the end of September 2016 demonstrating the growing need for social housing in the area.

    “The council occasionally uses Pontins at Prestatyn for short stays to accommodate people in need of emergency accommodation say after a fire or where rented accommodation is deemed unsuitable for health and safety.”

    Deputy council leader and the authority’s lead member for housing also said:

    “We pride ourselves that we will not see anybody rough sleeping and will find somewhere for them to stay.

    “Pontins is only used to put larger families up in an emergency where bed and breakfast would not be appropriate and they need cooking facilities.

    “There is increasing pressure on the council house waiting list which is being caused by austerity and demand seems to be outstripping supply.” 

    What do you think?

    Please tweet comments @suppsolutions.

    August 22, 2017 by Abimbola Duro-David

    According to new data, at least 1 in 25 NHS jobs in Thames Valley is vacant – the highest figure in the country, Get Reading reports.

    The NHS employed over one million people in England in March, which is 2% more than the previous year.

    The NHS in Thames Valley has grown, employing with an equivalent of 433 more people full-time in March 2017 than it did in March 2016.

    The new data which includes both frontline doctors, nurses and support staff shows the following about Thames Valley:

    • The equivalent of 34,281 people were working full-time in the NHS in Thames Valley in March
    • A full-strength NHS in the region would have at least 35,736 staff and at least 4.1% of posts were vacant
    • Monthly data on vacancies has been published on its current staff going back to February 2015 and this figure is the joint-second highest on record
    • This data has fluctuated between 3.0 per cent (one in 34) and 4.1 percent (one in 24) since 2015
    • Real vacancy could be higher because, at times, the NHS advertises many jobs in the same advert

    What do you think?

    Please tweet comments @suppsolutions.

    August 18, 2017 by Abimbola Duro-David

    After ombudsman shows concerns in a Northamptonshire Council, homelessness policy is under review.

    Kettering Borough Council has amended its letters to homeless residents to let them know of their right to request a temporary accommodation review.

    According to an ombudsman, Michael King:

    “People in temporary accommodation have a legal right to a review of that accommodation, and ultimately to have that review considered by the courts.

    “But they can only follow this process if councils tell them about their rights in a timely manner, as statutory guidance dictates.”

    A spokesperson for Kettering Borough Council said:

    “Kettering Borough Council accepts the findings of the ombudsman’s report and …

    “The council has also reviewed its procedures and standard documentation for the management of applications from homeless households to ensure that the procedural errors that have been identified in the report are not repeated.”

    What do you think?

    Please tweet comments @suppsolutions.

    For more details, visit Inside Housing.

     

    August 17, 2017 by Abimbola Duro-David

    Latest Briefing

    Introduction The National Statement of Expectations for Supported Housing (NSE) was finally published on 20 October 2020, five years after the 2015 Comprehensive Spending Review suggested regulatory and oversight changes were needed, although in 2018 the government >>>

     

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