Housing services and integrated health and social care: housing advice note

Guidance for integration authorities, health boards and local authorities on their responsibilities to involve housing services in the integration of health and social care.

This document is part of a collection

5. The Strategic Commissioning Plan and the role of Housing

5.1. Strategic planning is a vital part of ensuring that public services remain focussed on the needs of the population, perhaps especially at times when services are being reshaped. Both for housing and for health and social care, the respective legislation sets out specific requirements for strategic planning. This section summarises the main points and describes how planning for housing services and for health & social care can be better aligned.

The Strategic Commissioning Plan

5.2. The Integration Authority must prepare and produce a Strategic Commissioning Plan, or SCP (referred to in the Act as a "strategic plan"). This plan will have a 3 year life-cycle and provide the strategic context for the commissioning of services as directed by the Integration Authority. All delegated functions must be included within the plan and an annual financial statement provided. The plan will set out how the delegated functions will be delivered and the resource allocation to support the achievement of national and local health and well-being outcomes.

5.3. The Strategic Commissioning Plan Guidance provides a framework for the operation of the strategic commissioning function by the Integration Authority. Strategic commissioning is the term used for all the activities involved in assessing and forecasting needs, linking investment to agreed desired outcomes, considering options, planning the nature, range and quality of future services and working in partnership to put these in place. The Guidance states that the SCP should ensure correlation with other local policy directions as outlined in, for instance, Single Outcome Agreements, NHS Local Delivery Plans, Housing Strategies, NHS Clinical Strategies, community plans and other local corporate plans.

The Local Authority's Local Housing Strategy

5.4. The Local Housing Strategy is a Local Authority's strategic document for housing and housing services. The Housing (Scotland) Act 2001 sets out the strategic responsibilities of Local Authorities to:

  • Prepare a Local Housing Strategy ( LHS) and keep it under review;
  • Assess housing needs, demand and condition, including for specialist housing and housing related services (Local Authorities collate evidence on this in Housing Need and Demand Assessments including on accessible and adapted housing, wheelchair housing, and housing support services for independent living);
  • Assess the level of homelessness and produce a homelessness strategy. (In most cases, the homelessness strategy will form part of the LHS.)

5.5. The Housing (Scotland) Act 2006 also introduced a requirement for a Local Authority to include as part of their LHS a strategy detailing a Scheme of Assistance - for improving the condition of houses. This Scheme of Assistance outlines how a Local Authority will help people living in private sector housing (home ownership or private renting) to repair and maintain their homes as well as adapt them to meet their needs (i.e. adaptations services).

5.6. The Scottish Government published updated LHS Guidance in August 2014 which, among other things, includes a specific focus on specialist housing and independent living, including the role of housing in health and social care integration. It emphasises the need for strategic planners in both the Local Authority housing and planning functions to engage with health and social care planners to share evidence, identify needs and plan solutions for those with 'specialist' needs. It highlights the importance of involving stakeholders in the strategic housing planning process undertaken by Local Authorities. These include social services, the NHS and Housing Associations as well as tenants and residents.

Coordinating the SCP and the LHS

5.7. It is clearly desirable for there to be strategic coordination between the expressed approaches of the SCP and the LHS as they relate to health and housing. Three requirements to support this coordination are: the involvement of housing representatives in the Integration Authority's Strategic Planning Group and localities; shared work on the Needs Assessments underpinning the two strategies [4] ; and the production of a Housing Contribution Statement by each Integration Authority, as part of its Strategic Commissioning Plan, to explain how services have been aligned.

5.8. An Integration Authority is obliged by the legislation to establish a Strategic Planning Group ( SPG) for its area, for the purposes of preparing the SCP. In addition the Integration Authority is required to involve a range of relevant stakeholders, including "non-commercial providers of social housing" and other interests. Housing stakeholders should therefore be fully involved, informed and consulted on the SCP.

5.9. Underpinning the strategic commissioning plan will be a Joint Strategic Needs Assessment ( JSNA) analysing the needs of local populations to inform and guide the commissioning of health, wellbeing and social care services within the area. The main goal of a JSNA is to accurately assess the care needs of a local population in order to improve the physical and mental health and wellbeing of individuals and communities. Given the strong focus on the importance of home to better health and well-being outcomes, it is imperative that the interaction between housing, health and social care needs within the local population is considered.

5.10. There may be opportunities to use evidence of need, collated through the JSNA, as part of the evidence for a Housing Need and Demand Assessment, and vice versa.

5.11. The Joint Improvement Team has published a User Guide for assessing the housing related needs of older and disabled households. The guide's primary purpose is to improve analytical capacity in strategic housing planning and understand better the impact on health and well-being. It has also been designed as a tool in 'making connections' across the housing, health and social care sectors to:

  • Develop a deeper shared understanding of local population dynamics and communities, the services and assets that exist and how these are distributed across the local area;
  • Broaden understanding of the structure and features of housing and neighbourhoods and how these facilitate or hinder individuals to live independently for as long as possible;
  • Assess the potential role of specialist housing and well-designed mainstream housing for older and disabled households to inform the setting of joint local strategic priorities;
  • Consider ways in which housing providers could reach people before they require more costly, long-term interventions and contribute to the goal to deliver locally appropriate preventative intervention and services.

5.12. Closer alignment of the LHS and the SCP will improve joint understanding of the housing, health and social care needs of individuals and their families and the provision of services by Integration Authorities, Local Authority Housing, Housing Associations and others. A Housing Contribution Statement, forming a discrete part of the SCP, is required to provide this bridge to the LHS. Section 7 of this Advice Note gives more details.

Key Points on the SCP and the role of Housing

  • The Integration Authority should involve the Local Authority Chief Housing Officer in current and future discussions on health and social care integration
  • The lead officer/s responsible for the development and implementation of the Local Housing Strategy should be involved in the development of the SCP and the Joint Strategic Needs Assessment ( JSNA).
  • The JSNA may consider and draw upon the housing needs and demand evidence outlined in the Local Housing Strategy.
  • In areas where the Local Authority has transferred all its housing stock to a Housing Association, there should be agreement between the Integration Authority and the local housing sector ( LA and Housing Associations) on arrangements for representation and input into the Strategic Commissioning Plan process.
  • Best practice would point to a need for the Strategic Planning group in all areas to have at least two housing representatives - one from the Local Authority and one from a Housing Association.


Email: hscintegration@gov.scot

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