From Hospital to Neighbourhood | Why Housing, Care and Support Must be Part of the NHS’s New Model

For years, health leaders have talked about moving care out of hospital and closer to home. The Government’s 10 Year Health Plan now makes that shift—from hospital to community, and from sickness to prevention—a defining ambition, backed by investment in neighbourhood health centres.
This is a major change for the NHS. But for supported housing providers, working in neighbourhoods is not new. It is what we have always done.

Starting with the whole person

At Look Ahead, we have spent more than 50 years supporting people in their homes and communities. People's lives and needs don’t segment neatly into separate boxes. Housing worries, applying for benefits, difficulty attending multiple health appointments: people’s lives are complicated. This is the real strength of our integrated housing, care and support offer: we meet the needs of the person in front of us.

Look Ahead staff work across multiple specialisms, supporting people with homelessness, mental health needs, survivors of domestic abuse, and people with learning disabilities and autism. At the same time however,  we acknowledge that we cannot meet people’s needs alone, and that’s where our partnerships come in[BK1.1]. When working with NHS clinical teams or substance misuse specialists in particular, we combine partn[BK2.1]ership working with a stable home with specialist support to help people recover, build independence and live well in their community.

Bringing community expertise into NHS pathways

Over the past decade and particularly the last five [BK3.1]years, Look Ahead has strengthened its partnership working with the NHS through the delivery of essential community-based services as part of the mental health pathway. Our support teams work hand in glove with NHS clinical teams providing holistic continuity of care to support someone’s recovery.

Our crisis houses provide a safe, therapeutic alternative to hospital admission for people experiencing an acute mental health crisis. In homely, non-institutional settings, people can benefit from round-the-clock support from Look Ahead staff alongside NHS clinical care, while staying connected to their communities and loved ones.

Our hospital step-down services apply the same principles. At Ibis House in Newham, people who are clinically ready to leave hospital can continue their recovery in self-contained accommodation with 24-hour support. Look Ahead staff support with medication, benefits, finding new housing to move on to when the time is right, and daily living, while people remain connected to NHS teams.

This model has delivered clear benefits. Ibis House's ten step-down beds enabled the NHS trust to reduce its monthly spending on private beds for this group from more than £370,000 to zero, while also ending its use of bed-and-breakfast accommodation.

Neighbourhood mental health in practice

We built on this experience at Barnsley Street Neighbourhood Mental Health Centre in Tower Hamlets - the first NHS neighbourhood mental health centre to open in England.
Barnsley Street brings together Look Ahead, East London NHS Foundation Trust, and the Tower Hamlets Mental Health Alliance of local third sector partners[BK4.1]. People can access clinical treatment, practical support, groups, activities and short-term guest beds where necessary under one roof. There is no need to make an appointment: if people need support, they can access it. Whether that is sitting down for a cup of tea with one of our staff or a consultation with a consultant psychiatrist: the multi-disciplinary team is ready to support.

Look Ahead’s contribution goes beyond our staff. We own the building and managed its refurbishment, creating an accessible, welcoming and deliberately non-clinical environment. Barnsley Street shows what is possible when mental health services are designed and delivered in partnership.[BK5.1]

Stronger together

In light of the Government’s announcement this summer of £343 million in funding for 159 NHS mental health centres in England, the shift to neighbourhood health presents a major opportunity to organise care around people’s lives rather than organisational boundaries.[BK6.1]

The NHS brings indispensable clinical expertise. Supported housing and community organisations bring secure homes, trusted relationships, local knowledge and the ability to work with the whole person over time.

Together, we can meet people where they are, addressing clinical needs alongside housing, welfare and support. We can help people avoid unnecessary admissions, leave hospital safely and ultimately enjoy a better quality of life in their community where they belong.