The Prime Minister has recently found himself sailing in troubled waters, and has pinned his hopes on the government’s flagship ‘Levelling Up’ policy being the game changer for his premiership, bringing regional prosperity and bridging inequality.

By extension, he will be hoping the paper’s ambitions can begin to heal the sizeable scars which have become all too visible in the health and social care landscape.

The paper pinpoints poor health as ‘one [of the] gravest inequalities faced by our most disadvantaged communities.’ Set out in twelve core ‘missions’, the government proposes what it sees as a bold agenda to tackle present issues in the sector, such as unequal health outcomes and raising healthy life expectancy.

So, do the plans begin to sufficiently address deep and lasting regional health inequalities? Could it potentially shake up the social care system and drive the future development of new care models?

Improvements to health outcomes

One of the missions identified in the paper is improvements to health outcomes. The government’s commitment that Healthy Life Expectancy (HLE) will rise by five years by 2035.

To illustrate the scale of the challenge and levels of regional disparity faced by the government, the paper highlights the male national average life expectancy was 79.4 years between 2017 and 2019. Over the same timeframe, Blackpool was 9.2 years shy of the average, whilst Rutland was 8.6 years ahead. This represents a near 17-year gap between the highest and lowest average life expectancies.

In its adult social care reform white paper, the Department for Health and Social Care (DHSC) pledged to play a more proactive role in ensuring support is targeted where it is needed most. It pledges £300 million to integrate housing into local health and care strategies.

Stark statistics such as those highlighted in the Levelling Up paper highlight the pressing need for any such interventions to come at a regional level in the DHSC’s funding commitments over the next three years.

It is important to note this is not the department’s final word, as it intends to produce a separate white paper “designed to tackle the core drivers of disparities in health outcomes”. This is expected to be published this year, with the aim of preventing disparities by ethnicity, socioeconomic background, and region.

There can of course be, as the Levelling Up paper highlights, a myriad of factors contributing to poor health outcomes. Poor diet and lifestyle choices are among those, yet home is also where the heart of the issue may lay.

Housing for older people

The paper also acknowledges older people can become trapped in non-decent or unsuitable accommodation, which does not sufficiently account for their care needs and contributes to poor health outcomes.

ARCO, the main body representing the UK Integrated Retirement Community (IRC) sector, has vigorously highlighted the gap in the social care sector for housing and care options for those caught between care homes, and those receiving care in their own home, but one that no longer meets their needs.

By definition, the group has urged for cross-government action to tap into the IRC landscape and its potential to fill ‘a policy void’. It is pushing for sector-specific regulation to increase offerings such as ‘housing with care’. Statistics highlight just the gap in retirement community settings currently available in the UK, compared with other countries.

Just 0.6 percent of over-65s in the UK live in a retirement community, compared with 5.5 percent in New Zealand, 5 percent in Australia and 6% in the United States of America.

The paper has announced that a new Task Force will be launched shortly, with the aim of assessing ways in which ‘better choice, quality and security of housing for older people can be provided’. It also pledges to address regional disparities in supply of appropriate and where necessary specialised housing.

The government’s own adult social care reform agenda announced in December, also pinpointed there being too many people with care and support needs living in inappropriate homes, providing neither a safe nor stable environment conducive to their care.

Reflecting on a previous Boris Johnson slogan announced in June 2020, the answer may well be found in ‘build, build, build’. Building bespoke housing, in addition to communities, capable of matching the specific care needs of our older people.

Mr Johnson is skippering the ship, and he will need to ensure it reaches communities far and wide if he and his government are really to level up and address the gravest of health inequalities.