# Rapid review: Three ways local government could improve inequality, public health and wellbeing outcomes in supported housing in England

## TL;DR

This paper explores how local government in England can improve health and wellbeing outcomes in supported housing by focusing on partnerships, evaluation, and addressing care quality.

## Contribution

The paper identifies three actionable strategies for local government to enhance supported housing outcomes through public health integration and system evaluation.

## Key findings

- Health outcomes in supported housing depend on the type of support and population served.
- Quality of life is influenced by how supported housing is operated and the environment provided.
- Current support approaches fail to meet all resident needs, highlighting the need for strategic improvements.

## Abstract

To rapidly review evidence of public health, wellbeing, and/or inequality outcomes of different supported housing schemes, with a focus on identifying relevant lessons from the evidence for local government in England.

Rapid evidence review.

Peer reviewed qualitative, quantitative and/or mixed methods studies were identified for review. Databases (EMBASE, ASSIA) were searched in September–October 2024. A two-phase screening and selection process was conducted, with papers sifted and ranked for relevance. Data on outcomes, factors, and implications of supported housing related to public health, wellbeing and/or inequality was extracted from papers ranked of highest relevance.

Six key findings were identified: 1) health outcomes (e.g. symptom management, hospitalisation rates) in supported housing vary by type of support and population; 2) there are varied understandings of ‘successful’ outcomes for people who access supported housing: success depends on who is being supported and in what types of supported housing; 3) quality of life outcomes relate to how supported housing is operated and governed, and how support is provided; 4) the quality of the environment (physical housing, social and community) is critical to rehabilitation, life progression and health and wellbeing outcomes; 5) autonomy is clearly linked to resident experience, life progression and health and wellbeing outcomes; and 6) approaches to support and care are currently not addressing all needs nor promoting ‘successful’ care. Trust and relationships are key aspects to building successful care.

As supported housing has been opaque historically in what it is, definitions, and what it is for, this has consequences for the system – therefore we need to be clearer about what the benefits are, and what realistic goals for supported housing should be. Three ways local government in England can improve supported housing are: 1) local government could usefully approach supported housing as a public health asset and link with relevant parties and leverage partnerships to affect change locally; 2) as supported housing is part of a complicated wider local system of service delivery, complexity-informed evaluation is needed to evaluate appropriate outcomes for populations or individuals accessing supported housing; and 3) because care and support approaches do not currently meet all needs, strategic action is needed in the supported housing sector to address both quality (e.g. undertrained staff) and quantity issues (e.g. insufficient amounts of care provided).