The best advert for Liverpool City Council’s Healthy Homes Programme, winner of The MJ Public Protection Achievement of the Year Award 2011, is the residents whose lives have been transformed as a result. Nicola Carroll reports

Mrs Moon’s home was made secure from intruders, fitted with grab-rails to aid mobility and had a washing machine installed for the first time.

Claire, a mother whose young family were living in freezing conditions without hot water, had her boiler repaired. An elderly couple, who had been sleeping on the ground floor of their damp house, moved into sheltered accommodation providing the support they need. In other cases, landlords have been forced to take action in properties where there are rats, mould growth and dangerous electrical wiring in some of the most deprived areas of Liverpool.

The council won The MJ Public Protection Achievement of the Year Award for its strategic use of regulatory powers to improve housing conditions and reduce health inequalities, which has generated financial savings for public bodies. Poor housing is regarded as a significant contributor in up to 500 deaths and around 5,000 illnesses in the city each year and the Healthy Homes Programme (HHP) aims to prevent accidents and conditions such as respiratory diseases related to sub-standard housing.

The team delivering these improvements are delighted the work has been recognised with The MJ award. Programme manager, Phil Hatcher, says: ‘The award is great for the staff and a platform for sharing best practice. The team are highly motivated because they can see how they make a real difference to people’s lives.’

Speaking to the professionals involved, who are clearly very passionate about the project and say they are ‘elated’ to have won, reveals three vital ingredients that have made it a success. The first is the partnership with Liverpool Primary Care Trust (PCT) and other organisations. The second is being able to use hard data to demonstrate effective use of public resources. The third is its proactive approach.

The HHP programme began in 2009 and the PCT has awarded £6m for it to run over four years. ‘We have an outstanding environmental health team and have worked together in the past’, says PCT commissioner, Joan Brookman, who describes the relationship as, ‘a proper, partnering arrangement.’ The business case for investing to reduce housing-related accidents and illnesses requiring medical attention was established and the financial commitment is based on agreed outcomes. ‘We have had more than a return on our investment,’ she says.

More than a dozen partners – including the fire service, benefits advisors, fuel poverty groups and SureStart – are involved as well as the council and health services. A single assessment process has been developed to make the work of the partners as integrated as possible.

The Liverpool team had been sort-listed for The MJ award previously. Mr Hatcher puts this year’s victory down to the fact that it is the first time Building Research Establishment modelling data has been provided: ‘This is a complex project and it now has the evidence base to demonstrate its outcomes.’

In the first 18 months, the team visited over 11,000 properties and 11,700 referrals were made to partners, for example directing residents to register with dentists or smoking cessation services. A total of 1967 rented properties were referred for environmental health officer intervention and 1457 serious housing hazards were identified and removed. Over 25,000 properties will be visited and at least 4,300 passed over for regulatory inspection during the lifetime of the project. It is estimated that work by the council should save the NHS in excess of £2m each year and provide £5m in benefits to wider society. Interventions with landlords mean £3.1m has been spent on property improvements, creating jobs in construction locally.

Ian Watson, programme co-ordinator, says councils from around the country and as far afield as Japan have been in touch to find out about the programme. The HHP targets areas with highest levels of need using 12 sets of data and its proactive stance is what makes it stand out. The HHP concentrates on the private rented sector as this is where the majority of problems lie. Residents are ‘warmed up’ via community engagement activities and letters from councillors before the team travels in a minibus to a particular street. There are now 35 posts involved, including advocates and case support officers.

‘We walk down streets and knock on doors. We never know what we will find. There are people who are under the radar and afraid of getting evicted if they speak out against poor conditions. Vulnerable people are often in denial about how bad the conditions they are living in are,’ says Mr Hatcher. ‘Shocking conditions’ uncovered include properties that have crumbling walls or are rank with excrement.

The council uses a lighter touch for good landlords, but a heavy hand where necessary. Notices can be served on landlords who do not tackle problems and the council can prosecute and carry out the work in default. When fines are issued this is heavily publicised as a deterrent and compliance has improved as a result. As Ian Watson comments: ‘Part of the problem is educating landlords and the Landlord Accreditation scheme has proved valuable in that. We have been surprised at how little active enforcement we have had to do’. This means fewer resources have been required for prosecutions than envisaged.

Last year the Marmot Review of health inequalities cited Liverpool’s HHP as a case study example of dealing with poor housing.

As Mr Hatcher sums up: ‘The programme makes healthy housing a right, not a privilege, for people in Liverpool.’