Simon Stevens' suggestion of individual budgets for the whole of a patient's healthcare needs in one year rather than a disease-specific approach is attractive and makes a lot of sense. However, individually tailored and purchased healthcare is not much use if the individual has housing problems or is finding maintaining a tenancy difficult.

Simon Stevens' suggestion of individual budgets for the whole of a patient's healthcare needs in one year rather than a disease-specific approach is attractive and makes a lot of sense. However, individually tailored and purchased healthcare is not much use if the individual has housing problems or is finding maintaining a tenancy difficult.

As an ex-health professional now involved in supported housing for vulnerable people, I can see the need to "join up" the support (which will increasingly come through individual/personal budgets from the soon to be un-ringfenced Supporting People budget, channelled through local area agreements) with healthcare.

Hopefully, commissioning organisations will help to achieve Mr Stevens' vision of specialised health and social care - within which housing/tenancy maintenance needs to be included. The impact of this development in commissioning on the provider market will be interesting, to put it mildly.

Bottom line: health and housing are inextricably linked and funding streams need to reflect that.

Sue Norman, London

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