Housing-related services and the DH preventative agenda

Housing-related services and the DH preventative agenda

Clare Skidmore, DH Care Networks

Some Facts and Figures...

Prevention in Housing, Health and Care

• “Lifetime Homes, Lifetime Neighbourhoods: a national strategy for housing in an ageing society, 2008

• Putting People First, 2007

• Next Stage Review, Darzi, 2008

• Care and Support Green Paper ‘Shaping the Future of Care Together’

• Ageing Strategy, ‘Building a Society for All Ages’

• National Dementia Strategy

• End of Life Care Strategy

Enablement

Assistive Technologies

Personal budgets

Person-centred support plans

Neighbours

Community Networks

Volunteers

Information advice and advocacy

ULOs

Leisure, transport etc Better housing

options

Responsive, flexible services

Housing and Prevention – Examples

Primary Prevention

- Universal information and advice services

Secondary Prevention

- Integrated housing, health and social care interventions

- Handypersons’ services offering ‘that bit of help’

Tertiary Prevention

- Home Improvement Agencies providing large scale adaptations

• Extra Care Housing - for rent and / or sale

Building an Evidence-Base

• ‘Low level support’ highly valued by older people.

• Proving benefits and cost-efficiencies requires establishment of a causal link between a specific service and its outcomes

• This is complex because:

– costs and savings often fall to different sectors and organisations;

– it is difficult to predict what would have happened had a particular intervention not been available; and

– many quality of life measures are perceived as subjective

Housing and Prevention - the Evidence

• DH Partnerships for Older People’s Projects

• DH Predicting Social Care Costs Project building on the PARR tool

• LinkAge Plus led by DWP

• Supporting People Benefits Realisation Local Model led by CLG

• Foundations Future HIA Project

• Health and Safety Rating System

POPP: 2008 Findings• 99,988 individuals received a service within the POPP across 470 projects including housing-based services

• Demonstrable effect on reducing hospital emergency bed-day use

• For every £1 spent on POPP, average of £0.73 saved on the per month cost of emergency hospital bed-days

• Positive effect on self-reported quality of life and health

• POPP programmes associated with wider culture change

• Health /social care partnerships and joint commissioning strengthened

• Almost half the staff in the projects were older volunteers

Predicting Future Social Care Costs

• Project led by Nuffield Trust, builds on PARR tool and combined model

• Using anonymised health and social care data to forecast which individuals in a population are at greatest risk of incurring social care costs through loss of independence due to age-related conditions and ill health

• If more effective investment is to be made in prevention, councils need ways of identifying individual risk accurately across their population so they can target effective interventions

• Strong interest in continuing to explore ways of exploiting health and social care information in the common aim of maintaining individuals’ independence and developing more cost-effective approaches

LinkAge Plus: 2009 Evaluation

• LinkAge Plus (LAP) - comprehensive approach for accessible joined-up services for older people

• Services include housing choices advice; home safety checks; and other housing-related interventions

• Benefits included: promoting older people’s independence; acting as a catalyst for the increased join-up of services across public services, and the community and voluntary sector

• Older people stress that it is the small things that make the difference

• Final evaluation demonstrates cost-effectiveness, including savings to the public purse

Useful References

• Clark,. H, Dyer, S. and Horwood, J. (1998) ‘That bit of help’ The high value of low level preventative services for older people, JRF

• Curry, N. (2006). ‘Preventive Social Care: Is it Cost Effective?’ Kings Fund Publication

• ODI’s ‘Better outcomes, lower costs’ report, Heywood and Turner, 2007

• http://www.kingsfund.org.uk/publications/kings_fund_publications/appendices_to.html

• http://www.dwp.gov.uk/ageing-society/linkage/evaluation.asp

• http://www.dhcarenetworks.org.uk/prevention/

• http://www.dhcarenetworks.org.uk/independentLivingChoices/housing/

• http://www.careandrepair-england.org.uk/pdf/healthyhomes.pdf

• http://www.viewcare.co.uk/Publications/fallsint.pdf

• Supporting People Benefits Realisation Local Model on the SPK website - http://www.spkweb.org.uk/

Conclusion• Evidence of the cost-benefits

• Proof is difficult in such a complex area

• Difficult economic times

• Wider transformation agenda

• Can commissioners afford not to invest in an integrated approach which includes housing-based solutions?

• Hand over to Steve Malone from Foundations, for interactive session focusing on the contribution of Home Improvement Agencies to prevention and early-intervention

[email protected]://www.dhcarenetworks.org.uk/IndependentLivingChoices/Housing/

Thank you