In the context of Leicestershire’s county wide Integration Programme, housing, health and social care, partners recognised a major opportunity to radically redesign housing support, moving away from a historically fragmented set of services and constructing a new integrated housing offer focused on health and wellbeing outcomes, such as maximising independence in the home and preventing falls. This example of a local initiative forms part of our managing transfers of care resource.
The Hospital Enablement team is part of the Lightbulb Project in Leicestershire, the project brings together County and District Councils and other local partners to help people stay safe and keep well in their homes for as long as possible, by bringing together a range of support. The team in hosted by Blaby District Council and delivers the service on behalf of Rutland, Leicester and Leicestershire Councils, and is a significant partnership working initiative. The team aims to demonstrate that an effective and pragmatic housing service can positively impact on delayed transfers of care (DToC) and provide a better after care service provision for patients moving from hospital to home.
The scheme involves housing enabler posts, their role involves aiming to assess patients as early as possible, and offer patients options to resolve housing issues. Support workers work alongside the housing enablers, to offer support with the transition from hospital to home or a new home. The support worker assists in setting up tenancies and sustaining tenancies.
The Lightbulb project consists of two schemes:
- Lightbulb: home adaptations
- Hospital lightbulb: providing housing for people being discharged from hospital
The Hospital lightbulb project is funded by three CCGs and one hospital. The team are pleased with progress and ensure they can present a robust business case and clear evidence to demonstrate the value of the service.
A few examples of the interventions that are provided by the service include:
- access to private rented accommodation
- support with rehousing in future
- house clearance (including hoarding issues)
- negotiations with landlords around repairs
- setting up utilities
- minor repairs.
By working with low level adaptations the service can complete a high volume of interventions, which has led to very positive results in a way that is person-centric.
The project has faced a number of barriers, these include; annual bidding for funding across three funders; success of service has meant that demand outstrips staffing resource; community hospitals are the next natural expansion to the service but as yet have not been able to secure funding; integration of the service across Leicester, Leicestershire and Rutland.
Despite the challenges, they have seen usual wait times of around six weeks in hospital for home adaptations reduced to one/two weeks, which has meant a significant reduction in costs and improved experience for individuals.
Analysis of 357 patients from University Hospital Leicester (UHL) three months post intervention showed:
- 57 per cent reduction in A&E attendances
- 54 per cent reduction in A&E admissions
- 27 per cent increase in no activity
- 84 per cent reduction in NHS costs for this cohort, saving £220,000, which scaled up could mean a potential £550,000 saving over 12 months.
For the Hospital team, they are evolving the service, and looking at interim solutions for patients while waiting for housing.
For the Community Service there are now plans to develop the service further and looking at smarter procurement processes for builders to create a clearer framework. In addition, they are investigating how the use of assistive technology can further support people to stay safe and well at home.
Housing and Community Services Group Manager