A service devised to get people in poor health into homes more suited to their needs has saved Nottingham’s health, housing and care services more than £500,000 in just nine months.
The project is funded by NHS Nottingham City Clinical Commissioning Group (CCG) & Nottingham City Council as part of the Integrated Care Programme, and is led by Nottingham City Homes (NCH) and Nottingham CityCare Partnership. It has contributed to more timely discharge from hospitals and rehabilitation units across the city to free up inpatient beds for those with medical need.
Following a successful first year, the scheme has been awarded an extension of 12 months. As part of its funding extension, Nottingham City CCG and Nottingham City Council are also investing in a third Housing Health Coordinator, who will support the existing team as part of the integrated care model
Savings have been made within the NHS through reducing the total number of avoidable stays in residential health or social care facilities by 1,858 days. NCH have also been able to fill independent living properties across the city, increasing rental revenue by £85,600 and making sure a number of vulnerable people did not become homeless.
Thanks to reductions in length of stay and earlier housing intervention for those in ill health to prevent hospital admission, the scheme has so far saved the NHS around £274,000.
Gill Moy, Director of Housing and Customer Services at Nottingham City Homes, said: “We felt as a housing organisation that we could quite literally hold the keys to a valuable solution to one of the NHS’s biggest challenges – ensuring timely discharges from hospital to free up beds for those who need them most.
“We have a number of properties, often in our independent living schemes across the city, that have been adapted over the years to accommodate specific mobility issues. The adaptations that already exist in these homes, or even just the type of properties they are, such as bungalows or ground floor flats, make them the perfect solution for people who need a home more suited to their needs.”
Not all referrals to the scheme come from hospitals looking to discharge patients - some come from teams in the community, identifying those in need of alternative accommodation that could improve their health and wellbeing and reduce future hospital admissions.
Some of those referred to the team could have found themselves homeless following hospital admission, due to personal circumstances such as loss of income and eviction. Through the scheme, these individuals were all found new homes, and NCC’s Housing Aid, social care and aids and adaptations services have collaboratively saved £142,000 in administration and housing costs.
The work has been delivered by a team of just two Housing Health Coordinators, who have worked alongside all the city’s services to ensure individuals that need assistance, are moved as quickly as possible - speeding up the process for finding a home in an independent living scheme from an average of 129 days to just 33.
Steve Upton, Sustainability and Transformation Lead at Nottingham CityCare reflected on the project’s success and added: “This innovation has helped us to address housing needs in a person centred, timely way to both expedite discharge from secondary care and avoid predicted negative impacts of poor or unsuitable housing conditions on health. It demonstrates the way in which integration can drive new ways of working that have a direct impact on citizens’ lives in ways that go beyond what we may normally see as health intervention.”
Claire Kent, Commissioning Manager at NHS Nottingham City CCG said: “This is a great example of integrated health and social care, with agencies working together to address demand on NHS services and improve citizen experience. This service has real impact in its first year and we hope to see continued benefits through an extension of the contract.”
Mr Smith*, a frail elderly gentleman, was admitted into hospital after having a fall on the stairs at home. He was living in a third floor property, accessed up multiple staircases. His injuries as a result were extensive and included three broken ribs, a punctured lung and several cuts and bruises. Mr Smith had previously suffered several falls, which caused injuries that required medical intervention.
Due to his injuries, Mr Smith wasn’t able to return to his home as it was believed this was contributing to his poor state of health. An occupational health therapist at Nottingham City Hospital referred the case to the NCH’s Housing and Health Coordinators.
They met with Mr Smith, and within 18 days, had secured a ground floor property for him, with a level access shower and wet room.
*The patient preferred to remain anonymous
A summary report with a range of statistics and anecdotal stories is available on request.
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