Lack of suitable housing costing NHS millions
Published on 03 September 2014 12:00 AM
Lack of suitable housing costing the NHS millions every year
40,000 [i] needless days spent in hospital awaiting home adaptations before discharge
Unsuitable housing is leaving thousands of older people facing unnecessary delays in being discharged from hospital, according to new analysis by Age UK.
Official figures show that patients who need home adaptations, such as grab rails or ramps fitted at home, are having to wait for an extra 27 days on average[ii] - more than 40,000 days in total[iii] - costing an estimated £11.2 million year[iv] in delayed discharges.
In its new report ‘Housing in Later Life' (published today), Age UK is calling on the Government to ensure that all new homes are built to the lifetime homes standard[v] so they can be easily adapted as people age.
The Charity argues that housing design which complies with basic accessibility standards is a cost-effective way to help older people sustain their independence at home. Such design would allow older people to age safely and would reduce costly falls and accidents which are impacting on NHS resources. Falls and fractures in people aged 65 and over account for over four million hospital bed days each year in England alone.[vi]
Industry figures have shown the cost of adapting a standard new house design to make it into a lifetime home is approximately £1,500[vii]. For the cost of less than 6 delayed days in hospital, a new home could be brought up to a decent accessibility standard - and with the average cost of a hip fracture, often due to a fall in the home, standing at just over £12,300,[viii] and a year in residential care costing an average of £26,000,[ix] it's clear that getting housing right for older people could have immense benefits for the tax payer, as well as for those in later life.
In addition, simple adaptations to existing homes do not have to be hugely expensive. Age UK estimates that fitting a grab rail so an older person can get to the toilet safely costs between about £20 and £40[x] - and yet the benefits are often substantial. The average grant available to adapt an existing house to allow an older person to remain at home is just over £6,800 - this is money which can fund essential alterations such as the widening of doors and installation of ramps or stairlifts, or the adaptation of heating or lighting controls to make them easier to use.[xi]
The vast majority of the four and a half million households containing at least one person with a mobility problem are aged 60 plus [xii] and this figure is likely to increase as the population ages - over the next two decades the number of pensioner households is expected to rise to 13 million, up 40% from 2008. Yet according to the Charity's new report, all too often older people are finding themselves in inflexible housing that is hard to adapt - currently only 3% (740,000) of homes have all the recommended features of the lifetime home standards for someone with mobility problems.[xiv]
It is also worrying that so many older people are living in housing that is poor quality and in a state of disrepair - more than a fifth (23%) of households containing an older person are in non-decent housing.[xv]
Age UK's new report puts forward a raft of recommendations to the Government, local authorities and the building industry, including:
- All new mainstream and specialised housing should comply with higher accessibility standards to reflect the lifetime homes standard.
- We should move to a position in which all older patients coming into contact with health care services are automatically offered an assessment of their home with an action plan to ensure it is safe for them.
- The Government should work with local authorities to encourage the development of older people's housing strategies which provide a range of different options including: smaller homes, flats, retirement villages, bungalows, shared ownership, private rented schemes, new forms of co-operative housing and co-housing.
Although investment in specialist retirement housing is important, recent Age UK research suggests that only 3% of people would consider moving into a retirement flat in later life, and only 2% would be tempted by a retirement housing scheme[xvi] - demonstrating the need for all homes to be accessible and adaptable, rather than just those built as specialist retirement housing.
Caroline Abrahams, Charity Director at Age UK, said: 'Ensuring all new housing can be easily adapted would save the country millions and help end the nonsense of older people lingering for long periods in hospital, simply because of delays in fitting adaptations like grab rails and ramps so they can safely return home. Building all new homes to higher accessibility standards would cost a little more today but it would pay off hugely tomorrow, and both older people and the NHS would substantially gain.'
'It is worrying that so many older people are living in homes that are hard to adapt and in a poor state of repair. It's time we woke up to the fact that good housing is central to supporting older people to be independent, fit and well. Yes, we need a much wider range of specialist housing for older people but as most prefer to remain where they are it is crucial we do more to make all our mainstream housing fit for the purpose of accommodating our ageing population.'
Age UK provides information, advice, practical services and specially designed products to help older people stay independent for as long as possible. Age UK's free advice guides include ‘Housing Options', ‘Adapting Your Home' and ‘Home Safety Checker'. For a free copy or for further information, people can call Age UK Advice free on 0800 169 6565 or visit www.ageuk.org.uk/publications.
Contacts: Sarah Scott/ Helen Spinney
Telephone: 020 3033 1434/ 1430
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Notes to Editors
For further information or a copy of Age UK's new Housing in Later Life report and to arrange an interview with an Age UK spokesperson or case study, please contact Sarah Scott on 020 3033 1430 or by email at email@example.com
About Age UK
We work with our national partners, Age Scotland, Age Cymru and Age NI and our local Age UK partners in England (together the Age UK Family). We also work internationally for people in later life as a member of the DEC and with our sister charity Help Age International.
Age UK believes that everyone should have the opportunity to make the most of later life, whatever their circumstances. We provide free information, advice and support to over six million people; commercial products and services to over one million customers; and research and campaign on the issues that matter to people in later life. Our work focuses on five key areas: money matters, health and well being, home and care, work and training and leisure and lifestyle.
Age UK is a charitable company limited by guarantee and registered in England (registered charity number 1128267 and company number 6825798). Age Concern England and Help the Aged (both registered charities), and their trading and other associated companies merged on the 1st April 2009. Together they have formed the Age UK Group ("we"). Charitable services are offered through Age UK and commercial products are offered by the Charity's trading companies, which donate their net profits to Age UK (the Charity).
i. The exact figure is 40,922 days. Source: Delayed Transfers of Care Statistics for England 2013/14, NHS England, May 2014
ii. NHS England (2014); "Delayed Transfers of Care Data 2013/14" - http://www.england.nhs.uk/statistics/statistical-work-areas/delayed-transfers-of-care/delayed-transfers-of-care-data-2013-14/
iii. The exact figure is 40,922 days. Source: Delayed Transfers of Care Statistics for England 2013/14, NHS England, May 2014
iv. Calculated from NHS figures. Hospital bed day cost is £273 (source: NHS Reference Costs 2012/13) and the number of delayed days due to ‘Awaiting community equipment and adaptations' is 40,922 day (source: Delayed Transfers of care Statistics for England 2013/14, Table 2, NHS England 2014).
v. The Lifetime Homes standard is a set of 16 design criteria that provide a model for building accessible and adaptable homes. http://www.lifetimehomes.org.uk/pages/revised-design-criteria.html
vi. Royal College of Physicians, 2011 Falling Standards, broken promises: report of the national audit of falls and bone health in older people 2010.
vii. Assessing the health benefits of Lifetime Homes by Mike Roys, Building Research Establishment Ltd July 2012 commissioned by the Department for Communities and Local Government.
viii. Age UK Chief Economist's calculation based on NHS published costs for 2010. Costs are for two years and include hospital and social care costs.
ix. Laing and Buisson Care of Elderly Market Survey 2013/14.
x. Figure calculated by sampling the costs provided by local Age UKs in different parts of the country
xi.The Disabilities Facilities Grant is available from Local Authorities to help people pay for home adaptations. The mean average for the latest reported year (2010/11) was just over £6,800 for England. Source: DCLG archived files, table 314 https://www.gov.uk/government/statistical-data-sets/live-tables-on-housing-finance-and-household-expenditure.
xii.Department of Communities and Local Government (2009) English House Conditions Survey 2007. DCLG.
xiii.Pannell, J. Aldridge, H and Kenway, P (April 2012) - Market Assessment of Housing Options for Older People. NPI.
xiv. 3.4%. Department of Communities and Local Government (2009) English House Conditions Survey 2007. DCLG. The recommended features are level access, flush threshold, WC at entry level and circulation space.
xv. English Housing Survey Housing Stock Summary. Statistics, Table DA3202, 2010.
xvi.TNS omnibus survey for Age UK (August 2014). 1,990 adults aged 18+ in Great Britain were interviewed between 30/07/14-03/08/14.