Domestic news has been dominated this week by hospitals – with headlines focussing on the rate of admissions – and behind the scenes focus on the rate of discharge. The connect with the hospital location has meant that so much of the dialogue has been around peoples immediate health needs, but in a sense, the story I want to talk about is about what do people need to get back home.
Over the last month Sitra have been working with the LGA to promote the role of Housing in the integration agenda – recognising that together health, housing and social care can provide real alternatives to the existing models of provision. I think that this is the thinking that housing can bring to the current acute crisis. For most people entering or leaving hospital, they will be coming from home and wanting to return home. It stands to reason then that those who offer housing services are a critical part of the response. To date that contribution has been largely untapped – now we want that to change.
I have been talking with our members about what could be offered to support the immediate challenge – and there are definitely both national and local responses which could support both the push and pull on acute services. Key resources exist within the housing sector.
For example there are large numbers of highly skilled housing support workers whose focus is on supporting people to live independently who could be a critical force in enabling someone’s smooth return home. They are often strongly connected to a locality, and could be an immediate bridge to local services, helping build up a robust network of support, for instance, in those first 48 hours and beyond, when someone comes home.
Many localities will have handyperson or home improvement teams who can rapidly respond to help make temporary adjustments to individuals homes to ease their return home after an operation or fall – including grab rails, moving furniture round for ease of access or beginning the process of longer term adjustments such as stair lifts or flat access bathrooms. Peoples entry to hospital can often be exacerbated by their living environment – and connecting up with landlords early on can mean that issues around heating, damp, condensation or hoarding – can be addressed during the hospital stay – meaning that they can return to a safer healthier environment.
Finally, housing may have suitable short term accommodation to offer a transition for those who no longer need hospital care, but are unable to return to their own home – potentially for short term access reasons, for example they have short term use of wheelchair for recuperation purposes or indeed whilst repairs or longer term adjustments are being made to their own home.
To get the most out of housing, we need coordinated responses which have housing at the table. There are a small number of existing examples of housing support professionals embedded in hospitals – both in the accident and emergency room – and in the discharge team. We need to escalate this approach and make sure that every hospital has the support it needs to make the best use of these housing resources. Pilots have shown it works – it saves money – and most importantly – it gets people back where they want to be – home.