It was with a heavy heart that I read this section of the government’s recent Budget Statement
[The Government…..is exploring the cost-effectiveness of options to integrate spending around some of the most vulnerable groups of people, including:
- exploring whether improving housing can help people with care needs stay in their homes longer and reduce costs to the NHS. [my emphasis]
When talking to a leading epidemiologist and a consultant specialising in dementia later in the day, their comment was that sometimes there seemed to be a lack of basic common sense. Wasn’t it obvious that older people’s health and ability to live well at home was made worse by poor housing?
Just days before the Budget the Building Research Establishment (BRE) had published its latest analysis of the health cost benefits of specific home improvements and adaptations, The Cost of Poor Housing to the NHS. This shows that the annual cost to the NHS of poor or hazardous housing is between £1.4 and £2.5 billion – on a par with the cost of smoking.
I was reminded of the excellently titled Finding Ways to Say Yes a report by the leading adaptations researcher, Frances Heywood OBE, which highlighted good ways to provide help with home adaptations.
Increasingly we are faced with is ‘Finding Ways to Say No’ . As public funding is squeezed ever tighter, citing lack of evidence is one way to say no to funding activities which people may have thought were self evidently ‘a good thing’ and so haven’t built up a research evidence base to prove it.
I am a huge supporter of prioritising what works and there are undoubtedly areas of accepted practice across health, social care and housing that are not cost effective. We should root out poor practice, but we do need to balance this with a reality check.
Surely the question for government is not ‘whether‘ improving housing helps people live well at home or reduces NHS costs, but how to spread best practice and deliver ‘what works best’ to gain the greatest cost benefits, improve people’s health and, so importantly, improve their lives.
Reflections by the CEO of Care & Repair England, Sue Adams, [April 2015]