Integrating Housing, Health and Care in Leicestershire

Our vision for Health and Care Integration in Leicestershire   We will create a strong, sustainable, person-centred, and integrated health and care system which improves outcomes for our citizens.

Integration Policy Context – the 6 pillars

Integrating Housing Health and Care The story so far… “Housing Offer to Health” developed through the Housing Services Partnership in collaboration with CIH and the Health and Wellbeing Board An opportunity to transform housing support into a new integrated offer county wide, historically fragmented services across multiple organisations Recognising and capitalising on the part housing can play in maximising health, wellbeing and independence in the home Transformation Challenge Fund bid secured £1m funding from DCLG Programme team worked with partners and stakeholders to challenge and redesign existing systems, and break down barriers to change New Integrated Housing MOT developed and tested, streamlined DFG processes, maximising prevention opportunities, housing as a key component of hospital discharge Business Case evidences benefits for customers, commissioners and the Leicestershire pound Lightbulb is about making a difference

Housing and Hospital Discharge: Testing a Key Component of Lightbulb Collaboration between 3 CCGs, Leicestershire Partnership Trust, Adult Social Care and District Councils Steering Group of key partners for oversight and governance of project Operates on 3 acute hospital sites plus Bradgate Mental Health Unit Funded from the BCF The Housing Discharge scheme provides: Housing specialist (s)– working directly with patients and hospital staff to identify housing problems that are a barrier to discharge and putting in place the right steps to address them Furniture packs – where required and appropriate Rent deposit/rent in advance – funding to access the private rented sector for housing where appropriate Low level housing related support – to assist with the transition from hospital to home and provide support with setting up a new tenancy or managing the existing home Works across 3 UHL hospital sites and Bradgate Mental Health Unit

Overview of Interventions Access Private Rented Accommodation Accessed Social Housing Supported with rehousing in future (Housing Application form) Eviction issues resolved House Clearance/supported family with hoarding or clearance issues Furniture move - for ground floor existence with package of care Supported to approach local authority for temp accommodation Benefit Advice (support to apply for new claim or reapply) Mediation to return to family / friends with long term plan for re housing Negotiated with Landlord for repairs Furniture pack provided Heating fixed / temporary accommodation arranged whilst being fixed Minor repairs (i.e. fix loose carpet / locks) Supported with reconnection (out of area)

Referrals and Themes 362 referrals to the acute hospitals service in 2015/16 224 referrals April – Nov 16 April – Nov 2016 data analysis themes: Primary reason for involvement was homelessness, unsuitable home or unclean home On average, contact is made within a day of referral to the team Average time taken for the team to resolve the case was 6 days 115 referrals to Bradgate Unit service in pilot period; 79 referrals April – Nov 16 Primary reasons for referral are homelessness and family refusing return. Other interventions included: Support with life skills Debt advice and support with rent arrears

Measuring Impact - 1 357 UHL patients analysed Comparing service usage pre and post intervention Using PI Care Trak PI tool Comparison one month pre/post intervention: 70% reduction in emergency admissions 56% reduction in A&E attendances 50% increase in ‘no activity’   Comparison three months pre/post intervention:  57% reduction in emergency admissions 54% reduction in A&E attendances 27% increase ‘no activity’

Measuring Impact - 2 84% reduction in NHS costs for this cohort of patients in the three months post intervention Reduction in emergency admissions alone from this cohort of patients at the three month post intervention point indicates a potential saving to the health economy of around £220,00 Bradgate Unit 920 delayed bed days classified as a housing delayed transfer of care - £219k saving Embedded community follow up has measurable impact on readmissions 40 service users continued to receive support in the community following discharge from the Bradgate Unit; of these only one was readmitted

Next Steps Liaison with housing providers to improve the supply of  move on/interim supported accommodation for patients (particularly those leaving the Bradgate mental health unit) who do have not permanent accommodation to return to Housing workshops for consultants and health leads planned for end Jan – these will: set out the national and local housing landscape and challenges, for example implications of Welfare Reform, homelessness legislation and local housing supply raise awareness of the role and work of the Hospital Housing team examine a number of case study examples to illustrate practical and realistic solutions include a tour of a local supported housing project Successful LLR Homeless Trailblazer bid includes reference to homeless hospital patients Hospital housing discharge support embedded as part of new Lightbulb service

Next Steps Workshop today gives more detail on the entire Lightbulb Housing offer – hospital discharge support is just one component. Lightbulb Business Case Currently in process of being approved across council partners in Leicestershire with a view to implementation of the new integrated offer in entirety in 2017. Weblink to Lightbulb Business Case http://politics.leics.gov.uk/ieListDocuments.aspx?CId=135&MId=4607&Ver=4 (Agenda Ref Number 499)

For Further Information about Leicestershire’s Integration Programme Contact: Cheryl Davenport Director of Health and Care Integration Cheryl.Davenport@leics.gov.uk 0116 305 4212 07770 281610 Visit: www.healthandcareleicestershire.co.uk Follow: @leicshwb Read: our Stakeholder Newsletters http://www.healthandcareleicestershire.co.uk/health-and-care-integration/health-and-care-integration-newsletters/