2. Home from Hospital Service Health Care & Well-being Forum 11 th December 2014 Suzanne Hilton Chief Executive Age UK Bolton

3. The Challenge Older people rely more on GP & acute services Two thirds of people admitted to hospital are 65 plus Older people stay longer once admitted 80% of delayed transfers are over 70 In last 10years re- admissions risen 88% Re-admissions in 30days cost NHS £2.2bn

4. The Bolton Context 47,000 over 65s 37% live alone Almost 50% of over 75s live alone 14% of over 65s care for another 12% more deaths in winter-27,000p.a. 206 everyday Estimate 3,700 over 65s will be discharged over the winter months October 13 to March 14 9.4k attendances at A&E by over 65s- mild winter

5. Epidemic of Loneliness Loneliness linked to poor health, morbidity & depression- Worse than smoking 15 cigarettes a day People who regularly experience loneliness are 2 x more likely to develop Alzheimers 25% of people 52+ feel lonely sometimes or often At 80+ nearly half feel lonely often 1 million people over 65 feel lonely all the time Families at a distance (where children live more than 1 hour’s drive away 50% older people see them only every 2-6months)

6. AUKB Home from Hospital Short Term/Time LimitedMedium Term/On-going Presence in A&E and on wards Befriending Service and afternoon teas to tackle loneliness & isolation Early discharge planning and full assessment before deflection or discharge from hospital Medication & appointment reminders Involvement with MDTs Lunch & Leisure Clubs- hot meals in a social setting Getting home safely- opening up, putting the heat on, organising aids & adaptations prior to arrival Support at follow-up medical appointments Immediate practical support- collecting prescriptions, organising meals delivery, washing- up, help to deal with correspondence built up whilst in hospital etc. One to One support and encouragement to work on rehabilitation goals identified by healthcare professionals. Plus support to regain confidence in daily independent living tasks

7. AUKB Home from Hospital Short Term/Time Limited Medium Term/On-going Home checks-falls prevention, fire safety Chair-based exercise to promote steadiness, mobility and independence Follow-up calls and visits for emotional and practical support Falls prevention checks Information & Advice e.g. help with benefit applications for help with the cost of additional support Handyman service for help with gardening and DIY to manage the home Signposting to other services, GPs, Careline, Care & Repair, Single Point of Access Hobby and creative activities and digital inclusion support to stay connected with family and friends at a distance Liaison with family, friends & neighbours Befriending support to tackle loneliness and isolation Medication & appointment reminders

8. Reduction in unnecessary hospital re-admissions & crisis care interventions Age UK Tried and Tested Model

9. The Evidence Sheffield Hallam evaluation of Age UK Rotherham scheme and PSSRU other Age UK services including Stockport & Salford in GM: R.o.I.- Between £1.50 and £6.30 for every £1 invested in H.f.H schemes Reduced avoidable re-admissions an crisis social care interventions Reduced hospital stays, A&E visits & hospital based physio’ by up to 50% Further 15% reduction in GP appointments Rotherham saved £74k p.a. in bed days, additional up to £18k p.a. for hospital transport and forecast £358k- £717k across health & social care services in 12months.

10. Partners & Funding Partners Age UK Bolton- lead delivery partner & funder working with Senior Solutions Bolton FT Hospital – host & in-kind support Funding CCG -£55k (£30 AUKB + £25k SS) AUKB - £30k BMBC - £30K

11. OutcomeMeasure Reduced emergency and avoidable (re)admissions % of older people supported by HfH readmitted as inpatients or attending A&E compared to % of wider 65+ cohort Reduced & delayed admissions to residential care Recorded number of 65+ still at home 30 days after discharge Improved experience of care for older people and their carers Evaluation feedback questionnaires from HfH clients Increased number of older people who feel supported to manage their own health and long term conditions HfH clients still at home 30 days after discharge Evaluation of feedback questionnaires on personal recovery goals Increased satisfaction with care & support provided to older people Evaluation feedback questionnaires from HfH clients

12. Going Live Staff team recruited Building volunteer team- ahead of profile Setting up base in the hospital Aligned to Staying Well Developing data capture, referral mechanisms and monitoring and evaluation systems Launches on 15 th December

13. Loving Later Life

14. suzannehilton@ageukbolton.org.uksuzannehilton@ageukbolton.org.uk 01204 701525 / 07790 817454