1. Integrating Housing, Health and Care in Leicestershire

2. 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.

3. Integration Policy Context – the 6 pillars

4. 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

5. 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

6. 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)

7. 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

8. 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’

9. 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

10. 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

11. 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
(Agenda Ref Number 499)

12. For Further Information about Leicestershire’s Integration Programme
Contact: Cheryl Davenport Director of Health and Care Integration Visit: Read: our Stakeholder Newsletters