20 October 2016
We keep reading in the press about how delays in discharging patients from hospital after treatment could be costing the NHS nearly £1bn a year.
Vulnerable and frail patients cannot be discharged if their homes are not suitable for them, or if the support is not there in the community for them. Long, unnecessary stays in hospital are not good for older people as they can become institutionalised too quickly.
The NHS has serious concerns about this winter. Trips and falls at home can only exacerbate an already difficult situation, and when people are admitted to hospital they need to treat them, and then discharge them as soon as they are well enough to leave.
So how can district councils help? Well, we hold the keys to both helping to prevent falls and to preparing homes while people are in hospital so that they can be discharged sooner.
Nearly half of all trips and slips happen at home. As the housing authority, district councils are responsible for Disabled Facility Grants (DFGs) which are used to allow adaptions to be made to make homes safe for people. They could involve adding a rail by the shower, a stair lift or ramp to help prevent slips and trips. Although a means-tested benefit, many district councils supplement their DFG service with an affordable handy person service to help those who do not qualify.
This service can go even further. My own district council, Sevenoaks, has recently struck a deal with our local CCG to provide a referral system allowing patients to begin the DFG process while in hospital, so that they can be discharged sooner. The new referral system allows other council services to be included such as private sector housing; our holistic advice service HERO (Housing, Energy and Retraining Options); and the healthy living team to be involved in providing preventive measures, avoiding further hospital admissions.
Council handyperson services are often more than a repair service. Often they are trained to look for other hazards or signs of the resident not coping while they are in their home. They can work with the fire service to have smoke alarms fitted, notice if there is no food or if the resident is not behaving normally – flagging up other potential problems. They are also likely to be a dementia friend.
Energy efficiency can be linked to the DFG service. Keeping people warm, but especially older and vulnerable people warm, will also prevent slips and trips as well as illnesses.
And, of course, by using their housing together with their planning role, district councils can try to meet demand for specialist older peoples’ homes whether they are supported living or simply designed for older people (all on one floor, etc).
District councils also have responsibility for leisure. Residents that take part in the DFG or handyperson services can also be referred to falls prevention programmes (exercises to strengthen core muscles to help prevent falls, while socialising and preventing loneliness) to activities at the local leisure centre, such as swimming or even golf. Keeping older people fit and active will in turn help to prevent falls.
District councils sit at the centre of a huge web of community groups and activities. By working through community groups they can promote their services to make sure they have prevented as many older and vulnerable people from falling as possible. They can also help to galvanise the power of volunteers to check on older people, clear their driveways or front door steps from snow or ice, and make sure they have enough food over the winter.
The health service and county councils need to really reflect on how district councils can help them prepare for winter by both helping to prevent hospital admissions and prepare homes so patients that are admitted are discharged as soon as possible. District councils could be the secret key to helping unlock bed blocking this winter.
