In the months before the coronavirus crisis, more than 80% of adult critical care beds in England’s hospitals were occupied. So, when people began getting seriously ill with the virus, there were huge concerns about hospitals reaching full capacity.
As a provider of 40 specialist mental health services in London and the Home Counties, Look Ahead has long advocated for out-of-hospital care, citing the improved physical and mental health outcomes experienced by the people we support.
In late 2019, ahead of the coronavirus crisis, we set out to demonstrate the cost savings for Clinical Commissioning Groups, NHS mental health trusts and councils involved in these services. We commissioned independent consultancy Europe Economics to work on the robust research that led to our report, “The financial case for integrated mental health services and supported housing pathways”, published in February.
Coronavirus may have delayed the publication of the report, but it also made the evidence outlined within it even more pertinent. As we make our way out of the coronavirus crisis, how can we make the case for enabling more people to leave hospitals and institutions?
Europe Economics found that, not only does the integration of housing support with clinical and social care enable individuals to receive tailored treatment and interventions closer to (or at) home, they also save public money – something that is going to be crucial post-pandemic.
Focussing on the costs of running three different types of housing based mental health services, the researchers predicted there could be a massive £1 billion of potential savings to the NHS and social care if these models were put in place across England.
Europe Economics examined our housing and support, which provide community-based alternatives to in-patient psychiatric treatment, rehabilitation services and forensic step-down services to support people leaving more secure in-patient settings. Their analysis concluded that individuals who receive specialist support through these services are less likely to need to go back into hospital, and more likely to go on to live independently, to secure work or training, and to reconnect with family and friends.
As everyone who works in housing knows, a safe and secure place to live is the foundation everybody needs to thrive. The report found that securing the path to appropriate housing is a vital element of integrated services and enables individuals to focus on their recovery.
Integrating mental health pathways and housing makes sense for everybody involved – the challenge is to make this possible at scale.
We need more housing associations to provide this kind of specialist accommodation-based support that can make a huge difference to people’s lives. However, to do this, there needs to be more capital grant funding from Homes England that is ring-fenced and grant rates set at a level that works, specifically for new mental health and learning disability schemes.
At Look Ahead, we have a programme of repurposing existing homes to provide integrated care and support services, but there’s potential to do so much more. With relatively modest increase in grant levels to ensure these schemes stack up it would have huge benefits, improving the quality of life for those currently living in inappropriate settings but also to the public purse. We operate in an extremely challenging market. The government needs to do more to enable organisations to replicate the positive outcomes we’ve experienced across the country.
After the year we’ve had, we’re all much more aware of the need for hospitals to have capacity.
We also have a better idea of what it’s like to experience isolation, to be away from friends and family, and unable to move forward in our lives in the way we’d hoped.
We urge others to share the findings in our report and to help us to demonstrate that specialist supported housing providers have the skills, expertise and spaces to care for and support individuals to live their lives more fully, outside the confines of institutions and critical care wards.