Primary and community healthcare support for people living with frailty

This National Audit Office report examines the effectiveness of the government’s approach to identifying and managing frailty on non-hospital based services in England.

With some references to home but no emphasis on housing, it particularly considers the growing problem of frailty, how best to support people living with frailty and links to the new plans for neighbourhood health services. It estimates the cost of frailty per year to the UK healthcare system is £5.8billion and found that people living with frailty are 6 times more likely to be admitted to hospital than people who don’t have a frailty.

At a neighbourhood level, the report outlines the impact of more integrated approaches to deliver care at home (or often citing care homes) and considers more joined up integrated care as a way of deepening the involvement of adult social care in out-of-hospital care pathways. However, there is no mention of the role of accessible and adaptable homes offers helping to frailer older people to remain more independent at home; for example, new, purpose-built extra care housing or the use of Disabled Facilities Grants to help adapt an existing home.  And while there are references to technology, this is seen in the context of virtual wards, primarily to support a clinical community health response, hospital at home and/or enhance care in care homes, often following a hospital admission.

While these are important interventions and there are useful examples of integrated care systems, a fully neighbourhood health services must proactively also include housing for people living with frailty in order to provide a holistic approach to supporting people living with a frailty at home. Housing can also be a preventative solution, supporting rehabilitation at home, reducing risks at home ie trips and falls, improve condition or tackle disrepair, and help deliver better health outcomes. 

If you found this of interest, take a look at our Health and Housing Intel pages where we curate a range of resources that evidence the impact of better housing and related services on the health and wellbeing of frailer people and older people.