Every resident of extra-care housing saves the health and care system an average of at least £2,441 a year because they need fewer interventions by doctors, nurses and ambulances and because they stay out of costlier care homes, a study suggests.
There is “a strong argument for providing more specialist housing for older people, particularly extra-care housing, on the basis of the significant cost benefits that it provides to the NHS and local authority adult social care”, according to the study by the Housing Learning and Improvement Network (HLIN), which researches and promotes housing for older people.
The network calculates that on present plans, there will be an overall shortage of 400,000 units of specialist housing for older people in England and Wales by 2035. In particular reference to demand for extra-care, it projects shortages of 61,000 in England and 7,500 in Wales by 2030. And its mapping of existing provision shows that shortages are much more acute in some regions than in others.
Compared with the average for England, the West Midlands has 52% more extra-care provision but the East Midlands 47% less. In Wales, Conwy has 11.4 extra-care units per every 1,000 people aged 65 or over, but Rhondda Cynon Taf just 1.3 and Powys 1.1. In Scotland, West Lothian has nine but Stirling’s provision is recorded as negligible.
Why such stark variations? The HLIN suggests that since councils started to commission extra-care in the early 2000s, some have embraced it much more enthusiastically than others. One issue has been reluctance to provide contracts funding providers’ core care costs, such as for overnight staffing, on an assumption that residents will be able to claim the government’s attendance allowance – money for people aged 65 or over who have care needs – to cover them.
Mears Group, which commissioned the study, is calling on government to set a national target to build 400,000 new extra-care properties over the next 10 years. At local level, it wants councils and the NHS to work together to plan provision as an integral part of health and care systems, freeing up general housing for younger homebuyers and renters.
Previous research drawn on by the HLIN has shown that people living in extra-care schemes visit the GP less often than others of their age, need fewer visits by community nurses, are admitted to hospital less frequently and have fewer falls. There are savings in ambulance call-outs and homecare costs, which otherwise would be met by councils.
Other claimed benefits are less easy to quantify. One HLIN study has suggested that residents of retirement villages with extra-care experience half the degree of loneliness that affects others in the wider community. Because lonely people seem to make more use of the NHS, the HLIN reckons this alone could save £36 per person each year.
