Bauer, Annette 
ORCID: 0000-0001-5156-1631, Knapp, Martin ORCID: 0000-0003-1427-0215, Wistow, Gerald, Perkins, Margaret, King, Derek ORCID: 0000-0002-2408-4558 and Iemmi, Valentina ORCID: 0000-0003-3301-0689
(2017)
Costs and economic consequences of a help-at-home scheme for older people in England.
Health and Social Care in the Community, 25 (2).
pp. 780-789.
ISSN 0966-0410
Abstract
Solutions to support older people to live independently and reduce the cost of an ageing population are high on the political agenda of most developed countries. Help-at-home schemes offer a mix of community support with the aim to address a range of wellbeing needs. However, not much is currently known about the costs, outcomes and economic consequences of such schemes. Understanding their impact on individuals’ wellbeing and the economic consequences for local and central government can contribute to decisions about sustainable long-term care financing. This article presents results from a mixed-methods study of a voluntary sector-provided help-at-home scheme in England for people of 55 years and older. The study followed a participatory approach, which involved staff and volunteers. Data were collected during 2012 and 2013. Social care-related quality of life was measured with the Adult Social Care Outcomes Toolkit (ASCOT) for 24 service users (59% response rate) when they started using the scheme and 4 to 6 months later. A customised questionnaire that captured resource use and wellbeing information was sent to 1,064 service users (63% response rate). The same tool was used in assessment with service users who started using the scheme between November 2012 and April 2013 (100% response rate). Costs of the scheme were established from local budget and activity data. The scheme was likely to achieve a mean net benefit of £1,568 per person from a local government and NHS perspective and £3,766 from the perspective of the individual. An expenditure of £2,851 per person accrued to central government for the additional redistribution of benefit payments to older people. This article highlights the potential contribution of voluntary sector-run help-at-home schemes to an affordable welfare system for ageing societies.
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