BRINGING PEOPLE HOME
South Yorkshire Housing
Our ‘Living Well’ service has brought 35 individuals with serious mental health problems, living in expensive out-of-area hospital care, back home to Sheffield by providing housing with support in SYHA homes.
This has reunited them with family and saved the NHS substantial sums, and this new system has reduced by 97% the amount of time the 35 customers have had to spend in hospital, with many of these people now living independently.
Speaking about the scheme, Professor Tim Kendal, National Clinical Director for Mental Health said: “One of the things we were really aware of, was that our crisis and acute care, and our rehabilitation, was such that we had people out of area. People who instead of receiving care in Sheffield, were being sent to get care, often quite far away. People would be put into private hospitals, and sometimes stay there as long as 5 years. So we made it a top priority to bring back all the patients that we could.
We developed a partnership with South Yorkshire Housing Association (SYHA) to bring these people back, and put them in standard tenancies, that South Yorkshire Housing prioritised for us. We’ve brought back nearly all of the patients that have been out of Sheffield in these locked environments, and the vast majority have gone into tenancies provided by SYHA.
Given that these people were commonly being kept in hospitals for about £150k a year, bringing them back and providing really top quality care, at half the cost, was a really big saving for all of us. Which meant we could invest more in-patient care.”
The national picture:
- 50% of the mental health budget is being spent on inpatient care for just 0.3% of the population
- An out of area placement costs a minimum of £140,000 a year, the average is approximately £400,000 per year but we do know of one that cost £900,000 per year.
Nationally Between July and September 2017 in England there were:
- A total of 67,891 out of area days
- 1872 out of area placements started
- The cost of this is £25,616,000
- 739 placements were greater than 100km away from home
- A national 1% decrease in inpatient bed days has the potential to free up £15.4 million a year.
Our model - the new Sheffield picture:
- 37 people had been using 13,505 bed nights per year
- In the last 40 months, out model in Sheffield has contributed to a 99% reduction in the number of out of area placements
- Sheffield hasn’t sent anyone out of city for three years.
SYHA’s Care, Health and Wellbeing Director, Juliann Hall commented: “The reality was that many people with a mental health diagnosis had been displaced for many years, and were in rehabilitation units, and those places will never be a home. When you’re in your own home, you have access to your things - your books, your family, your community, and when people are sent away, that link’s broken, so they lose the very connection with the thing that makes them well.
As a housing association, we believe that your home is the absolute bedrock to everything, that you cannot be well without a good home and roof over your head.
Living Well is a brilliant example of innovation for a number of reasons - it has really broad impact - so it has impact on the health economy, delivers a really good saving for the health economy, and that can be invested in other care. It’s had a brilliant impact on our organisation, it’s changed the way we think about mental health services, and our colleagues at the trust tell us it’s made them change the way they think about housing.”
Terry Proudfoot came along to an SYHA board meeting a couple of years ago and talked about her journey. Following a mental health crisis, Terry had been placed in hospital out of Sheffield, but eventually brought back home to Sheffield through the Living Well model. Her journey has been extraordinary. Terry now sits on our board as a valued Non Executive Director of SYHA.
Terry joined our Board in 2017 and her views are proving vital to help us design, deliver and evaluate new and existing services within our Living Well portfolio.
Terry is also a governor at Sheffield Health and Social Care NHS Foundation Trust and is currently studying for a postgraduate certificate in Recovery in Mental Health.
“For me, it’s important being back somewhere I know, somewhere I’m familiar with. When I go out of the door, I know where to go, I know where I am, and I know which way to turn.
The consultant decided to send me to hospital in Bradford. I had no idea where I was because I’d just been taken there. My family didn’t know I was there, I didn’t have chance to tell them, so I felt as though I was completely on my own. I was welcomed by staff at the hospital, but again, they had procedures I didn't know anything about… so I got various possessions taken away that I wasn’t allowed to have, which made me even more anxious because of the Asperger’s I’ve got, and I need to know where everything is. I actually wrote to my mother to let her know where I was… it took her hours to get there.
I was at the hospital in Bradford for about two and a half years, and then I got moved to another out of area placement near Nottingham, but again, I had no idea where I was. I was in there for about a year and a half. And then I got transferred back to Sheffield to live in my own house with support from services and support from South Yorkshire Housing.
In that first month, if I hadn’t had the support that I was first given, I would have ended up straight back in hospital. Initially I had access to a lot of support, really for most of the day, if I needed someone, which gradually over time was tailored down a bit, as I got more confident.
It is really that familiarity, that comfort of being in a place that you can call home.”