Tuesday, 10 April 2018
Royal Voluntary Service is advocating for more person and community-led approaches to help tackle increasing pressure on health and social care and deliver better outcomes for older people.
The number of people aged 65 and over is projected to rise by over 40% by 2034 (1) which will put increasing pressure on public resources. Meanwhile, social care faces a funding gap of £2.3 billion by 2019/20 (2) and hospital readmissions cost the NHS an estimated £2.2 billon each year (3) .
To support its call and following a strategic review of its existing offers, the charity is introducing three new commissioned service packages to support older people: Supporting Your Recovery
; Supporting You at Home
; and Supporting Healthy and Happy Lives
. These volunteer and community-led commissioned services which are supported by trained staff will provide tools to help older people better support themselves and build meaningful social connections. All are grounded in evidence showing that ageing is malleable (4) and are available to CCGs, NHS Trusts and local authorities across England, Scotland and Wales.
"People are living longer than ever before, but for many, later life is experienced in poor physical or emotional health. There is general acceptance of getting older and what that can mean, but scientific data indicates there is considerable malleability in ageing and that efforts to enhance health and wellbeing at any age are likely to be worthwhile. We have built on our experience and pilot activity to create three seamless propositions we feel will support older people when they need it most, helping them achieve quality in their quantity of years and reducing demand on health and social care. Central to the delivery of these new services will be dedicated teams of volunteers, supported by trained staff, from a wide background and age range who are playing a vital role in supporting their communities and delivering meaningful impacts for older people."
Sam Ward, Director of Commissioned Services at Royal Voluntary Service
The charity’s new Supporting Your Recovery commissioned service places trained Royal Voluntary Service volunteers on hospital wards to help older people return home stronger and more quickly after a hospital stay. Support encompasses physical and mental exercise (Cognitive Stimulation Therapy for those with mild to moderate dementia) to build confidence, muscle strength and social connection and hydration and nutrition advice. An additional Home from Hospital component is available for those with at-risk characteristics for readmission, with Home from Hospital volunteers providing support for up to twelve weeks, including home safety assessments, goal setting and assisted shopping.
The Supporting Your Recovery commissioned service is based on a proven model of success – a partnership between the charity and nine hospitals in Leicestershire through 2015-16. Rates of readmission within 30 days were lower in patients supported through the service than the CCG rate. The service achieved a 9.2% readmission rate compared to a national figure of 15% (5) for those 75 years and over.
"The Home from Hospital scheme is considered as a form of reablement service. Reablement is a broadly used term, but in this instance, it refers to returning the patient, as far as possible, to the kind of life they had prior to their admission into hospital. This approach aims at helping people do things for themselves, rather than having things done for them. The Royal Voluntary Service volunteers provide vital practical support for patients in Leicester in such a way as to help them develop both the confidence and skills needed to carry out daily activities themselves and therefore regain their independence in their own home."
Dr Sulaxni Nainani, lead GP for older people and Leicester City CCG Board Member
Loneliness is increasingly recognised as a key determinant of health and wellbeing with a lack of social connections cited as being as damaging to health as smoking 15 cigarettes a day (Holt-Lunstad, 2015). Royal Voluntary Service’s new Supporting You at Home commissioned service matches volunteers with older people who are identified as lonely or isolated and who may benefit from practical help towards reablement and reconnection with their communities. Regular one-to-one support helps restore confidence and independence by building resilience and improving physical and mental strength. Referrals can be made from health and social care agencies, local networks or self-referral.
The charity’s new Supporting Healthy and Happy Lives commissioned service gives older people - predominantly those living with low to moderate dementia - tools to help them add quality to their life through personal support and social activities such as gentle exercise sessions, Cognitive Stimulation Therapy (to help improve cognitive function) and hobby or interest classes. These activities will be delivered in group settings at the charity’s community centres and social clubs. The service has been developed following evaluation of a recent Royal Voluntary Service-led pilot of Move It or Lose It, a seated resistance-based exercise programme designed specifically for older people. The pilot resulted in significant improvements in physical function and mental well-being in frail older people.
"We are thrilled to be working in partnership with Royal Voluntary Service to empower older people to enjoy more active, healthier, happier lives. By delivering exercise sessions that improve mobility and strength in a way that is engaging and enjoyable, we can reach people who would otherwise avoid exercise and help make activity part of their daily routine. This brings about feelings of vitality and leads to greater independence and confidence. Together we are transforming the way we age."
Julie Robinson, Founder of Move It or Lose it
"The roll-out of these new services will unleash the power of volunteers and could significantly ease pressure on health and social care by reducing readmissions to hospital, time spent in hospital and the frequency of calls and visits to A&E departments, as well as enriching the lives and experiences of thousands of older people across Great Britain."
Sam Ward at Royal Voluntary Service
(1) National population projections for the UK, 2014-based, Office for National Statistics, 2015
(2) The Autumn Statement – the Health Foundation, the King’s Fund and the Nuffield Trust – Nov 2016
(3) CHKS briefing. Foundation Trust Network. February 2011
(4) Kirkwood, T (2017) Why and how are we living longer? Experimental Physiology, Vol 102(9): pg 1067-1074
(5) Emergency readmissions to hospital within 28 days of discharge: indirectly standardised percent, 75+ years, annual trend
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Royal Voluntary Service is one of Britain’s largest volunteering charities with over 25,000 volunteers supporting thousands of older people each month in hospitals and the community.
The focus is on building confidence, improving well-being and keeping loneliness at bay through an array of social activities and more structured support.
Working across hundreds of hospitals in the community, the charity is one of the largest retailers in the NHS, with its network of cafés, shops and trolley services providing much valued services in hospitals.
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