Household energy bills in 2023: using adaptations to reduce long term costs

By Adam Ferry, Occupational Therapist and clinical advisor to Abacus Specialist Bathroom Solutions

As professionals supporting people with disabilities, how often have we walked past something in an exhibition and thought “that’s too expensive, there’s no way I’ll get approval for it”, or “I am looking for a ‘cheaper’ solution”?

The term ‘expensive’ is often used to describe something that ‘costs a lot of money’ or ‘more highly priced in comparison to another’ but with little consideration of how cost effective the solution might be.

Cost effectiveness can be defined as:

‘When the greatest benefit is gained for a comparatively low price. The concept is commonly employed when choosing from a variety of investment options, so that the greatest possible return is generated in exchange for the amount invested.’

This definition is clearly aimed at the financial sector, but is easily transferable within healthcare, where investment options in this case are the choices, we have over equipment and adaptations, and return on investment (ROI) is the saving made elsewhere as a result.

Let’s consider therefore how we determine ROI on adaptations within the healthcare sector, using published research and data to provide a robust evidence base.

The World Health Organisation (WHO) Housing and Health Guidelines is a literature review considering international research into benefits of adaptations and accessible housing. It found that:

Studies reported considerable decrease in perceived difficulties performing activities of daily living after home modifications.

Self-efficacy, defined as confidence in managing difficulty, was improved in intervention groups (those who had home adaptations/modifications).

Increased safety was identified 2 months after modifications.

Greatest safety benefits were identified in bathroom and access, and in particular when difficulty in bathing and toileting were identified.

The Centre for Aging Better found that ‘preventive work to mitigate worse than average hazards associated with falls on

Perhaps the clearest evidence on ROI comes from the Building Research Establishment (BRE), who provide clear data on the number of specific home hazards, cost of modification, and savings on both health and social care.

They describe, for example, how resolving 8,265 bathing hazards, at an average cost of £627 per home, totalling a spend of £5,181,460, would save the NHS £2,299,090 over 2 years, and save social care £25,628,882 in 2.5 months.

Now, clearly their average spend of £627 per home doesn’t buy an awful lot; maybe a bath lift or a bath board and some grab rails, but even if you account for 20% of these modifications being specialist baths, like the Gemini 2000 from Abacus, the figures demonstrate the total spend would pay for itself within 3 months, through a combination of reduced requirement for health input after injury, and reduced care need.

*50376

*Centre for better ageing (2018) The role of home adaptations in improving later life.

*BRE (2016) The cost-benefit to the NHS arising case studies which demonstrate the cost effectiveness of proactive adaptations to delivering a positive ROI.

https://www.foundations.uk.com/library/dfg-evidence/

Indeed Foundations, the national body for Disabled Facilities Grants in England, provide case studies which demonstrate the cost effectiveness of proactive adaptations to delivering a positive ROI

case studies which demonstrate the cost effectiveness of proactive adaptations to delivering a positive ROI.

It is clear that rather than considering the initial outlay in terms of expense, or indeed ‘expensive’, we need to reflect more on cost-effective solutions and being able to provide an accurate and robust rationale which includes the return on investment.

In an economic climate where everyone, including local authorities, is needing to tighten their budgets, surely we must stop thinking of spending within the context of one financial/tax year?

Instead, consider the longer-term impact on health and social care by investing in adaptations that are going to save tax payers money, which can be re-invested to ensure high quality housing, and clinical services can be delivered for generations to come.

For further CPD insight to enhance everyday practice, visit the Abacus Academy at: https://www.abacushealthcare.co.uk/abacusacademy/ or telephone: 01527 400 024