Impact of our support Avoided state costs As a result, he was bed-bound and Providing Mr Hughes with practical costs to the healthcare system having difficulty with his speech. and emotional support saved the as well as indirect costs, such as £3,787 Mrs Hughes was finding it increasingly state money in several ways: health complications resulting from difficult to care for him, and he was malnutrition and related costs to other refusing to drink or co-operate public health services. with her. We prevented Mr Hughes from £1,152 His GP referred him to the British Red requiring a GP residential visit Outcome We prevented Mrs Hughes’ stress Prevented home Cross on a Friday to see if we could Our support avoided the need for a and anxiety from worsening visits from a nurse help with his fluid intake. The GP GP visit in the home, costing £121 Assumption 1. Assumed four said he would review the situation on per visit Without our support, Mrs Hughes visits per day, initially, Monday, but would have to admit him may also have required some sort reducing over a to hospital if he had not improved. of medical or emotional support period of We prevented Mr Hughes from in the midterm. The direct costs for three weeks We arranged to visit Mr Hughes at needing another admission to of depression and anxiety cost least four times a day to encourage hospital the state around £22 billion a year him to take fluids, fitting in between through lost productivity, inability to visits from his existing carers in the The unit cost of a non-elective commence or return to employment, morning and evening. inpatient stay for more than one health facility usage and medication Mr Hughes happily drank for our night (based on the average number costs8. This represents an annual 2 volunteers every time they visited over of days stayed) is £2,334 . Mr cost of £7,875 per case. Around 35 the weekend, and we helped Mrs Hughes would also have required per cent of mental health treatments Hughes create a fluid diary to keep an ambulance transfer to hospital deal with people experiencing anxiety £2,514 Outcome 3 Prevented ambulance (£180) resulting in a total cost of 9 track of his intake. We also liaised with £2,514 for the admission. disorders . Applying this proportion call out and his carers to ensure Mr Hughes drank suggests avoided costs around unnecessary hospital as much as possible. £2,620 per year, per person. admission We also helped him cut up his food, We prevented Mr Hughes from Assumption Average length as his hands were very shaky due to needing further health or social of stay and one his Parkinson’s. care home visits from statutory Overall, the support we ambulance transfer services delivered to Mr Hughes His health began to improve and by represents total avoided Sunday evening he was out of bed The cost of a home visit from a costs to the state of £3,787. 4 and watching TV in the living room nurse is £64 an hour . We assume with his wife. From Monday we agreed visits would be required four times with Mr and Mrs Hughes to visit a day, in line with what we provided. only twice a day, which decreased Assuming each appointment lasted Mr Hughes shortly afterwards to one visit, until around 30 minutes, daily costs 1. PSSRU (2011), Unit costs of health and social our assistance was no longer needed would have been around £1285. care 2011, The University of Kent publications. around three weeks later. These visits would be required 2. Ibid. 3. National Audit Office (2011), Transforming During the course of our visits we for three weeks, in line with what the NHS ambulance services: presentation we provided at a cost of £1,152. to the House of Commons. http:// reported back on Mr Hughes’ situation www.connectingforhealth.nhs.uk/ to his GP. systemsandservices/pathways/news/fullreport. pdf Additional benefits 4. PSSRU (2011). Our support meant 5. PSSRU (2011). Mr Hughes was able to We prevented Mr Hughes from 6. Elia (Chairman & Editor) Stratton, Russell, developing longer-term health Green, Pan; (2005); “The cost of disease- stay at home with his wife related malnutrition in the UK and economic problems considerations for the use of oral nutritional and avoid a readmission supplements (ONS) in adults”. British Without our support, Mr Hughes may Association for Parenteral & Enteral Nutrition. Mr Hughes, 81, suffers from Parkinson’s disease to hospital. have suffered longer-term problems http://www.teespublichealth.nhs.uk/document. aspx?id=3202&siteID=1012 and lives with his wife, his main carer. After as a result of malnutrition. 7. McKinlay (2008) “Malnutrition: the spectre at It also gave Mrs Hughes the the feast”, Journal of College Physicians of recently being discharged from hospital, he The overall costs of malnutrition Edinburgh 38:317–21 Outcome confidence to arrange for extra carers across the UK amount to around 8. Layard (2005), “Mental health: Britain’s largest Prevented residential became mildly dehydrated and had a possible to visit to relieve some of the pressure social problems?”, Paper presented at the GP visit 6 No. 10 Strategy Unit Seminar on Mental Health on her in the long term and ensure £7.3 billion per annum , affecting Assumption urinary tract infection. 5 per cent of the British population (or 20 January 2005 One GP visit to Mr that they were both better able to 7 9. Hallam (2008), “The social costs of anxiety £121 Hughes’ home cope with their situation. 2.9 million people) . This represents disorders”, Congresso Istituto Tolman: a cost of around £2,483 per person, Psicoterapia competenti per la communita: I per year. This figure includes direct percorsi, gli ostacoli, le soluzioni. Palermo, 3 Dec, 2006. 10 11