Delaying and reducing the need for care and support for older people with earlier diagnosis, intervention and reablement means that they and their carers are less dependent on intensive services. When people develop care needs, it is crucial that support is delivered in the most appropriate setting as this enables people to regain their independence.
There is strong evidence that reablement services lead to improved outcomes and value for money across the health and social care sectors. Reablement aims to maximise people's independence and ability to live at home, in order to minimise their need for ongoing support and dependence on public services. It tends to be provided to older people who have just been discharged from hospital or are entering the care system following a crisis.
Here we are looking at the impact that reablement, intermediate care or rehabilitation services have on older people following a hospital episode. The measure of success is the proportion of people aged 65 and over who are still at home 91 days after discharge from hospital into reablement services. Between 2011/12 and 2019/20, the proportion of older people still at home after 91 days fluctuated at around 82%. In 2020/21, this fell below 80% for the first time, to 79%.
The proportion of people still living at home 91 days after discharge from hospital is a measure of success for reablement services, but it is useful to analyse whether the rates vary by age and gender.
Since 2011/12, there have been higher rates of successful reablement for women compared to men. In 2020/21, 81% of women aged 65 and over who received a reablement service were still living at home 91 days after discharge, compared with only 77% of men.
Stratifying by age groups shows that success rates of reablement services fall as age increases. Reablement is least successful in the oldest age group (people aged 85 and over). In 2020/21, 77% of people aged 85 and over were still living at home 91 days after discharge, compared with 81% of people aged 65 to 74.
The proportion of older people (aged 65 and over) who receive reablement services after discharge from hospital has fluctuated over time at around 3%. In 2020/21, 3.1% of older people discharged from hospital received the service, an increase from 2.6% in 2019/20.
Despite a recent increase in proportion, the number of people receiving reablement services decreased slightly from 43,335 in 2019/20 to 43,193 in 2020/21. The increase in percentage is instead a reflection of the substantial decrease in the number of older people discharged from hospital, from 1,663,210 in 2019/20 to 1,377,575 in 2020/21. Please see the ‘About this data’ section for more information.
About this data
These indicators use data from NHS Digital's Adult Social Care Outcomes Framework (ASCOF). Indicator 2B measures the success and coverage of reablement services for older people (aged 65 and over).
Numerator: Number of older people (aged 65 and over) discharged from acute or community hospitals to either their own home, or to a residential or nursing care home or extra care housing for rehabilitation, with a clear intention that they will move on/back to their own home (including a place in extra care housing or an adult placement scheme setting), who are at home or in extra care housing or an adult placement scheme setting 91 days after the date of their discharge from hospital.
Denominator: Number of older people (aged 65 and over) discharged from acute or community hospitals to either their own home, or to a residential or nursing care home or extra care housing for rehabilitation, with a clear intention that they will move on/back to their own home (including a place in extra care housing or an adult placement scheme setting).
For 2020-21, the denominator was calculated using the total number of people, aged 65 and over, discharged alive from hospitals in England between 1 October 2020 and 31 December 2020. During this period, hospitals were adjusting to deal with the impact of the Covid-19 pandemic by reducing non-essential treatments, so the number of hospital admissions and discharges will have been lower than in previous years.
For more information, please see the ASCOF Handbook of Definitions.