What is the cost-effectiveness of home adaptations for older people?


As people get older it can become more difficult to manage in the home and maintain independence. This can be a particular problem for older people living with frailty, who are at higher risk of losing independence, falling or having to move to a nursing home. This can reduce quality of life in older age, and is costly for the NHS and social care.

Home adaptations can help promote independence in later life. The 2015 Government Spending Review increased the budget for Disabled Facilities Grant (DFG) in England from £220m to £431m in 2017/18, with incremental rises up to 2020. Available international evidence indicates benefit from home adaptations for older people, but there is an absence of high quality evidence from UK studies. Furthermore, there is an absence of evidence on cost-effectiveness of home adaptations.

Evidence on cost-effectiveness of home adaptations for older people is critically important as it can help support sustainable commissioning. Furthermore, evidence that highlights how home adaptations should be targeted for particular groups to maximise benefit can help identify how commissioning of services should be refined to provide greatest value for money. Finally, we need more knowledge about the effectiveness of home adaptations in improving health outcomes related to falls.

The aim of our study is to provide evidence on the cost-effectiveness of home adaptations for older people, including for those living with different levels of frailty. We will also assess the impact of home adaptations on fall-related hospital admissions. The study will use routine data from Care and Repair Cymru linked with health and care data in the Secure Anonymised Information Linkage (SAIL) Databank.

The study is funded by the Dunhill Medical Trust and is a multi-centre collaboration between the University of Leeds, Swansea University and University of Liverpool. Care & Repair Leeds, Care & Repair Cymru, Care & Repair England, Age UK Leeds and Foundations are partners on the project.


Our collaboration with Home Plus Leeds, and existing links with Care & Repair Cymru, will facilitate wider dissemination of findings to key national organisations, including Care & Repair England. We have strong existing links with NHS England and will use these links to disseminate findings nationally.