We are pleased to launch the final Future HIA report looking at the role of home improvement agenices in delivering major adaptations.

Since the announcements about modernising the Disabled Facilities Grant (DFG) programme made within 'Lifetime Homes, Lifetime Neighbourshoods', there have been substantial rises in central government DFG allocations (more than 7% last year and 15% the year before that). Home improvement agency activity in this area is also up. In 2008/09 agencies carried out 11,248 DFG-funded adaptations - an increase of 16% on the previous year, and a also significant shift in terms of the total proportion and value of all work carried out by agencies. For the last two years, home improvement agencies have processed DFG funded work equivalent to half the entire central government allocation, so there can be little doubt that the sector is a key player in delivering the national DFG programme.

Our final Future HIA report, 'Adapting for a lifetime', has many positive messages about the health of this area of the sector. However, while our report can identify many examples of good practice and innovation within the sector and their partnerships with local authorities, the reality is that many adaptations services across the country are failing, and the combination of funding shortages and long waiting lists means that services are unable to meet the needs of disabled people. Many of the preventative benefits of such services are lost if adaptations cannot be installed quickly, and the current DFG system seems to be working against achieving this goal.

Research for this report found that adaptations work is much less within the control of home improvement agencies than the other services they offer. Some local authorities may use agencies to deliver services on the ground but do not involve them in a strategic way in designing better adaptations policies and improving process inefficiencies. There is also a lack of quantifiable evidence about the benefits of the holistic home improvement agency approach, and when dealing with a process heavily criticised for its slowness, complexity and the number of different hands involved, it can be an uphill struggle to convince commissioners that they are a force for good.

The report sets out a number of ways that home improvement agencies can lead the challenge to improve adaptations services within the budget constraints which are bound to have an impact in the next few years. Chapters look at:

• the context for changing our approach to adaptations

• results of research carried out by Foundations, including sector surveys in conducted in 2008 and 2009

• stretching adaptations budgets through recycling equipment, getting better prices from suppliers, encouraging the re-use of adapted accommodation, and more flexible use of funding 

• improving adaptations processes through comparing with others and re-engineering processes, as well as working better with other professionals involved in the process

• moving from a provider-led to a user-led process - already a key strength of the home improvement agency approach - the chapter links adaptations work to other key Future HIA themes of supporting choice and offering a broad range of options at an early stage, and

• demonstrating the value of adaptations to commissioners, which focuses on the importance of monitoring outcomes and also gives a number of case studies illustrating the breakthroughs  being made in linking the preventative benefits of adaptations services with wider health and care funding agendas.

Our conclusions and recommendations are quite challenging for the sector and will also pose questions to national and local adaptations policy makers.

The report can be found on our website. We welcome your comments on the report - please email these to Malcolm Ramsay.