Assessing the economic cost of a community unit: the case of Dr Barnardo's Intensive Support Unit

The number of children resident in large mental handicap hospitals has fallen substantially in recent years but those that remain tend to be amongst the most profoundly handicapped. If the benefits of community care are to be extended to this group of children then new residential facilities will have to be sufficiently resourced to cater for their special needs. In this discussion paper we report on the economic costs of one such unit, the Dr Barnardo’s Intensive Support Unit (ISU) in Liverpool, which was established especially to accommodate severely mentally handicapped young children. The paper begins with a brief description of the concept of economic cost and a discussion of how the general methodology was applied in practice. The costs of care in the ISU are then compared to the costs of caring for children with similar high levels of disability in an NHS community unit. Although the ISU is found to be initially more expensive per child than the larger NHS unit it has succeeded in its policy of finding foster homes for its children. This success is not only likely to improve the welfare of the children but also reduces the long-term costs of their care. The unit has not been in operation for long enough to ensure that all the costs of foster care are included, However, after three years, it does appear that ISU based care is no more expensive than care in a larger NHS community unit.