For future living: Innovative approaches to joining up housing and health

The 65-plus age-group is set to be England's fastest growing in the next decade. This reflects some positive trends – medical advances mean people can expect to live longer, fuller lives – but demographic change brings with it challenges as well. The number of single-person households is growing, especially in older age, meaning that less informal support and care is provided within the home. At the same time, the costs of providing adult social care for both older and vulnerable people are increasing, putting strain on local government finances and the NHS.

For too long, the policy realms of housing and health have been disconnected, with each tending to follow its own path. This gap becomes more visible, and more important, as people age. Older people spend more time in their home than other age-groups (HAA 2013), are more at risk of poor health, and consume over three-fifths of all social care spending (NAO 2014). It is therefore essential to ensure that the place they live in supports them in maintaining good health.

The housing options available to older people in England remain poor. More than a fifth of homes fail to meet the Decent Homes standard, more than a decade after its introduction. Fewer than 5 per cent fulfill all four of the key accessibility criteria, and more than a quarter meet none. New developments are not filling the gap, which means that older people looking to downsize or move into more appropriate accommodation as their personal circumstances change may struggle to find an appropriate property: a 2012 study found that just 28 per cent of over-55s had moved home in the previous 10 years, compared to 66 per cent of other households.

The challenge for the market, social housing developers and policymakers is to develop housing both that people want to live in, and that permits people to live healthy, independent lives in their home for as long as possible. This report focuses on reform options in mainstream housing, for example to improve standards in new-build homes, and specialist housing developments, for example to increase the range of choice available to older people.

In addition to a review of international examples, the report takes into account the results of focus group discussions with both over-55s and over-65s.

Our recommendations fall under three broader objectives.

• Helping people to adapt their homes: for example, by improving the disabled facilities grants system, including by allowing GPs to 'prescribe' home adaptation grants where a patient's health would benefit.
• Ensuring housing reflects societal changes: for example, by locking space standards and the 'Lifetime Homes' standards into building regulations, and ensuring they are conditions of any publicly funded housing developments.
• Supporting people to look after one another: for example, by testing 'intentional community' models, where self-organised groups are empowered and supported to develop new housing and in-home care services that fulfill their own needs.