Published date: 27 June 2019

Blog: How can we build healthier homes and places?

Read John Westwood's blog on the possibility of building healthy homes

At NHS Property Services, we believe it’s possible to build healthy homes and places and secure vital reinvestment for the NHS at the same time. To this end, we are launching a campaign this year to better understand what ‘healthy housing’ is and how we can support the industry in delivering it.

To kick-off the campaign, we held our first ‘Health and Housing’ roundtable this month, which brought together senior colleagues across a number of sectors to act as a sounding board for our ideas. We had architects, planners, lawyers, developers as well as 3rd sector organisation seeking to create more inclusive intergenerational communities, which produced a fascinating debate that addressed how housing and place impact on our nation’s health.

What we learnt

The roundtable produced a number of interesting discussion points, and the key findings for me were:

First and most importantly, our homes could be ‘healthier’. On this there was consensus round the table. From poor housing stock, minimum space standards becoming the maximum, to overheating and indoor pollution, it was agreed that the homes we live in can have a detrimental effect on our health, and that there is much more that can be done now that would start to solve this. The consequence for the NHS is straightforward: a healthier population means less pressure on the health service.

Outside the home, the provision of communal spaces, green spaces, and mixed-uses increase wellbeing. A property developer discussed how his development seeks to reduce illness and isolation by facilitating more social inclusion and community engagement. With the rise of build-to-rent, developers are thinking longer term on how to best use their shared spaces to retain rental tenants for longer. This was just one of the strong arguments that advocated for focusing on the social (and environmental) value of well-designed places as well as their financial worth.

Second, healthcare needs to be closer to the community. With the health service under unprecedented financial pressure and the estate being transformed to meet the needs of modern healthcare, we need to find ways to bring health services and facilities closer to the communities they serve.

One model for this, social prescribing, provides positive health outcomes using non-clinical treatment such as yoga, gardening and painting, as part of healthcare facilities. There is emerging evidence this can create positive health outcomes with great examples such as at the Bromley-By-Bow Centre in East London.

Elsewhere, we can take simple measures, such as reimagining a currently underutilised NHS estate. At NHSPS, we have launched ‘Open Space’, which makes rooms in NHSPS properties available to commercial, charity, clinical or social prescribing uses; this generates footfall, makes better use of NHS resources, and even has the potential to deliver a revenue return for the NHS.

One of the most interesting points of discussion was the high street and how healthcare services could be central to reinvigorating increasingly run-down town centres. In the UK, housing is typically concentrated around the high street, so integrating primary care services such as GP surgeries into large housing developments would be a terrific way to bring healthcare to a reimagined community space. In fact, other research shows that private development could fund healthcare facilities on site through innovative construction and funding methods such as overbuilding, where homes are built above public assets.

Finally, it was agreed that to deliver on this, the NHS could be better integrated, although this is difficult considering the pressure on financial resources. One participant suggested the idea of a “patient care hotel” for in and outpatients that would save NHS bed space. This was just one example, but key to the success of any new model is a viable business case and clear health outcomes that are strategically planned. In this context, the NHS Long Term Plan’s ambition for more Integrated Care Systems, which bring together NHS bodies as well as local authorities and other third parties, is very much welcome.

Next Steps

These points will guide the direction of our health and housing campaign as we further explore this topic throughout the year. Ultimately, we want to find a way to facilitate much needed new housing, create healthy communities, and also support the NHS through reinvestment of capital receipts from disposing of land that clinicians no longer need.

I would welcome contributions from others interested in this campaign, so if you have strong opinions either way please get in touch.