Setting the direction for making housing a prevention priority
A clear and practical route to action on housing for leaders across health, housing and social care
People are living in homes that are making them ill, and it is driving avoidable demand across health and care.
Housing must be treated as a core determinant of health and a central part of prevention.
RCOT’s Building Health into Homes Operational Toolkit sets out how leaders across health, housing and social care should act on one of the biggest drivers of system pressure – people’s homes.
This follows RCOT’s Strategic Report, which set out the evidence and system case for change. The focus now is delivery.
This toolkit shows how systems can put that into practice.
The scale of the issue
- Poor housing costs the NHS in England £1.5 billion every year, with wider societal costs of £18.5 billion annually.
- 3.5 million homes are non-decent, affecting millions of people.
- 87% of homes fail to meet basic accessibility standards, limiting independence and increasing care needs.
- People discharged to unsuitable housing are significantly more likely to be readmitted to hospital.
This cannot continue.
The case for change
Housing is still addressed too late. People are not getting the right support at the right time, and avoidable pressure is placed on already stretched services.
The case for change is clear: housing must be embedded in how systems deliver prevention, reduce pressure and improve outcomes.
Read the Strategic Report to understand the evidence and system case for change
System leaders have an opportunity and a responsibility to act now
Leaders across the NHS, Integrated Care Systems and local authorities have a direct role in changing this. Chief Executives, Directors of Adult Social Care, public health leaders, housing leaders and service leads can reshape how services are designed and delivered.
What needs to happen now
The Operational Toolkit provides a clear and practical route to action.
It brings together tools, guidance and real examples to support leaders to:
- strengthen collaboration across health, housing and social care
- embed housing within prevention, population health and system priorities
- make the case for investment in earlier housing-led intervention
- design services differently to reduce avoidable pressure on acute and crisis care.
Scaling success
This approach works, and it should now be scaled.
System leaders need to act now to:
- review the toolkit at the executive and system leadership level
- embed housing within strategic priorities and delivery plans
- work across partners to identify immediate opportunities for action
- prioritise early intervention to reduce long-term demand
RCOT is calling on system leaders to make housing a core part of how prevention is delivered and how demand is managed.
Impact on display
Where systems are taking this approach, results are already being seen.
Earlier occupational therapy involvement and housing-focused interventions are reducing hospital admissions, enabling faster discharge, improving independence and delivering cost savings.
In Essex, a specialist housing occupational therapy service has reduced waiting times for urgent housing interventions from more than 84 days to just 2–21 days, helping to prevent avoidable hospital admissions and support earlier, safer discharge from hospital.
Martha's story
The impact is also being felt by individuals.
Martha, a disabled woman from South West England, spent more than a year longer than necessary in an inpatient mental health setting while waiting for suitable housing.
After occupational therapists helped ensure her housing needs were properly understood, she was matched with a genuinely accessible home that supports her independence and wellbeing.