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The Cost of Unhealthy Housing to the NHS

It's estimated that poor housing conditions in the UK cost as much as £2.5bn annually. The NHS has established new initiatives to support healthy housing, but policy makers and organizations must address these issues holistically in order for them to succeed.

By

Date

February 28, 2019

On Tuesday, February 26, the All Party Parliamentary Group (AAPG) for Healthy Homes and Buildings held a debate on the cost of unhealthy housing in Westminster Hall, based on a White Paper published earlier this past autumn, that IBI Group contributed to. The White Paper up for debate addressed numerous issues relating to health and wellbeing in UK homes and buildings. We welcome the approach of the APPG to continue to work with others, and we would hope a key part of future engagement would integrate homes and buildings as part of a much wider system that supports health and wellbeing initiatives.

When designing these buildings with health in mind, daylight, temperature, internal air quality, internal layouts, and space allowances must be considered holistically. All of these factors can influence positive health and wellbeing, and in turn, support communities to lead healthier lives. However, the internal environment of a home or building cannot be isolated from the external environment. Nor can you expect healthy homes to automatically lead to healthier citizens without putting the conditions in place to encourage healthier lifestyles. Both of these factors must be considered alongside our homes and buildings themselves and we look forward to further collaborative work, including with other APPG’s that are examining improvements in the external environment.

This timely debate links to the recently published NHS Long Term Plan which places an increased focus on population health and includes new commitments to prevent ill health. Supporting health and wellbeing through home and building improvements clearly connects to this plan as well.

The government has committed to building an average of 300,000 new homes a year, and there is a real opportunity for cross-department collaboration, innovation, and wellness-driven design practices in order to achieve this goal. Building regulation standards can be used to improve the emphasis on health and wellbeing in design, and this should be explored. Alternatively, incentive programs based on achieving new evidence-based standards like Fitwel or WELL could be considered to achieve higher standards in new homes or buildings.

The government has the opportunity to explore potential pilot programmes through channels such as the NHS Land Disposal programme. Under this programme, surplus NHS land is used to support new local housing needs through land disposals. Could this programme support innovation and new approaches to housing design that achieves long-term value for the healthcare system through the conditions in which it sells the land?

The recently established NHS Healthy New Towns Network of house builders and housing associations could provide a delivery route for such pilots on NHS surplus land, given their commitment to prioritising health and wellbeing. The network has committed to promoting the innovations piloted in the Healthy New Town demonstrator sites within their own developments. Linking these networks to the disposal programme could lead to developing progressive healthier homes and buildings.

Without an incentivised pilot programme to support the growth of a central evidence base, there is little enticement for house builders to adopt such principles. While there is much guidance on the subject matter of health in place, practitioners comment that ‘the lack of a centralised evidence base makes conversations about going beyond minimum standards a significant challenge’.

Could the long-term role of the Healthy New Towns initiative be to create a centralised base for assessment and collation of evidence and best practice? This could take place over the longer term, and continually evolve and develop based on knowledge from completed and evaluated projects.

While the White Paper offers some welcome recommendations which could tighten building regulations to avoid harm, a more holistic approach that considers both internal and external environments should be part of any further dialogue and debate.