Healthy housing interventions to reduce health and social care demand

Key statistics 

• a 2013-14 study found a 39.5% reduction in A&E use and a 53.8% reduction in acute hospital stays among clients with a history of falls receiving support 

• 86.3% of clients reported improvements in health, wellbeing, anxiety, confidence and feeling safe at home 

• in 2015-16, 20% fewer Hub clients were admitted to hospital for emergency inpatient care compared to a matched control group 

• 91% of clients remained living in their own homes 12 months after intervention 

Key messages 

• addressing housing-related risks can reduce emergency healthcare use and improve wellbeing 

• partnership working between housing, health and social care services supports identification and engagement of vulnerable individuals 

• targeted interventions such as home adaptations, heating improvements and hazard reduction can prevent deterioration in health 

• preventive, place-based approaches can reduce demand on NHS and social care services 

• interventions can support people to remain living independently for longer 

Policy implications 

• integrate housing services into health and social care planning and delivery 

• prioritise preventive interventions targeting people at highest risk of poor housing-related health outcomes 

• support cross-sector referral pathways between GPs, hospitals, social care and housing services 

• invest in low-cost home improvements as part of wider strategies to reduce hospital admissions 

• embed housing as a key determinant within local health and wellbeing strategies 

Gaps 

• evidence is based on local service evaluations rather than peer-reviewed research 

• limited detail on long-term outcomes beyond one year 

• the study focuses on one city, which may limit generalisability to other areas 

• limited exploration of user experience beyond selected case studies 

• no detailed cost-effectiveness analysis presented alongside outcomes 

Commentary 
This case study shows how housing conditions directly affect health and social care outcomes. The Healthy Housing Hub targets people whose living environments put them at risk, including older adults, people with long-term conditions and those on low incomes. 

The findings show clear reductions in emergency care use and hospital admissions. Improvements to heating, safety and home conditions appear to reduce risks such as falls, illness and delayed hospital discharge. The data presented in the evaluation summary highlights the scale of these changes, including reductions in A&E use and increased independent living. 

A key strength of the model is its collaborative approach. Referrals from health and social care professionals allow the service to reach people who may otherwise not engage with housing support. This helps target those most at risk of poor outcomes. 

From a health and social care equity perspective, the Hub addresses inequities linked to poor housing. People living in inadequate housing are more likely to experience ill health and higher use of emergency services. By improving living conditions, the service reduces some of these avoidable differences. 

The case study also shows that relatively low-cost interventions can have a significant impact. Simple changes such as installing heating, removing hazards or improving accessibility can support people to remain at home and reduce reliance on more intensive services. 

Overall, this example highlights the importance of housing as part of an integrated health and social care system. Without addressing housing conditions, efforts to reduce health inequities are likely to remain limited.