With babies born in the 21st century expected to live, on average, to 100, by 2050, one in four people in the UK will be over 65. And they will all need somewhere to live that is suited to their needs. Most adults in later life experience some form of ill health, such as arthritis, cognitive impairment, heart problems or issues with hearing and vision.
The problem is that the UK housing stock is nowhere near ready to cater to this need. Only 9% of British homes meet basic accessibility standards.
In 2023, over one in five people in the UK were living with a disability. And yet, there were more than 20,000 people on English local authority waiting lists for wheelchair and accessible homes. Some people have been waiting for decades. Demand is far outstripping supply.
This matters not just to the people whose lives are impacted by ill-suited homes. Our research shows that suitable housing not only supports health and wellbeing, but also plays a crucial role in reducing health inequalities and alleviating the long-term burden on health and social care systems. Every £1 invested in preventative home improvement measures can save up to £7 in healthcare costs.
The impact of poor housing
The UK builds the smallest new houses in the western world. And size matters: the smaller the house, the more difficult it is for those people with disabilities to move around and live fulfilled lives.
Space limitations can lead to all kinds of problems. Cramped entrance lobbies and hallways make coming and going difficult. Bathrooms located on upper floors are not accessible to people with mobility difficulties. Those located on the ground floor are often too small to accommodate disabilities.
The World Health Organisation has long highlighted quite how much this compromises people’s ability to cater to their personal hygiene and care needs. On a societal level, it also has severe consequences for the healthcare system. As journalists Melissa York and Georgia Lambert put it in 2023:
Poor quality housing costs the NHS £1.4 billion a year, yet the relationship between housing and health is rarely acknowledged.
Older adults, and those individuals with disabilities, are often forced to stay in the hospital longer than they need to, when their homes are unsuitable to their health needs. Pundits and experts alike have repeatedly warned that the UK’s social care system is at breaking point. Poor housing is routinely cited as a major cause.
Why we need supportive housing design
Built environment professionals, including architects, stress the importance of reimagining housing design by establishing Part M Clause 2 (category 2) of the Building Regulations as the baseline to better support healthy ageing. In practical terms, this means creating homes that are accessible and easily adaptable.
This means walls that can be easily be moved or removed to accommodate changing mobility requirements, or floors and walls equipped to support hoists and grab rails. A 90-year-old great-grandmother can live independently if her home features wide doorways, no-step entrances and a walk-in shower with grab bars.
Most people think that implementing these changes is costly. But actually, while more space is needed for a home to be made truly accessible and adaptable, the associated building costs are only marginally higher. Reinforced walls and floors or wider doorways can result in minimal additional expenses during the construction phase.
Introducing this kind of feature can, in fact, help to level up standards across the UK, which in turn can promote long-term cost effectiveness.
The John Morden Centre in Blackheath, London, illustrates how thoughtful design can support older residents’ quality of life. Designed by London-based architectural practice Mae Architects, this elderly daycare facility is housed in a sequence of red brick pavilions featuring communal spaces for social interaction, activity areas and gardens.
In 2023, it won the Royal Institute of British Architects’s Stirling prize for design choices, the institute said, that “sensitively anticipate the varied needs, abilities and disabilities of users”. These choices include level door thresholds, concealed handrails, walkways with built-in seating and floor edging with high-contrast patterns that provide, the institute says, “dementia-friendly wayfinding”. This supportive environment fosters independence and wellbeing in its users.
Of course, ideas need to be put into practice for them to really change the way people live. In construction terms, this means that supportive design needs to be enshrined in building regulations and the wider housing policy.
Right now, UK building regulations require builders to make reasonable housing provision for a wide range of occupants, including older people, those with reduced mobility and some wheelchair users. This includes guidance for wider corridors and door opening widths, larger room sizes and provision of a ground floor wet room etc.
But this is not compulsory. The UK’s reliance on mass housebuilders to fulfil its housing needs explains why the government has been reluctant to make this more than a recommendation.
Making such design regulations compulsory would see the housing industry effectively contribute to reducing the burden on the NHS and our social care system. It would improve the quality of life for older and disabled people at home. And it would promote independent living for longer. A residential care place can cost between £50-£90k for an average two-and-a-half-year stay, or £380-£700 per week.
Enabling individuals to remain in their homes for extended periods would result in savings for both residents and local councils. This is particularly crucial considering the mounting pressures confronting local authorities, many of which are teetering on the edge of bankruptcy due to the escalating demand for social care services.
Architects talk about resilient housing to describe homes that are built for the long-term with sustainable healthy ageing in mind.
Currently, the homes on most residential streets in the UK are not built for the long-term. The construction industry prioritises single-use homes and operates on a demolition-first mentality.
People’s needs change as they get older. But ageing and disability should not be barriers to health, wellbeing and everyday activities within the home. The homes we live in should allow us all to thrive and contribute to society, at every age.