Alongside the NHS 10 Year Health Plan’s focus on prevention and the community, and wider understanding for the need to reduce inequalities and support people to live independently for longer, the Royal College of Occupational Therapists' (RCOT) new Building Health into Homes report delivers a clear message: housing is health. 

The report highlights a growing challenge across the UK. Millions of people live in homes that are cold, inaccessible, overcrowded or unsuitable for their needs. Analysis shows that a huge 3.5 million homes in England are classed as ‘non-decent’, which affects 7.5 million people. Furthermore, 87% of homes fail to meet basic accessibility criteria. Poor housing contributes to a range of health issues, from falls and respiratory conditions to declining mental wellbeing and social isolation. At the same time, it places significant pressure on health and care services, driving avoidable hospital admissions, delayed discharges and increasing demand for support. In fact, poor housing costs the NHS in England £1.5 billion every year. 

For occupational therapists, these findings are unlikely to come as a surprise. The profession has long recognised the relationship between a person's environment and their ability to participate in everyday life. What the report does, however, is elevate housing from an individual practice issue to a strategic health priority. 

Too often, housing problems are addressed only once they have become a crisis. An older person may be admitted to hospital following a fall caused by an inaccessible home. Someone with a long-term condition may struggle to manage their health because their living environment does not support their needs. Delays to adaptations or housing support can lead to deterioration, loss of independence and increased reliance on health and social care services. 

The report argues that a more preventative approach on a structural level is needed - one that identifies and addresses housing-related barriers before they result in poor outcomes. Without this, wider NHS ambitions to shift care closer to home, reduce pressure on acute services and focus on prevention rather than treatment alone are unlikely to be recognised. 

Occupational therapists are uniquely positioned to contribute to this agenda. Through their understanding of the relationship between people, occupation and environment, OTs can identify how housing affects health, independence and participation. Whether supporting hospital discharge, assessing for adaptations, working in community rehabilitation or influencing service design, occupational therapists already play a vital role in helping people live safely and well at home.