Salus journal

Healthy Planet. Healthy People.

Senior care / Healthy Cities

Healthcare at home: right size, right location

By Mohammed Ul-Haq and Neil Orpwood 10 Oct 2019 0

This poster aims to discuss the importance of the existing urban environment and its role in providing the foundations of good elderly care accommodation.


The debate on housing is well known. A number of reasons, we’re told, drive a chronic shortage, whether open-door immigration policy, greedy landlords, NIMBYs, or even private housing developers limiting the flow of houses entering the market to avoid devaluing their land.

Governments typically like their policy gestures painted in primary colours. But with 16 housing ministers in 20 years, a slew of policy interventions that have failed to hit the target and an ongoing, entrenched gap between aspiration and reality, urgent action is needed. It feels that the response from repeated governments to this complicated and multi-faceted social issue is chest-banging optimism or lunging from one reactive measure to another – whether that is a tweak to the planning system, Help to Buy or altering Stamp Duty thresholds. All solutions thus far have failed to adequately respond to the challenge. 

Consecutive budgets have set ambitious targets of delivering 300,000 new homes a year with just over half that figure actually built. The aftershock of this housing crisis is felt across multiple sectors of public policy, not least in housing for the elderly and healthcare in general. Figures suggest the 55-79 age group are sitting on £720bn worth of homes, with a quarter of this age group considering downsizing but put off by the lack of quality and attractive options to meet their changing needs. This can be solved; lack of choice, quality and flexibility can be addressed. Sensitivity to the importance of health, wellbeing and community can reframe the options. 

A more systemic remedy is required to enable significant and sustainable change. This has brought us to the conclusion where a two-pronged approach is required in order to tackle this growing problem. The first approach is to develop suitably designed elderly care accommodation that allows the user to remain in their chosen accommodation for as long as possible – fighting the conveyor belt of care accommodation brought on by declining health and the need for increasing care. 

The second approach recommends that the road to significant change must begin with the location. Too often, elderly care facilities are isolated and remote, attempting to re-provide facilities and functions that are readily available in our towns and cities. Our aim is to discuss the importance of the existing urban environment and its role in providing the foundations of good elderly care accommodation.

Organisations involved