When we think about the future of housing in England, we often picture first-time buyers, families on waiting lists or regeneration schemes in towns and cities. But one of the biggest and most urgent housing challenges we face is not being talked about nearly enough – the growing need for age-appropriate older people’s housing.
The Government’s upcoming Housing Strategy for England and the Spending Review are vital opportunities to address this issue. Without serious, long-term investment in retirement and extra care housing, we risk failing a generation of older people – and placing additional, but avoidable, pressures on hospitals, residential care services and the wider health and care system. This is not just a housing issue. It is a cross-sector challenge that affects everything from health and social care capacity to local infrastructure and community resilience. Improving older people’s housing options is one of the most cost-effective and human-centred actions the Government could take.
A growing issue
Our population is ageing rapidly. According to the Office for National Statistics, by 2043 nearly one in four people in England will be aged 65 or over, yet our housing supply has failed to keep pace with the changing demographic profile of the population.
Compared to other developed countries, such as the United States and Australia – where retirement communities and integrated housing with care models are far more common – the UK has a striking shortage of age-appropriate housing. This leaves many older people stuck in homes that are unsuitable, unsafe or unaffordable. Poor-quality or inaccessible housing increases the risk of falls, hospital admissions and delayed discharges. Falls are already the leading cause of injury-related hospital admissions among older people in England, with more than 220,000 emergency admissions recorded each year.
Across people of all ages, poor housing conditions are responsible for around 500,000 injuries that require medical attention each year and are estimated to cost the NHS at least £1.4 billion in additional treatments. For older people, living in inappropriate housing can also contribute to isolation, worsen long-term health conditions and ultimately lead to higher demand for costly residential care. Despite repeated warnings from across the housing and care sectors, successive governments have failed to grasp the scale of the challenge. Strategies and funding programmes to date have made limited reference to older people’s housing, with no long-term delivery targets, ringfenced funding or joined-up approach. This silence risks becoming a scandal if we do not act.
What do we need?
Any meaningful Housing Strategy must do more than mention older people in passing. It must recognise the scale of need and treat specialist housing as a vital part of the country’s infrastructure – as essential as schools, hospitals and transport networks. At Housing 21, we believe that at least 20% of the 1.5 million homes promised by the Government in England should be specifically designed for older people. That figure reflects both the proportion of the population and the scale of need across the country.
Meeting that target will require dedicated funding streams, such as specific allocations within the Affordable Homes Programme or a revitalised Care and Support Specialised Housing Fund. This should be alongside planning reforms that prioritise age-appropriate housing and joined-up policy between housing, health and social care. Funding mechanisms must also be reviewed to make it viable for providers to deliver retirement and extra care housing at scale. Currently, the complex and fragmented funding landscape makes it extremely challenging to develop schemes that are affordable for older people while remaining financially sustainable.
Planning systems also need reform. Local plans rarely prioritise older people’s housing and specialist providers often face lengthy, costly and unpredictable processes that delay or derail much-needed developments. We must remove the practical and financial barriers that prevent housing with support or care from being delivered where it is most needed.
The evidence for investment is overwhelming
Specialist housing is not just better for individuals – it is more cost effective for society as a whole. Housing 21’s own experience shows that extra care and retirement housing enables older people to live independently for longer, with reduced reliance on domiciliary care packages, hospital stays and residential care placements. Residents report improved health, wellbeing and quality of life. Local health and care systems benefit too, with lower demand for acute services and a smoother flow through hospitals.
Broader sector research reinforces this. A 2024 report by the National Housing Federation highlighted that shortages in supported housing are contributing to delayed discharges, costing the NHS £71m a year. Other analysis shows that building 90,000 new social homes – including specialist housing for older people – could save the public purse significantly over the long term by reducing benefits payments, healthcare costs and pressure on public services. Investing in the right housing now could relieve huge financial pressure, while providing older people with dignity, security and choice.
The cost of inaction
If the Housing Strategy and Spending Review fail to make older people’s housing a priority, the consequences will be severe. Thousands of older people could remain stuck in hospital beds because there are no suitable homes for them to move into. Demand for costly residential care will continue to rise, placing additional strain on already stretched social care budgets. Local authorities will face growing challenges in providing support, while hospitals will see further pressure on discharge pathways and step-down care.
There is also a social and emotional cost. Too many older people are already living in homes that isolate them from their communities or put them at physical risk. Without appropriate housing, people’s health deteriorates faster, their independence is lost sooner and their need for higher-cost care grows more urgent. And when older people can’t move, their larger, family-sized homes remain occupied by one or two people, limiting opportunities for younger households and creating bottlenecks throughout the housing system. In short: the absence of a clear strategy for older people’s housing does not just affect older people – it impacts us all.
A chance to lead – and a duty to act
The upcoming Housing Strategy and Spending Review present an opportunity to get things right. The Government must show leadership by placing older people’s housing at the heart of its plans for the future. That means moving beyond short-term fixes and towards a genuine, long-term vision that recognises the vital role of specialist housing in building a sustainable health and care system.
Housing 21 is ready to play its part. We have the expertise, the experience and the commitment to deliver the homes that older people need and deserve. We work every day with residents whose lives have been transformed by moving into retirement or extra care housing. We have seen firsthand how the right home, with the right support, can help someone regain independence, rebuild social connections and live a fuller life for longer.
But we cannot do this alone. We look forward to working with commissioners, care leaders and policymakers to make this ambition a reality. Older people have contributed throughout their lives to our communities, our economy and our society. They deserve better than to be overlooked once again. Now is the time to act – for today’s older generation and for all of us who hope to age with dignity, security and independence.
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Bruce Moore is Chief Executive of Housing 21. Email: [email protected] LinkedIn: @Housing-21