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Building Health into Homes: Strategic Report - How occupational therapy can unlock the connection between housing and health

Building Health into Homes Strategic Report cover sml

Poor housing is driving avoidable pressure across health and social care services and damaging people’s health. Millions of people are living in homes that do not meet their needs, identified in a this report by the Royal College of Occupational Therapists (RCOT) launched at the House of Lords in June 2026. 

Published in collaboration with Foundations, and building on RCOT’s 2019 publication by the Housing LIN, ‘Adaptations without Delay’, analysis in Building Health into Homes strategic report found that:

  • 3.5 million homes in England are classed as non-decent, affecting 7.5 million people
  • 87% of homes fail to meet basic accessibility criteria
  • One in five wheelchair user households in Scotland has unmet housing needs
  • Poor housing costs the NHS in England £1.5 billion annually.

Packed with practical examples, recommendations for leadership, preventative interventions, closer system integration improvements and workforce improvement, RCOT is calling for the governments of all four nations, local governments, and health, social care and housing systems to work together to address where people live. Health prevention and system reform can only be delivered once housing needs are met.

Housing is being addressed too late across the system. When people are discharged to homes that do not meet their needs, their health deteriorates and demand on services increases. This means people are not getting the right support at the right time. Poor housing is also driving health inequalities, with people in worse housing more likely to have poorer health.

Jeremy Porteus, CEO of Housing LIN, said: 

As part of the project advisory board, I was delighted to be invited to attend the launch of this report at the House of Lords. OTs play a critical role in assessing the adaptations needs of older and disabled householders and ensuring the right home environment can support independence. This report provides the practical examples about why delivering home improvements matter, demonstrating the health and wellbeing outcomes and care effectiveness of these vital interventions.