Nuffield Trust

Will the State of England’s Housing Thwart ‘Hospital to Home’ Shift? Summit 2026 Session

The summit’s final session examined whether England’s deteriorating housing stock will sabotage the NHS’s ambition to shift care from hospital to home. Panelists noted that the NHS’s virtual‑ward and hospital‑to‑home programmes rely on safe, accessible homes. Yet millions of properties are overcrowded, damp, poorly insulated or lack basic accessibility. Private‑rented accommodation often stalls adaptations for years, creating bottlenecks that translate into delayed discharges, preventable readmissions and added pressure on carers. Martha Hall’s testimony illustrated the human cost. Citing Francis Ryan’s warning that “disabled people are vulnerable when governments withhold resources,” she recounted being forced into homelessness after psychiatric admission, receiving unsuitable temporary housing, and enduring weeks of unsafe conditions despite occupational‑therapy recommendations. Her annual care cost of £36,000 contrasted with £110‑220k per year when institutionalised, underscoring systemic inefficiencies. The discussion concluded that without a coordinated housing‑health strategy, NHS targets will falter, health inequalities will widen, and public spending will rise. Investing in rapid home adaptations, expanding social‑housing stock and aligning local‑authority planning with NHS discharge pathways are presented as urgent policy levers.