As awareness of the problems related to bed-blocking in the NHS grows across mainstream media, new figures reveal that patients who are ready to be discharged spent 109,029 days (circa 300 years) stuck in mental health hospitals in England in 2023/24, impacting their health outcomes and preventing new admissions, due to a severe shortage of supported housing.
Furthermore, the number of people unable to be discharged from general hospitals for housing-related reasons, including a shortage of supported housing, has more than tripled since 2021, growing from 49 to 153 patients per week.
These findings are detailed in a new report by the National Housing Federation (NHF). A lack of supported housing was responsible for one-fifth (20%) of all delayed discharges, and nearly three-quarters (73%) of all housing-related delayed discharges , from mental health hospitals. These delays cost the NHS an estimated £71m last year.
The role of supported housing
Supported housing provides homes with support, supervision and care to help people with a range of support needs to live independently. A growing number of supported housing schemes have been forced to close in recent years, as the sector faces a financial crisis due to the combined impact of cuts to council contracts and rising running costs. A survey by NHF found that one in three (32%) supported housing providers in England have had to close schemes in the last year due to financial pressures. These schemes were home to residents including young people leaving care, older people, people with learning disabilities, survivors of domestic abuse and people who have been homeless among others.
There are currently around half a million supported homes across England. However, the provision of these homes is falling; there are 1,540 fewer supported homes today than there were in 2007*, whilst the population has grown by 12%. The loss of these services has not only increased pressure and spending across public services, such as the NHS, but also puts people with support needs at risk of homelessness and poorer health outcomes.
Pressure on schemes
The government’s Supported Housing Review estimates that between 211,200 and 490,200 additional supported homes will be needed across England by 2040 to meet demand. However, the NHF says that a combination of the cuts to council budgets, cost pressures from inflation, rising energy costs and the cost of meeting new government regulation, such as environmental targets and building safety repairs, is creating a perfect storm, making it impossible to cover staffing and support costs and leaving no option but to close schemes.
On top of this, the planned rise in employers’ National Insurance Contributions (NIC), due to come into effect from April, further threatens the viability of these services. Whilst the government has provided a rebate for public employers, including local authorities and the NHS, there is no such protection for supported housing providers.
Without urgent action from the government to increase funding, providers responsible for one-fifth (18%) of all supported homes, have said they may have to stop providing services altogether in future. This would mean the loss of 70,000 supported homes across the country, and compound further the knock-on effects on the NHS.
The NHF is calling on the government to clearly identify funding for housing-related support allocated to local authorities in England. This will require at least £1.6bn annually and should form part of the government’s long-term housing strategy.
* In 2008 the ring-fence on council funding for housing-related support was removed. As a result, when council budgets were slashed from 2010 onwards, this vital funding was diverted to other areas of council spending, leading to lower value contracts year-on-year, with some councils decommissioning supported housing services altogether. The National Audit Office estimates that between 2010 and 2020, funding for supported housing was cut by 75%, equating to over £1bn.
