The issue of funding for old age needs no introduction. One of the Government’s much needed messages is that we are ill prepared for old age. We are living longer, much more so than we admit to ourselves, and we have saved too little. We can of course work longer and it’s well known that the ‘older person’ has much to offer in the work place.
But a less well known issue is that, although we are living longer, the length of time we are living without medical problems is not. Already people aged over 65 are the biggest consumers of spending within the NHS. Our increasing longevity will make the demands upon the NHS from this group ever more disproportionate.
Having gained deep experience in housing related analytics and planning we are now looking at the potential impact upon housing from the trends facing us over the next 20 years, and some startling findings are emerging.
Within a retirement village for whom we are providing strategic planning, the on site care and nursing facilities will have to double in size if we don’t rethink care provision. That means more staff and more buildings – not just to provide care, but to also house the staff. Approximately 50% of the caring service within the Village is provided by people from overseas. A doubling in size would only be possible with more immigrants, not a realistic proposition unless they have somewhere they can afford to live.
Here, and across the NHS, we have to find ways to provide care with less staff involvement. It means a greater capability for self-care, better use of technology, the ability for family and friends to provide support, and properties that are fit for purpose.
But this doesn’t seem to be on the radar within our social housing providers. Given that the life of a property is in the region of 60 years, those being built today need to be designed with future care needs in mind. Social housing providers house a significant proportion of the country’s older persons who in turn are likely to bear a disproportionate number of the complex health issues that will accompany increased old age. But properties being built today don’t appear to reflect this.
Can, for example, today’s properties permit good use to be made of ‘tele-health’ and ‘tele-care’ technology that has been shown to dramatically reduce admissions to hospitals?
How does the obsession about numbers of bedrooms in properties help family and friends to provide a level of support that could prevent long term health complications from escalating?
To what extent should the aids and adaptations that those with care needs can request be considered when a property is designed? The cost of inclusion at the design and build stage will be a fraction of the cost of subsequent adaptation.
Housing Associations are rightly wary about entering the market to provide care for their customers. Our analysis makes the risks and costs apparent. But if their stance is that long term provision of care is a problem just for Local Authorities and Social Services to solve then they are missing a big opportunity to make a big difference. The ability to provide person centred care to someone in their own home is going to really matter. But it will only be possible if the home is fit for purpose.
If anyone would like to see strategic analysis that makes the point loud and clear then please get in touch.