Supported housing crisis: mental health patients stuck in hospital for 109,000 days

New figures reveal that hospital patients, ready to be discharged, spent 109,029 days (circa 300 years) stuck in mental health hospitals in England last year (2023/24) impacting their health outcomes and preventing new admissions, due to a severe shortage of supported housing, a new report by the National Housing Federation (NHF) has found. 
 
A lack of supported housing was responsible for a 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. Furthermore, the report reveals that the number of people unable to be discharged from general hospital for housing-related reasons, including a shortage of supported housing, has more than tripled since 2021, growing from 49 to 153 patients per week.
 
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 NHF survey found that 1 in 3 (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 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.
 
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. According to research with the University of York, without supported housing, an additional 71,000 people would be homeless or at risk of homelessness, we would need 14,000 more inpatient psychiatric places, 2,500 additional places in residential care and 2,000 more prison places.
 
Supported housing contracts are commissioned by councils, and should be based on local need. Charitable providers bid for these contracts and provide homes with tailored support services. 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 estimate that between 2010 and 2020, funding for supported housing was cut by 75%, equating to over £1bn.
 
Alongside cuts to council budgets, providers have faced increased cost pressures from rocketing inflation alongside energy price increases, and the cost of meeting essential new government regulation, environmental targets and building safety repairs. This has created a perfect storm, squeezing operating margins at the same time as contracts from councils are shrinking, making it impossible to cover staffing and support costs and leaving no option but to close schemes. A staggering 38% of supported accommodation services for single homeless people have closed since 2010.  
 
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 a 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.  
 
To secure the future of this vital housing provision and ensure people with support needs can continue to live independently in safe and affordable homes, 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. 
 
 
Rhys Moore, Director of Public Impact at the National Housing Federation, says:   

"These figures show the far-reaching consequences of years of cuts to funding for supported housing. Not only are tens of thousands of people, who deserve the opportunity to live a healthy, happy and independent life, being failed, but the shortage of these homes is increasing pressure on public services, increasing homelessness and costing the NHS and ultimately the taxpayer more in the long run.    
 
“Demand for these services is higher than ever and yet every year more supported schemes are forced to close their doors. ​N​ow the increase in employers’ NIC has made a critical situation even worse. To protect this vital provision, we are calling on the government to ​commit to significant investment ​for housing-related support at the Spending Review, as part of a long-term housing strategy.”