For some time now, the link between health and housing has been becoming ever clearer; the models through which housing associations can best offer their skills to help solve the growing challenges facing the NHS are, however, not as obvious.
Last week, Inside Housing ran a profile of the work housing associations are doing in conjunction with frontline NHS services to try and ease the escalating adult social care crisis. With other headlines last week shouting about the NHS ‘haemorrhaging’ some 33,000 nursing staff a year, the other part of the puzzle is what the sector can bring to the table on a wider affordable housing offer for NHS staff in order to try and stem that flow.
The Royal College of Nursing has said that, in London, 40% of nurses were considering leaving the capital over the next five years due the pressure of housing costs. Of them, 75% would be more likely to stay in London if their housing needs were met. The loss of valuable hospital employees could be disastrous for our communities.
So where do the opportunities lie? Project Phoenix is a plan set up by the NHS in England to sell hospital land and property in order to free up cash to tackle hospital repairs and replace unsuitable key worker housing. It could benefit tremendously from the expertise of a public and private partnership approach. Using cash from private investment firms and the building expertise of housing associations could ensure the right buildings are created and sold on surplus NHS land at the best market price. Profits would be split, but a substantial amount could still be ploughed back into the NHS.
As ever with any sort of house building, the challenge here is over land. Traditionally, NHS Trusts sell surplus land to the highest bidder – but housing associations can deliver longer term value for the NHS, by offering truly affordable housing for its staff and supporting front line services. The National Housing Federation has set out a great argument for rethinking the concept of ‘best value’ and how the housing association offer could help deliver real longer term value for the NHS. Fundamentally, cashing in for the highest land receipt has often been the key interpretation of what best value means, but as Inside Housing’s piece pointed out, short-term gain and fire-fighting are doing the NHS a disservice.
At Thames Valley Housing (TVH) we have helped deliver housing schemes at 9 NHS sites in and around London, from Hammersmith, to St Georges in Tooting and Frimley Park in Surrey. The latter of these stemmed from a partnership formed in 2015, when we bought derelict buildings and land near to the hospital, which belonged to the Trust. Planning permission had already been secured for 120 new and converted apartments and houses for private sale, as well as 86 key worker homes. We delivered these homes within two years, as well as converting the original Frimley Cottage Hospital, a locally-listed landmark, into apartments; in doing so we transformed the lives of the nurses and doctors who were previously living in dated and unsuitable key worker accommodation.
The homes are genuinely affordable; typical rents for the specialist key worker accommodation, comprising a single bedroom and shared living space, range from £576-£631 per month, including utilities and council tax. For a one-bedroom flat, the typical rent is £686 per calendar month. These costs fall well below the average rental cost of a similar property in Surrey which is currently £1,004 per month, according to home.co.uk*.
Although the sale of the private homes at the site funded the provision of the key worker accommodation and enabled us to channel 20 per cent more profit than originally anticipated back to the NHS, the partnership was more than a financial agreement. The delivery of the new homes for local doctors and nurses supported the hospital’s recruitment drive by reducing the problems associated with attracting good quality staff to provide essential local health and social care services.
However I think there is also a need for a wider affordable housing offer for NHS staff, not just one that focuses on matching delivery outputs to the trust’s recruitment needs as invariably that offer becomes focused on cluster type accommodation. Whilst this is highly affordable and serves the needs of singles, it is unsuitable for couples and growing families. Offering larger rented homes at sub-market levels coupled with access to home ownership through scheme likes shared ownership, could be a real opportunity to help with retention.
Housing associations are uniquely placed to develop and manage all of the tenures that will ease the NHS’s multi-faceted burden – from sheltered housing all the way through to shared ownership and private sale – in a single development.
However, for this to happen, I believe that more conversations need to be held around the use of surplus land; the housing sector could play an instrumental role in helping the NHS achieve value for money solutions at pace in a pressurised system. We just need to be given a fighting chance.