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Extra care housing enables older people to remain in their ‘own home’, while providing appropriate housing and access to health and social care services that are responsive to their needs. This type of provision is very much in line with the government policy of fostering people's sense of control and independence, and is a priority area for expansion. We explored the current levels of development and expansion of extra care housing in terms of the numbers of schemes and places and factors that contributed to and were problematic in its development.

Using some case examples from Care & Repair England in the UK, this paper aims to focus on the integration of housing help in a hospital setting.

The paper gives some background on Care & Repair and the development of local housing and hospital linked projects. The broader debate about the role of housing is then considered.

Key recommendations from the case studies are discussed and the wider debate on improving integration is considered in relation to the UK Government's recent Care and Support White Paper.

The paper considers the role that housing plays in health and social care provision and why people engaged in the sector should continue to work towards better integration of housing, health and social care.

Older people (particularly 75 years+) are the main users of health and social care services. They are also the age group most likely to occupy non‐decent homes. Government health and social care policy is increasingly focused on enabling more older people to remain living independently in their own homes and on delivery of care ‘at or closer to home’. This article considers how greater recognition of the negative impacts of poor‐quality and inappropriate housing on older people's health and well‐being, combined with targeted housing repair and adaptation assistance, could contribute to achieving a range of current health and social care objectives, including enabling older people to live independently in mainstream housing and better management of chronic health conditions.

In this article we first give the facts on what extra care is. Second, we make a few points on what really helps improve commissioning. The article draws on innovative and up‐to‐date material developed for the Department of Health's Housing Learning & Improvement Network by Moyra Riseborough from CURS at the University of Birmingham and Peter Fletcher of Peter Fletcher Associates. To see more about the Housing LIN and its work, readers should go to its website at www.doh.gov.uk/changeagentteam/housing‐lin.htm.

In July 2007, Housing 21 began an exploration of how changes to the system of social care called personalisation might impact on specialist housing provision in England. Personalisation now forms the basis of English social care policy focusing the delivery of public services on what people might want or choose, in the context of eligibility criteria and means testing. It is designed to promote greater choice and control of the support that people receive.However, there have been concerns that the views of older people living in extra care housing settings have not been heard in the implementation of personalisation. In 2008‐09 Housing 21 engaged older people and other groups with an interest in sheltered and extra care housing to debate the implications of personalisation for current and future housing, care and support services. This article discusses what arose from this consultation and its relevance to housing providers and commissioners.

This year's Reith lectures focused on older people and questioned the inevitability of the ageing process. One lecture was to an audience of older people living in an ‘extra care’ scheme focused on activity and health ‐ ‘adding life to years’. In a specially commissioned series of articles, Nigel King explains how extra care models and new ‘retirement communities’ are becoming an alternative to residential care and traditional sheltered housing. The first offers a typology for extra care. The second will be about modelling the care services, and the third on land and building development issues.

The Government's drive to improve the overall health of the population, by tackling health inequalities and measures such as reducing falls and ending fuel poverty, has created a policy framework to address the housing related aspects of health. Opportunities for the NHS and local authorities to work with the voluntary sector to achieve these aims mean that there are new possibilities for wide‐ranging, innovative responses to improving people's health by tackling housing issues.Care & Repair England has undertaken research which examines how home improvement agencies (HIAs) are working with health‐sector partners to bring about health improvement through housing‐related initiatives and services.The resulting report, Healthy Homes, Healthier Lives, brings together key evidence that demonstrates the beneficial impact of improved housing conditions on health and examines the current policy context. A spectrum of joint projects is profiled including schemes providing information and training for health and care sector staff, a range of joint approaches to falls prevention, hospital discharge services and initiatives to address fuel poverty and cold, damp housing.

In this chapter, we examine the unique and heightened negative impacts of the COVID-19 pandemic through tracing how the preexisting social conditions of exclusion and precarity in which many disabled people live, effected access to safe, affordable, and accessible housing in Canada. We then illustrate the reverberating impacts housing choices have on how people with disabilities lived, lived well, and how they faced barriers to living well during the COVID-19 pandemic.

Using an intersectional livelihoods approach, we analyzed semi-structured interviews and focus groups with 32 diverse people with disabilities, 12 key informant semi-structured interviews, as well as academic and community literature and a social media scan of key disability advocacy organizations in Canada.

Pandemic-related policies in Canada often excluded people with disabilities, either overlooking barriers to access and safety, which exacerbated the already precarious livelihoods of people with disabilities or over-emphasized the usefulness of social adaptions such as work from home. These exclusions had more profound consequences for people with disabilities from historically marginalized groups, as they often faced increased barriers to livelihoods pre-pandemic, and disability- or care-specific policies failed to consider intersectional experiences of discrimination. People with disabilities formed communities of care to meet their needs and those of their loved ones.

To achieve a responsive policy response that addresses the cascading impacts of risk and care, it is necessary for governments to engage, early and often, with people with disabilities, disability leaders and organizations in emergency planning and beyond.

The purpose of this paper is to highlight the pivotal role of initiatives that address housing disrepair, home improvements and adaptations as a way of improving health, independence and quality of life in older age.

The author uses data from housing and health, combined with the author’s experience of policy formulation as well as working with older people and developing practical services, particularly those which address private sector housing stock condition.

As well as its massive economic impact, housing greatly affects people’s health and wellbeing, not only in later life but across the life course. In England, there is a long history of systematic, government backed action to improve and maintain housing stock condition. There are significant economic and social gains from a coherent national response to addressing private sector housing disrepair, including creation of employment opportunities, economic stimulus through enabling best use of assets, as well as health and social care gains. In addition to increasing housing supply through building much needed new homes, existing housing stock disrepair needs once again to be “on the radar” of policy makers operating across health, social care and housing. Concerted action to make homes safe, healthy places to live in later life, whatever an older person’s tenure, requires vision and innovation and is an essential element in the integration of health, social care – and housing. With significant funding constraints in local authorities, especially for adult social care, and in the context of growing pressures on the NHS, sustaining good health in later life is more important than ever. There is a compelling case for cross-sector action to reduce health hazards in ordinary, private housing, given that 79 per cent of older people who live in non-decent homes are owner occupiers. This is an opportune moment for Health and Wellbeing Boards to take a lead on this issue at a local level, as well as time to put housing stock condition back “On the Radar” of national government policy.

There is a need to embed practical housing services in the emerging integrated health and care systems in order to extend healthy later life for the majority of older people who live in mainstream housing.

The author draws on over 30 years’ experience of innovation, development and evaluation of older people’s housing, services and policy development to provide a vision for greater integration across health, care and housing.