The Time Is Now!
Housing Without Delay, a project launched by RCOT, Foundations, and sponsor Closomat, aims to speed up the process of turning homes into tools for health, inclusion and equity. Lauren Walker, Professional Adviser, Royal College of Occupational Therapists, and Rachel Russell, Head of Regional Advice, Foundations explain…
Twenty years ago, a small but powerful idea began to reshape how we think about housing and health. The publication of Minor Adaptations Without Delay introduced a simple concept: that older and disabled people should be able to access basic home adaptations quickly, without unnecessary bureaucracy.
It empowered housing association staff to assess and install minor changes – grab rails, ramps, lever taps – without waiting for specialist input. The result? Faster support, greater independence, and improved quality of life.
Since then, the conversation has evolved. In 2019, the Royal College of Occupational Therapists (RCOT), in partnership with Housing LIN, published Adaptations Without Delay, expanding the focus to major adaptations and highlighting the strategic role of occupational therapists (OTs) in enabling people to live well at home.
Now, with the launch of the Housing Without Delay project, RCOT, Foundations, and sponsor Closomat are taking the next bold step – moving beyond adaptations to explore how our homes can be a proactive tool for health, inclusion, and equity.
From adaptations to inclusion
Occupational therapists have long understood that the home environment is more than a backdrop to daily life, it’s a determinant of health. Whether it’s the layout of a kitchen, the presence of stairs, or the sensory qualities of a space, housing can either help or hinder our ability to live independently, safely, and with dignity.
Research from the King’s Fund and Public Health England estimates that poor housing costs the NHS at least £1.4 billion annually. But the true cost is measured in lives disrupted, opportunities lost, and wellbeing compromised.
Housing Without Delay reframes housing as a public health issue, and OTs as key agents of change. It’s not just about installing equipment; it’s about designing environments that enable people to thrive, preventing housing issues before they occur, and empowering people to address challenges in their homes proactively and effectively.
Homes for health and wellbeing
Housing Without Delay looks beyond the physical accessibility of homes, exploring the many critical ways that housing impacts health and inclusion:
Physical Health and Safety: Poor ventilation contributes to childhood asthma; inadequate heating leads to preventable illness. A safe, warm home is foundational to health.
Mental Health and Cognitive Function: Overcrowding and housing insecurity are linked to anxiety and depression. Stable, supportive environments promote mental wellbeing.
Sensory Environment: For neurodivergent people, sensory-friendly design can reduce overload and support regulation.
Home Management: Managing a home involves more than physical tasks, it includes cognitive demands like budgeting, maintaining tenancy, and navigating service providers.
Education and Development: Children in overcrowded homes are up to ten times more likely to fall behind in school. Housing stability is essential for learning and growth.
Employment Opportunities: Housing insecurity disrupts routines and creates stress, making sustained employment harder to achieve. Unsuitable home environments can make it difficult for people to prepare for work, travel to work, or work from home productively.
The OT perspective: bridging health and housing
Occupational therapists are uniquely positioned to address these challenges. Their training focuses on the dynamic relationship between people, their environments, and the activities (or occupations) they carry out day to day. This makes OTs natural advocates and agents for inclusive design.
Housing Without Delay will provide a blueprint for action. It invites occupational therapists, designers, policymakers, and housing professionals to work together in creating environments that support independence, inclusion, and wellbeing.
The outcomes of the project will be published in Spring 2026, and will be structured around three key components:
1) Strategic Document
Aimed at leaders in housing, health and social care, this resource will demonstrate how OTs can shift systems from reactive treatment to proactive prevention. It will position housing as a therapeutic tool and OTs as strategic partners in public health and housing.
2) Operational Tools
For managers in health, housing and social care, this toolkit will offer practical guidance on integrating OT expertise into housing services. It will include practice frameworks and examples of effective cross-sector collaboration.
3) Practitioner Resources
Designed for frontline professionals, these resources will support direct practice—helping OTs in all areas of practice to expand their knowledge and role in addressing housing challenges, and applying inclusive design principles in their everyday work.
Visit https://www.rcot.co.uk/ and https://www.foundations.uk.com/ to find out more.
Join the movement
Housing Without Delay is more than a project; it’s a call to reimagine housing as a platform for health and equity. You can be part of this transformation. RCOT and Foundations would love to hear your personal and professional experiences from the intersection between health and housing. What do you want health and housing leaders, managers and practitioners to know?
Get in touch with us at hello@rcot.co.uk and info@foundations.uk.com with the subject line Housing Without Delay and help us drive positive change. Together, we can ensure that housing is not just without delay; but without barriers. Let’s create homes that enable, empower, and include.