Summary

The number of households in Merton is projected to increase to 89,000 by 2016 (8%) and 99,000 (15%) by 2021 an average annual household growth of 2.2% This is ranked the fourth highest household growth in England1with much of the increase expected to be of single person households. Single person households at the time of Census 2011 made up 28% of all households, but will increase by 7,800 by 2016, making up 42% of all households. Lone parent households are also set to increase by 9%. The projected percentage increases in households between 2013 and 20212are: Merton: 19.2 %; London: 12.4%; England: 7.8%

Of the 78,757 households in Merton at the time of Census 2011 60.1% (47,360) were owner-occupied (either owned outright or with a mortgage or loan, or in shared ownership) 14.1% (11,102) were social housing tenants and 24.8% (19,503) were renting privately.

Merton’s social housing stock is amongst the lowest in London at 14% of total stock. The London average is around 22% with social housing stock as high as over 59% in large boroughs such as Southwark. The profile of stock differs between owner-occupied and social housing in Merton, with 58% of social housing and 63% of private rented homes being flats compared with only 24% in the owner-occupied sector. Social housing and private rented homes also typically contain fewer rooms than those that are owner-occupied.

There is a high level of housing need amongst Merton residents. Merton’s Housing Needs Survey, 2005 identified a need to develop an additional 1,848 affordable homes per annum between 2005 and 2010 if all housing needs in the borough were to be met. The 2010 Merton Strategic Housing Market Assessment (SHMA) showed that across Merton, around 17.2% of households are unsuitably housed, equivalent to 13,860 households (including owner-occupiers), with much of the unsuitable housing being in the eastern part of the borough.

With projected increases in people aged over 65 years (estimated 11% increase between 2011 and 2017)3one of the key concerns is the increase in older people living alone. This has implications for health and social care since 57% of the ‘fuel poor’ are aged 60 and over; poorly insulated homes and the continual rise in heating bills contribute to fuel poverty.

Although the number of homeless households in Merton is amongst the lowest in London, homelessness is on the increase, with homelessness applications rising from 188 in 2010-11 to 279 in 2011-12 and the number of households accepted as statutory homeless increasing from 89 in 2010-11 to 101 in 2011-12.

There are around 30 residents living on one permanent caravan site in Merton and there are also many gypsies and travellers living in ‘bricks and mortar’ housing in Merton; 139 people from the gypsies and travellers community took part in a research event organised by Merton Council in October 2011, and the latest Census 2011 shows that 217 people in Merton have identified themselves as gypsies and travellers. However, organisations working with this community believe that the figure is actually higher

Key commissioning recommendations

The challenge for the borough is to be able to forecast future housing needs, to inform potential providers of what is required, and to feed into and underpin the borough’s housing strategies. In particular, people with learning disabilities surviving into older age will potentially have a significant increased need for accommodation to support them to remain as independent as possible.

With increasing age will come:

  • Increasingly complex social and health needs requiring more sophisticated solutions for supported living, including a greater need for sheltered and extra care accommodation for people with learning disabilities as well as older people who have dementia or other disabilities, as population projections show these client groups to be on the increase
  • More people with learning disabilities are outliving their parents and family carers which will lead to an increase in the need for supported living as well as a potential increase in the need for tenure-based housing.

It is essential that local authorities and health services work together to provide accessible and appropriate services for these groups and to tackle health inequalities amongst homeless households and ethnic minority groups.

As councils become increasingly responsible for leading on health improvement within their local populations, planning experts will need to work closer with public health regarding regeneration and spatial planning to help deliver shared goals.

Health impact assessments are a useful tool for assessing the impact of local regeneration programmes and should be considered locally. A prospective health impact assessment can provide a useful opportunity to identify positive health impacts and opportunities and mitigate potential negative impacts for local regeneration programmes.

Local regeneration programmes should support a ‘people, places and markets’ regeneration framework (published by the DCLG). This approach to regeneration encompassing physical regeneration, social or community regeneration and economic development may influence health through broader determinants.

Influence on health

Housing quality is an important determinant of health and a marker for poverty. The condition of housing stock is a major influence on the borough’s capacity to reduce inequality.

Wider determinants of health: Housing

Where people live and the quality of their home have a substantial impact on health; a warm, dry and secure home is associated with better health. In addition to basic housing requirements, other factors that help to improve wellbeing and the ability to live independently include the neighbourhood, security of tenure and modifications for those with disabilities.

Factors that create risks to health include the presence of lead, asbestos, radon, house dust mites, cockroaches and other infestations, extreme low or high temperatures and inadequate ventilation, inferior air quality, dampness/mould, cramped conditions and multiple family occupancy, among others. Health outcomes that may result from these conditions include asthma and TB. Overcrowding and homelessness not only impact on physical health but also on mental health. It is estimated by the Building Research Establishment (BRE) that poor housing costs the NHS in England at least £600 million per year. The diagram above sets out the relationship between housing and health.

Key facts on housing in Merton

The map below identifies the proportion of the population experiencing barriers to housing and key local services in an area. The indicators fall into two sub-domains: ‘geographical barriers’ and ‘wider barriers’ which include issues relating to access to housing such as affordability. There are two areas that fall within the 20% most deprived for barriers to housing and services. IMD measures are relative, in relation to other areas in England. The domain is also not specifically housing alone.

IMD: Barriers to housing and services

Lower Super Output Areas (SOAs) by National Rank Quintiles

Source:Department for Communities and Local Government

©Crown copyright 2012. All rights reserved. ©1994-2012 ACTIVE Solutions Europe Ltd

 

Merton’s population in 2013 is projected to be 202,750, and projected to increase by 2021 to 205,7304  an increase of 1.5% on the 2013 SHLAA figure.5

The number of households in Merton is projected to increase to 89,000 by 2016 (8%) and 99,000 (15%) by 2021 an average annual household growth of 2.2% This is ranked the fourth highest household growth in England1with much of the increase expected to be of single person households. Single person households at the time of Census 2011 made up 28% of all households, but will increase by 7,800 by 2016, making up 42% of all households. Lone parent households are also set to increase by 9%.

 

Number of households, annual average percentage change, England 2011-2021.

Source: National Statistics, Dept. for Communities and Local Government Household Interim Projections 2011 to 2021

 

Projected number of households in Merton to 2021

Projected percentage increase in households between 2013 and 20212

  • Merton: 19.2 %
  • London: 12.4%
  • England: 7.8%

 

Of the 78,757 households in Merton at the time of Census 2011 60.1% (47,360) were owner-occupied (either owned outright or with a mortgage or loan, or in shared ownership) 14.1% (11,102) were social housing tenants and 24.8% (19,503) were renting privately.

 

Dwelling stock by tenure, Merton 2011

Merton’s social housing stock is amongst the lowest in London at 14% of total stock. The London average is around 22% with social housing stock as high as over 59% in large boroughs such as Southwark. The profile of stock differs between owner-occupied and social housing in Merton, with 58% of social housing and 63% of private rented homes being flats compared with only 24% in the owner-occupied sector. Social housing and private rented homes also typically contain fewer rooms than those that are owner-occupied. England has 64.1% households owner-occupied, 17,7% social housing and 16.8% privately rented. London overall has 49.5% households owner-occupied, 24.1% social housing and 25.1% privately rented.6

There is a high level of housing need amongst Merton residents. Merton’s Housing Needs Survey 2005, identified a need to develop an additional 1,848 affordable homes per annum between 2005 and 2010 if all housing needs in the borough were to be met. The 2010 Merton Strategic Housing Market Assessment (SHMA) showed that across Merton, around 17.2% of households are unsuitably housed, equivalent to 13,860 households (including owner-occupiers), with much of the unsuitable housing being in the eastern part of the borough. The SHMA has taken into account migrations into and out of Merton and estimates show an average net loss of about 2,000 persons between 2002 and 2006. There are now over 7,500 households on Merton’s Housing Register, up from 6,350 in April 2011. Around 42% of households on the Register fall within the statutory ‘reasonable preference’ categories which councils have to give priority to when allocating social housing.

Housing for vulnerable groups

Older people

With projected increases in people aged over 65 years (estimated 11% increase between 2011 and 2017) (from GLA 2012 Round Demographic projections)3one of the key concerns is the increase in older people living alone. This has implications for health and social care since 57% of the ‘fuel poor’ are aged 60 and over; poorly insulated homes and the continual rise in heating bills contribute to fuel poverty.

It is also necessary to increase housing choice for older people who are owner-occupiers, as 67% of all older people households in Merton are owner-occupiers, but at present, 79% of designated older people homes are for social rent, with only 21% catering for older owner-occupiers. We also know that in Merton, there are fewer extra care homes and leasehold sheltered homes per 1,000 pensioner households compared with the London average.7The ‘Pantiles’ extra care scheme completed in 2009 included 10 shared ownership homes (33%) that cater for owner-occupiers.

Projected population of Merton aged 65 years and over, 2013-20

Projected population of Merton aged 65 years and over, 2013 to 2020

Projected population aged 65 and
over as a proportion of the total population
2013 2014 2015 2016 2018 2020
  % % % % % %
England 17.23 17.48 17.69 17.86 18.19 18.52
London 11.27 11.29 11.31 11.31 11.36 11.45
Merton 11.70 11.63 11.57 11.61 11.51 11.52

Source: POPPI web site October 2013

People with learning disabilities

The focus for Merton over recent years has been on the resettlement of people living in NHS long stay accommodation and introducing the transformation change including personalisation in social care to support a better quality of life for people with learning disabilities. Support is needed to help people with learning disabilities remain independent and living in their own homes. Availability of housing and supported housing that can support an ageing population of people with learning disabilities is required and effective support is needed, both services and legal, to assist people to maintain tenancies.

There are a small number of people with learning disabilities who do not live with their families and for whom housing or supported living will not meet their needs. In this instance a protected environment offered by a registered care home is ideal. Over the past 10 years there has been a significant shift in commissioning patterns where more people with learning disabilities are living in the community so that registered care may only be needed for a very small number of people in the future.

Adults with learning disabilities (LD) in settled accommodation, Merton compared with South West London, 2010-11

Homeless people

Homeless people are more likely to be affected by poor health. Living in temporary accommodation can affect the health of children and homeless families can find it hard to access health services with a temporary address. A national audit undertaken by Homeless Link found that 8 in 10 single homeless people have one or more physical health needs, and 7 in 10 have at least one mental health problem. Poor health can also cause a person to become homeless in the first place, and many often leave health problems untreated until they reach a crisis point, making health problems more expensive to treat and hospital waiting lists longer leading to people being less able to support themselves in their homes.

Although the number of homeless households in Merton is amongst the lowest in London, homelessness is on the increase, with homelessness applications rising from 188 in 2010-11 to 279 in 2011-12 and the number of households accepted as statutory homeless increasing from 89 in 2010-11 to 101 in 2011-12. There has been a drop in the number of single homeless young people being referred to Merton Council’s Young Persons Nominations Panel, reduced from 68 referrals in 2010-11 to 53 in 2011-12. There were also 51 referrals of rough sleepers to the Council’s Rough Sleepers Case Conference Panel in 2010-11 or winter provisions through the Severe Weather Emergency Protocol (SWEP), and 50 referrals in 2011-12.

Gypsies and travellers

Determinants of health also vary according to ethnic group. By nearly all measures of health, the health of ethnic minority populations in the UK is poorer than that of the white population (Public Health Observatories). In particular, there is evidence to show that the health of gypsies and travellers is much poorer compared with the general population, even when allowing for factors such as variable socioeconomic status and/or ethnicity, with one research study finding that gypsy and traveller communities are the most at risk health group in the UK with the lowest life expectancy and the highest child mortality rate.8

There are around 30 residents living on one permanent caravan site in Merton and there are also many gypsies and travellers living in ‘bricks and mortar’ housing in Merton. 139 people from the gypsies and travellers community took part in a research event organised by Merton Council in October 2011, and the latest Census 2011 shows that 217 people in Merton have identified themselves as gypsies and travellers. However, organisations working with this community believe that the figure is actually higher.

It is essential that local authorities and health services work together to provide accessible and appropriate services if we are to tackle health inequalities amongst homelessness households and ethnic minority groups.

What works and best practice

Planning and housing design

The planning process, through design and layout, ensures that new developments and redevelopments implement sustainable design. Measures to improve housing conditions and reduce the occurrence of ‘sick building syndrome’ include:

  • The use of sustainable design and construction standards (such as the Code for Sustainable Homes) helps to focus attention on issues relating to health and wellbeing, with credits available for ensuring attention is paid to daylighting, sound insulation, private space, volatile organic compound use, drying space and ventilation.
  • High quality refurbishment and energy efficiency retrofit works can reduce fuel poverty and improve thermal comfort.
  • Appropriate re-housing and refurbishment initiatives are also likely to have beneficial health outcomes, including improvement in mental health.

As well as improving the sustainability of new homes through the planning process, there are also many initiatives being undertaken to improve the condition of existing housing stock in the social housing sector as well as the private sector. These include Merton Priory Home’s Decent Homes programme, which will improve around 6,500 homes to ‘Merton Standard’, which is over and above the ‘Decent Homes’ standard set by the Government, by 2015. The Council also runs a number of energy efficiency and home improvement initiatives by providing grants and loans to vulnerable households

Regeneration programmes have been defined as reversing economic, social and physical decline in areas where market forces will not do this alone. A recent review of literature on Regeneration and Health9suggested that regeneration interventions have had a mild or small impact on improving health. The indicators of health most measured have been self reported general health measures or those that specifically reflect mental health and wellbeing. Important caveats to note are that most of the findings from the literature relate primarily to physical regeneration, in particular housing improvement, and that health outcomes assessed have been in the short or medium term.

Key policy issues

Impact of housing policy reforms

Following its election the Coalition Government introduced a number ofnew housing and related policies and initiatives, which will have a profound impact on the housing landscape.

The majority of the proposals are set out in the policy paper ‘Local decisions: a fairer future for social housing’, and subsequently included in the Localism Act 2011. In addition to the budgetary measures, housing policies enacted through the Localism Act include changes to tenure, housing waiting list, the homelessness duty, the introduction of a new ‘affordable rent’ tenancy, and changes to the Housing Revenue Account (HRA) and decent homes funding. All these policy changes will have an impact on Merton households, with the exception of the implementation of ‘self-financing’ within the Housing Revenue Account, as Merton Council no longer owns any housing stock having transferred all council housing to Merton Priory Homes in March 2010.

Affordable housing provision

The Spending Review [2013] has significantly reduced funding for the development of new affordable housing. At the same time the Government has introduced a new product – Affordable Rent – with rents charged at up to 80% of market rents for all new housing in receipt of government funding and the use of increased revenue generated from the conversion of a proportion of existing social rented units to Affordable Rent upon re-letting, to assist the delivery of targets for new supply.

All new build affordable homes and a proportion of existing social housing are now being let at Affordable Rent of up to 80% of market rent. This can still meet a significant proportion of need but there are risks around charging much higher rents to low-income households. Although at present social rents at 80% of market would be fully covered by housing benefit, the switch to Affordable Rent could see increased benefit dependency, and should the proposed total benefit cap be introduced (see below) such units could be completely unaffordable to larger out-of-work households.

Tenure reform

The Government introduced radical reform to tenancy policy through the Localism Act 2011, by giving local authority and housing association landlords the option to offer a new type of ‘flexible’ fixed-term tenancies to new tenants. The driver for change is to ensure that social housing, an increasingly scarce public resource, can be ‘focused on those who need it the most, for as long as they need it’

Following the transfer of council housing stock to Merton Priory Homes in March 2010, all social housing in Merton is now owned by housing associations. Housing associations in Merton now have the options to offer new tenants fixed-term tenancies with a range of periods of no less than five years, with no maximum limit to be set. Housing associations will also be able to offer flexible tenancies as an alternative to assured tenancies at either an ‘affordable rent’ or a social housing (‘target’) rent. Merton Council is working with housing associations to promote tenure mobility for those who aspire to home ownership or whose housing needs have changed over time, in order to release much needed affordable housing, particularly family-sized homes, while providing a stable base and a safety net for the most vulnerable people in society.

Tenancy strategy

Local authorities have a duty to publish a ‘tenancy strategy’ that is drawn up in consultation with tenants and social landlords, and to set out the objectives to be taken into consideration by social landlords when developing their own tenancy policies relating to the granting of fixed-term tenancies. Local authorities will need to set out and publish the circumstances under which either lifetime tenancies or fixed-term tenancies will be granted and the circumstances under which the latter will be reissued. The overarching aim of Merton’s Tenancy Strategy (January 2013) states that housing associations should adopt a people-centred approach when granting initial tenancies and further fixed-term tenancies. Housing associations are expected to ensure that the most vulnerable households in society – such as older people; people with disabilities; injured ex-armed forces personnel; low-income households – are given the security they require for as long as they need it, and provided with homes suited to their changing needs.

Homelessness and social housing allocations

The Localism Act 2011 includes powers for local housing authorities to place homeless households in private rented sector lettings without having to seek the applicants’ consent. The Act also allows an authority to limit who can apply for and who can be given social housing within their areas but councils are required to continue to give priority to households who fall within the ‘reasonable preference’ categories as defined in the Housing Act 1996. Again, these are new powers extending an authority’s local discretion for dealing with homeless and other housing applicants and determining how to make best use of social housing to meet housing need. Merton Council has since refreshed its allocations policy, to include giving priorities to ex-armed forces personnel and to working households under certain allocations bands.

New Homes Bonus

The Government has introduced the New Homes Bonus (NHB) to incentivise local authorities to encourage new housing development, with an added premium for new affordable housing. The NHB, paid in the form of sums related to council tax income, will also be paid for empty homes brought back into use.

Impact of welfare benefit reforms

Wider government legislation including the Welfare Reform Act 2012 will impact on factors which can determine health and wellbeing. The Department for Work and Pensions (DWP) estimates that 56,000 households in England will have their benefits reduced in 2013-14 losing on average £93 per week. London is expected to be hit hardest by housing benefit reform with an estimated 159,000 households due to lose out DWP acknowledges this will lead to a higher risk of homelessness. In Merton it has been estimated that 309 people will be affected by the total benefit income cap and 958 claimants by the changes to housing benefit under occupancy.

Overall the proposed measures, whilst designed to better incentivise work, could result in greater levels of poverty particularly for larger households. There is widespread concern that the welfare benefit reforms will result in both private rented and social rented sector tenants struggling to maintain their tenancies. A reduction in benefits resulting from the welfare benefit reforms may result in higher incidences of homelessness and higher levels of fuel poverty as well as limiting the ability to make healthy lifestyle choices.

Key commissioning recommendations

The challenge for the borough is to be able to forecast future housing needs, to inform potential providers of what is required, and to feed into and underpin the borough’s housing strategies. In particular, people with learning disabilities surviving into older age will potentially have significant increased need for accommodation to support them to remain as independent as possible.

With increasing age will come:

  • Increasingly complex social and health needs requiring more sophisticated solutions for supported living, including a greater need for sheltered and extra care accommodation for people with learning disabilities as well as older people who have dementia or other disabilities, as population projections show these client groups to be on the increase
  • More people with learning disabilities outliving their parents and family carers which will increase the need for supported living as well as a potential increase in the need for tenure-based housing.

It is essential that local authorities and health services work together to provide accessible and appropriate services for these groups and to tackle health inequalities amongst homeless households and ethnic minority groups.

As councils become increasingly responsible for leading on health improvement within their local populations, planning experts will need to work closer with public health regarding regeneration and spatial planning to help deliver shared goals.

Health impact assessments are a useful tool for assessing the impact of local regeneration programmes and should be considered locally. A prospective health impact assessment can provide a useful opportunity to identify positive health impacts and opportunities and mitigate potential negative impacts for local regeneration programmes.

Local regeneration programmes should support the ‘people, places and markets’ regeneration framework ([published by] DCLG). This approach to regeneration encompassing physical regeneration, social or community regeneration and economic development may influence health through broader determinants.

References

1. ^ ab National Statistics, Department for Communities and Local Government (2013). Household Interim Projections 2011 to 2021, England and its Local Authorities

2. ^ ab Department for Communities and Local Government (2013). Household Interim Projections 2011 to 2021 for England and its Local Authorities

3. ^ ab SHLAA [(2013)].

4. ^ GLA (2012). SHLAA ward projection creator.

5. ^ HSSA (2011)

6. ^.Census 2011. Office for National Statistics.

7.^ Elderly Accommodation Counsel (EAC) Database (2010).

8.^ University of Sheffield (2004). The Health Status of Gypsies & Travellers in England. A report to the Department of Health.

9.^ NHSSM, 2010