Andrew Williams, BRE, presentation at Future Homes: Building better lifestyles for an ageing population, 30 July 2011

1. BRE Health – the role of the built environment in social
programmes - healthcare
Andrew Williams, Director of Innovation, BRE
Dr Ranjit Bassi (bassir@bre.co.uk)
Dr Keith Quillin (quillink@bre.co.uk)

2. The role of the built environment to 2020 and
beyond
Winston Churchill
„we shape our buildings thereafter they shape us‟
This is not news; but we are entering a new era where its
importance will escalate rapidly
– we must now deliver social equity (social
programmes)……. sustainably (in that order!)
The National Academy of Public Administration defines the term as “The fair, just and equitable management of all institutions serving the
public directly or by contract; the fair, just and equitable distribution of public services and implementation of public policy; and the
commitment to promote fairness, justice, and equity in the formation of public policy.

3. OECD 63 p.c. scenario breakdown: EXTREME
SCENARIO
Scenario 6: Other Spending Growing at trend
and Lower GDP Growth (IFS - Assumption)
accounting for 2009 GDP reduction
Age related Public Expenditure 1999 2000 2009 2010 2011 2012 2025 2026 2027 2028 2029 2030
Education 4.5% 4.5% 6.0% 6.1% 6.1% 6.2% 6.8% 6.8% 6.9% 7.0% 7.0% 7.1%
Pension2 7.3% 7.8% 8.5% 8.6% 8.7% 8.7% 10.3% 10.5% 10.6% 10.8% 11.0% 11.1%
Health 5.3% 5.2% 8.0% 8.1% 8.2% 8.3% 9.9% 10.0% 10.2% 10.3% 10.5% 10.6%
Total Age related spending 17.1% 17.5% 22.5% 22.7% 23.0% 23.2% 27.0% 27.3% 27.7% 28.1% 28.4% 28.8%
Other Spending
General Public Services3 4.5% 3.9% 3.9% 3.8% 3.8% 3.7% 3.3% 3.2% 3.2% 3.2% 3.1% 3.1%
Defense 2.7% 2.7% 2.6% 2.6% 2.6% 2.6% 2.5% 2.5% 2.5% 2.5% 2.5% 2.5%
Public Order and Safety 2.0% 1.9% 2.5% 2.6% 2.6% 2.7% 3.7% 3.8% 3.9% 4.0% 4.1% 4.3%
Economic Affairs4 2.2% 2.3% 3.1% 3.3% 3.4% 3.5% 5.9% 6.1% 6.4% 6.6% 6.9% 7.2%
Environmental Protection 0.5% 0.5% 0.8% 0.8% 0.8% 0.9% 1.7% 1.8% 1.9% 2.0% 2.1% 2.2%
Housing and Community Amenities 0.6% 0.5% 1.1% 1.1% 1.2% 1.2% 2.6% 2.8% 3.0% 3.1% 3.3% 3.5%
Recreation, Culture and Religion 0.8% 0.8% 1.0% 1.0% 1.0% 1.0% 1.3% 1.4% 1.4% 1.4% 1.5% 1.5%
Social Protection5 5.6% 5.2% 6.0% 6.1% 6.2% 6.3% 7.2% 7.3% 7.4% 7.5% 7.6% 7.7%
Accounting Adjustments 1.4% 1.2% 1.7% 1.8% 1.8% 1.8% 2.2% 2.3% 2.3% 2.3% 2.4% 2.4%
Total Other Spending 20.4% 19.1% 22.6% 23.0% 23.3% 23.7% 30.5% 31.2% 31.9% 32.7% 33.5% 34.3%
Total Public Expenditure 37.5% 36.6% 45.1% 45.7% 46.3% 46.9% 57.5% 58.6% 59.6% 60.7% 61.9% 63.1%

4. Just a new way of thinking!
• But as the OECD's Berglind Asgeirsdottir puts it (the
burden of ageing population):
"Speaking of the 'burden'... will only be valid if we fail
to restructure society and its institutions to reflect these
new realities”

5. The influences on the built environment will be
significant
• Buildings should not be passive in how they consume resources
or respond to the way we use them
• Significant increase in energy costs (70%)
• Potential brown-out in 2018/20
• New service models for healthcare, LA services, inclusion,
safety etc
• Grid supply energy models will change – more local renewables
– demand management
• Communication networks and capabilities will grow
• Data liquidity = financial liquidity
• New commercial data/energy models with High Street names
• As platforms become ubiquitous, „consumer electronics‟ will hit
hard

6. THE STOCK

7. Age profile for the projected
domestic UK building stock
35000
30000
25000
20000
15000
10000
5000
0
2010 2015 2020 2025 2030 2035 2040 2045 2050
New #REF! 1976- 1960-75 1939-59 Pre-1918

8. Age profile for the projected non-domestic UK
building stock
1,200,000
Analysis
1 By 2050, 60% of the building 1,000,000
stock will have been built prior
to 2010. 800,000
2 To achieve an 68.4 MtCO
600,000
reduction in CO2 emissions by
2050, improvements to existing
400,000
buildings will be required
alongside the construction of 200,000
new zero-carbon buildings.
0
2010 2015 2020 2025 2030 2035 2040 2045 2050
BRE, 2010 Energy Efficiency in New and Existing Pre-2010 2011-2015 2016-2020 2021-2025 2026-2030
2031-2035 2036-2040 2041-2045 2046-2050
Buildings...
8

9. WHAT ABOUT THE STOCK?
IT IS RELATIVELY WELL UNDERSTOOD THANKS TO CLG
AND THE ENGLISH HOUSING SURVEY, FOR EXAMPLE

10. Why the need for a national survey?
• Established link between poor housing and poor health
• Housing stock old – difficult to manage and maintain
• Difficult to adapt to modern requirements
• Difficult to make energy efficient
• Many owners don‟t have resources for
upkeep/improvement
• Limited funds for social housing
• Mismatch between housing need and provision.

11. Physical and social data
• The EHS collects more than just data on the physical
building:
– age
– type of the home
– current occupants
– household type
– income
– details of any occupants with disabilities
– etc.

12. Decent homes – the current standard for
housing
• Four key components
– Housing Health and Safety Rating System (HHSRS)
– Thermal Comfort
– Disrepair
– Modern Amenities
Lets consider one aspect, HHSRS

13. The HHSRS is based on…
1. Damp and mould growth 17. Personal hygiene, Sanitation and
2. Excess cold Drainage
3. Excess heat 18. Water supply
4. Asbestos (and MMF) 19. Falls associated with baths etc
5. Biocides 20. Falling on level surfaces etc
6. Carbon Monoxide and fuel combustion 21. Falling on stairs etc
products 22. Falling between levels
7. Lead 23. Electrical hazards
8. Radiation 24. Fire
9. Uncombusted fuel gas 25. Flames, hot surfaces etc
10. Volatile Organic Compounds 26. Collision and entrapment
11. Crowding and space 27. Explosions
12. Entry by intruders 28. Position and operability of amenities etc
13. Lighting 29. Structural collapse and falling elements
14. Noise
15. Domestic hygiene, Pests and Refuse
16. Food safety

14. Health Impact Assessment of mitigating falls on
stairs hazards for West Lancashire
Savings achieved each year and cost of repairs
£450
Thousands
£400
£350
£300
£250
£200
£150
£100
£50
£0
1 2 3 4 5 6 7 8 9 10
Years NHS costs saved this year Cost of repairs

15. BRE HEALTH

16. UK Population

17. BRE Health
Building fabric Social & Health
Digital & smart buildings Provision

18. BRE Health
• To develop a decision support tool and associated consultancy services
to enable built environment designers and commissioners to:
• Understand the options available to provide digital health and social care within a
range of domestic built environments for whole population groups, and using new build
and retrofit programmes (strategic)
• Be able to assess the digital health and social care requirements of
specific groups within wider populations and to understand the related domestic built
environment options (strategic)
• Be able to design large scale and individual retrofit programmes to
maximise the potential for digital inclusion of residents including provision for future
digital health and care requirements at minimal up front cost and minimising future costs
(practitioner)
• Develop a methodology for assessing the building for delivering, services
required, minimum requirements of services and user needs.

19. BRE Health – proof of concept
• Care homes (developing now)
• Gated communities
• Residential
• Polyclinics/PCTs
• Communities

20. BRE Health

21. BRE Health in action

22. BRE Health – a driver for change?
• Help manage and optimise service delivery (with many
others)
• Providing system transparency:
– Individual
– Dwelling/block
– Service provider (local, national)
– Product supplier/manufacturer
• Stimulate new markets (services and products)
• Drive industry change for the better

23. BRE Health – What next?
• Consultation with key ALIP partners regarding BRE Health
and others, eg:
– Bournemouth
– Willmott Dixon
– Cisco
• Identify technical areas that BRE Health needs to cover
– Interoperability of tele-care and tele-health services
• BRE Health event at INSITE 2011 in October 2011 at BRE
– Funding from BRE to develop methodology and test in 10-15 building
– More information on BRE Health

24. Contact BRE for more details of the programme
• Dr Ranjit Bassi (bassir@bre.co.uk)
• Dr Keith Quillin (quillink@bre.co.uk)
• Andrew Williams (williamsa@bre.co.uk)