As the health service struggles with the recruitment and retention of staff, we look at how one innovative model is helping to deliver modern keyworker accommodation that meets the needs of employees from the UK and overseas

Health and care workforces have been under immense strain, with NHS trusts reporting a staff shortfall of 150,000 employees – a figure set to rise to 360,000 by 2036 unless significant action is taken.

And one of the priorities for workers considering joining the NHS is where they will live.

Not only have economic pressures made private renting or purchasing homes unattainable for many health and care workers, but the standard of living in existing rental accommodation has declined rapidly, with widespread reports of mould, damp, and other major failings.

And, while dedicated keyworker housing does exist across the UK, these are often designed in a similar way to student housing provision, typically with shared bathroom and/or kitchen facilities, and are deemed inappropriate for those working in the health and care sector who are usually older adults, often with families.

Mind the gap!

This has left a gap in the market for the next generation of keyworker accommodation, a gap which developer, Prime plc, is hoping to fill.

Michelle Robinson, associate director at Prime, explains: “The NHS has long been impacted by a lack of capital investment, as evidenced by an increasing backlog maintenance requirement.

“It is understandable that constrained capital is focused on improvements to clinical spaces to support direct patient care. However, NHS staff also deserve quality accommodation.

“Ensuring staff have a safe, comfortable, and convenient place to live can significantly impact their wellbeing and, by extension, the quality of patient care.

“But investment in keyworker accommodation is not just a moral imperative; it’s a strategic one as reducing commute times and living costs can enhance job satisfaction, strengthen retention rates, and attract a more-diverse workforce.”

No place like home

Most existing keyworker housing schemes are operated by a housing group and offer a range of accommodation – typically studio or one-bed apartments – on a short-term basis.

But there is very little available for staff more long term, or for those with families.

Hyve by Prime has been set up by Prime plc as a not-for-profit management company aimed at addressing the high demand for desirable, affordable, and bespoke keyworker accommodation close to hospital sites.

Offering flexible tenancy lengths that meet the changing lives of residents, developments are built to sustainable, energy-efficient, and functional building designs to create comfortable and safe spaces for health and care professionals to call home.

Robinson told Healthcare Property: “Recruitment and retention is a challenge for health and care operators – and is now the worst it has ever been.

“International recruitment over the last few years has exacerbated this challenge, with trusts having to find places for staff to live.

“Trusts have found that international recruits struggle to get into the private rental market as they may have no credit history, guarantors, or UK bank accounts.

“Home-grown NHS employees are also struggling to afford their own homes.

“And many people make decisions on which jobs to take depending on if they can find somewhere to live and that they consider this affordable accommodation.”

A standard design

Through Hyve by Prime, developers are looking to refurbish existing properties and construct new-build units up and down the country using a standardised design approach.

Robinson said: “Currently a lot of keyworker housing stock does not offer en-suite facilities.

“Our standardised design of one-, two-, and three-bed apartments ensures there is enough space and room to live.

“These are going to be people’s homes, so each apartment provides private en-suite bedooms, a kitchen, and living area.

“This flexibility means you could have three individuals living in a three-bedroom apartment, for example, each with their own en-suite bedroom, or you could have a family living there.”

Under its model, Prime plc is responsible for purchasing and developing each site. Partner organisation, Hyve by Prime, then uses its not-for-profit status to keep rents affordable for keyworkers.

And this means NHS trusts do not have to put the cost of providing this accommodation on their balance sheets, thus protecting their ever-dwindling capital.

With keyworker developments recently having been built in Yeovil and Dorchester, NHS trusts now have a way to provide appropriate and long-term accommodation and in turn attract much-needed new talent.

Safe and convenient

Robinson said its research had revealed that while the optimal site for these developments in within trusts’ own estates; they are also looking further afield and working with local authorities to find additional sites, such as vacant high-rise blocks.

Robinson said: “We look for sites within 20 minutes walk from the hospital site due to the cost of travel and parking.

“In big cities, where public transport is better, we may go slightly further out, but, after a 12-hour shift, staff want to get home quickly.

“They also want to be safe and we have rejected sites where we would not want to walk that route home. Safety is very important.

“We then work with trusts to understand what accommodation they already have, what they need, and who they want to place there.”

In Yeovil, Prime secured £21m in funding to develop a new-build 176-bed complex across 66 apartments.

The units were funded by Canada Life and built by Speller Metcalfe.

And, in Dorchester, Hyve by Prime provided 63 one- and two-bed apartments just a 10-minute walk from Dorset County Hospital.

Robinson said: “Housing costs in Dorset are significantly above the national average.

“Set against a crisis in medical staffing, the increased costs of employing agency nurses has seen the trust employ a growing number of overseas nurses in recent years.

“In addition to offering homes to international and UK-based staff, the trust believes that a major incentive to work at DCH is to provide good quality, well-maintained accommodation close to the hospital and this is what we have done with the Alexandra House development.”

Breaking down barriers

Nick Johnson, deputy chief executive at Dorset County Hospital NHS Foundation Trust, added: “Here in Dorset, a lack of accommodation offering is further exasperated by its rural location and the fact that it is a holiday hotspot, with one in 13 houses a holiday home.

“I recall during one hospital walkaround a valued colleague telling me that they were moving to another NHS trust across the country simply because house prices were much cheaper and they could afford a family home.

“With this region-specific challenge staring us in the face, we turned to Prime to help us find a solution, and fast.

“The commercial structure and funding model created ensured the new accommodation met our needs without requiring NHS capital, demand guarantees or approvals – meaning our staff could move into their new homes quickly.

“By mitigating the housing-related barriers to recruitment and improving staff retention rates, we will reduce the financial strain associated with constant turnover.

“Consequently, this helps us allocate resources more effectively, enabling enhanced patient care, investment in training and improved overall service delivery.”