Five lessons from a supported housing pilot

What does good supported housing look like when demand is rising, provision is limited, and responsibility is split across housing, health, care, and funding? For people who need support to live well in the community, gaps in the system can mean delayed discharge and out-of-area placements.

At Rethink Mental Illness, our vision is equality, rights, fair treatment, and the maximum quality of life for everyone severely affected by mental illness. In 2024, Rethink and NPC published our user-centred analysis, The long journey home, which shows how the system shapes people’s day-to-day experiences.

Building on this, Rethink is leading a multi-year supported housing pilot across the UK, combining local test-and-learn work with parallel exploration in financing and policy. Sheffield is our most advanced pilot area. Our approach is deliberately adaptive: we set a clear direction, test practical changes, capture learning, and refine our theory of change so we can understand what works, for whom, and why. The goal is a more integrated system that supports recovery and long-term wellbeing, and a model that can scale.

Download the Programme Level Theory of Change as a PDF.

We are now at the halfway point. Here are five key lessons so far.

Learning 1: Collaboration and coordination are key, but not always easy

Local systems change starts with bringing people together to build trust and agree on shared goals. In Sheffield, over the last 12-18 months, we have brought together the NHS, adult social care, housing, voluntary, community and social enterprise (VCSE) partners, and experts by experience. Together, we have mapped local need, funding, and current provision.

We have seen strong interest and recognition that the system is not working as it should. But there are also practical barriers, including limited capacity and competing priorities. We are adapting by testing more flexible ways to convene (online, shorter or hybrid sessions, and smaller groups). We are also aligning with existing governance, so we do not duplicate what is already in place.

Establishing shared goals that reflect the challenges different stakeholders face, and are seeking to address, is critical. For example, in Sheffield, workshops highlighted increasing housing supply, more peer support, a simpler and more transparent referral process, and faster, more streamlined assessments as priorities.

Learning 2: Use good data to drive decisions

We need to understand the local current need and future demand for supported housing. However, the data is often incomplete and distributed across health, housing and social care organisations. The priority is not a perfect dataset, but a shared evidence base that partners accept as ‘good enough’ to support decisions and track change over time.

To this end, we took a dual approach: triangulating national datasets with local intelligence, then being explicit about assumptions and gaps. The Supported Housing Regulatory Oversight Act 2023 places a duty on local authorities to carry out a review of supported exempt accommodation and publish a five-year supported housing strategy by March 2027; we are anticipating this will support more joined up planning in the future.

Learning 3: Focus on the quality of supported housing

In Sheffield, partners have been clear that increasing supported housing supply must go hand in hand with quality. Our learning so far points to three practical ingredients:

1. Accessible, self-contained homes near community assets.
2. Support that reflects rising complexity, including specific mental health conditions and co-occurring needs.
3. Multi-skilled staff teams that can respond holistically, from peer support to benefits and employment support.

This sharper picture strengthens our theory of change and builds on our work to co-design supported housing models and property standards. These will be published later this year, watch this space!

Learning 4: Explore finance options, and be clear about assumptions and risks

The construction of supported housing can be financed through traditional lending, capital grants, philanthropy, and impact investment. But choosing a route is only the start. Viability depends on scenario modelling, for example, occupancy, commissioning changes, inflation, and interest rates. It also depends on confidence in revenue. Investors may want long-term support contracts, but commissioners can’t always offer them at the level required for high-quality support.

One useful discipline is to test whether the scheme still holds up under conservative assumptions, and to identify realistic contingencies (for example, what happens if you must operate on housing benefit income alone for a period). There are lots of great resources out there for charities like ours who are exploring social investment opportunities (for example: Good Finance).

Learning 5: Recognise the importance of lived experiences – plurality (and allow sufficient resources to work together)

The pilot reinforced that one advisory group is rarely enough. National lived experience groups can shape standards and models. Local involvement is essential for place-specific realities, such as referral pathways, neighbourhood preferences, and what feels safe.

Across both, the basics still matter. Set out an involvement plan early, budget for it, reimburse people thoughtfully, and build feedback loops so contributors can see how their input shaped decisions.

We are excited about the potential of this work over the next 12 months. To find out more about our approach, or to discuss opportunities to work together, please contact Tracy Blackwell at tracy.blackwell@rethink.org