Housing Feature
Housing Feature
© FG Trade via Getty Images person with the disability, diminishing their dignity, autonomy and choice.
The means test barrier
One significant challenge within the DFG system is the means test, which assesses household income and savings to determine eligibility for funding. While intended to ensure public funds target those most in need, it often inadvertently penalises adults of working age who may earn above the threshold, yet still struggle with high housing costs, mortgages, or family responsibilities.
Crucially, a partner’ s income is included in the assessment, meaning a single earner in a dualincome household may be deemed ineligible despite limited disposable resources.
This leaves individuals facing urgent adaptation needs without public support, forcing them to either wait indefinitely or fund adaptations privately, an option that can be daunting without professional guidance.
The occupational therapy perspective
Occupational therapists sit at the core of assessing the need for adapted living, but are often constrained by red tape procedures and funding limitations. We strive to facilitate safe and dignified ways of living but are often hindered by service blockages and systemic inefficiencies.
Having worked as an occupational therapist in the NHS for nine years, in a range of client areas, I felt frustrated and powerless seeing individuals’ conditions worsen while their application for adaptations sat with hundreds of others, on a waiting list with no clear timeframe.
Addressing gaps in support
Navigating adaptation design, contractors and compliance requirements independently can be complex and stressful. New approaches, exemplified by services such as Homes Reimagined, offer an integrated model: professional assessment, bespoke adaptation recommendations, and full project management, from planning and co-ordinating suppliers to overseeing installation.
This all-in-one pathway provides a clinically informed and timely solution for individuals who need adaptations but fall outside public funding criteria. By consolidating these steps, the approach ensures that adaptations meet safety and functional standards while reducing the administrative burden on clients and families.
Looking ahead, some things need to change to better meet the rising demand. I believe that systemic reform is essential. Investing in local authority resources, streamlining DFG application processes and fostering integration between health, housing and social care systems is vital. We also need to address those individuals who don’ t qualify for funding, yet have pressing needs, and legitimise independent pathways and supports.
Occupational therapists can lead the way by advocating for blended approaches that merge statutory and independent services, so that timely adaptation support can be delivered more equitably.
In conclusion, the increase of adaptation needs highlights both the strengths of the current system and its weaknesses, due to stretched resources.
While DFGs provide critical support, delays and eligibility constraints leave many left compromised with a poor quality of life. For occupational therapists, this raises ethical and clinical dilemmas.
Innovative and integrated occupational therapyled services are emerging as powerful supplements to statutory provision. By embracing both public and independent models, we can help unlock more equitable and responsive access to home adaptations, ensuring that independence is within reach for all.
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Manchester City Council( 2024) DFG Governance Report 2024. Manchester: Manchester City Council. Available at https:// bit. ly / 41adH4q [ accessed 17 March 2026 ].
NHS Confederation( 2024) Social care and housing: Disabled Facilities Grant delays. London: NHS Confederation. Available at https:// bit. ly / 4uHoccS [ accessed 19 March 2026 ].
Russell H( 2024) Revealed: The shocking waiting times disabled people face for home adaptations in south London, Southwark News. Available at https:// bit. ly / 4uIqoBe [ accessed 26 August 2025 ].
Gayle V, Hamada R and Boutaude C( 2022) Disabled people trapped waiting years for vital home adaptations. Available at https:// bit. ly / 4rBgjDb [ accessed 17 March 2026 ].
Words HAELA PATTEMORE, Occupational Therapist and Co-Director at Homes Reimagined Ltd. For more information visit www. homesreimagined. co. uk
March 2026 OTnews Extra D11