District nurse housing referral: a guide for community nursing professionals

District nurses and community nurses visit patients in their homes and are uniquely placed to observe housing conditions that may be affecting patient health. This guide is for community nursing professionals who want to understand when and how to refer patients with housing problems.

What community nurses can observe

During home visits, district nurses often encounter housing conditions that are directly affecting patient recovery and wellbeing. Relevant observations include:

• Visible mould or damp in rooms where patients spend time, particularly bedrooms and bathrooms
• Cold or poorly heated homes that are affecting wound healing or respiratory conditions
• Properties that are difficult to keep clean because of structural problems (broken windows, water ingress)
• Pest problems, mice, cockroaches, or other infestations that present hygiene risks for patients with dressings or catheter care
• Structural hazards, broken floors, unsafe stairs, that present a risk to mobility-impaired patients

These are not just incidental observations, they are clinically relevant. The conditions a patient lives in directly affect outcomes for wound care, infection management, respiratory conditions, and rehabilitation.

When housing conditions are affecting clinical outcomes

If you identify housing conditions that are contributing to poor health outcomes for your patient:

1. Document what you observe in your clinical notes. Include the date, what you saw, which rooms were affected, and your professional opinion on the likely health implications.

2. Discuss with the patient. Ask whether they have reported the problems to their landlord. Many patients, particularly those who are older, unwell, or have limited English, may not know they have rights or how to exercise them.

3. Consider a multidisciplinary referral. If a patient's home is significantly unsafe or unsuitable, a referral to the occupational therapist or social worker in the team may be appropriate to assess what adaptations or rehousing options are available.

4. Refer to a housing disrepair specialist. If the patient is renting and the landlord has not fixed the problem, they may have a civil housing disrepair claim. Support for Tenants handles these claims on a no win no fee basis and accepts professional referrals.

Writing a clinical letter to support a housing complaint

If your patient needs a letter from a healthcare professional to support a housing complaint, an environmental health inspection, or a housing disrepair claim, keep it factual and within your clinical scope:

• What you observed on your visits (dates, room, nature of the problem)
• The patient's relevant health conditions
• Your professional view on whether the housing conditions are likely to be affecting the patient's health or making your clinical work harder
• What you consider would be the risk of continuing in those conditions

You should not make legal assessments, those are for solicitors and courts. Your role is to provide clinical evidence.

Referring for a housing disrepair claim

If your patient is a private or social tenant and is experiencing disrepair (damp, heating failure, mould, structural problems) that their landlord has not fixed:

• Share our number with the patient: 0800 030 4669
• Or call on behalf of the patient if they consent to a third-party enquiry

We handle claims on a no win no fee basis, there is no upfront cost to the patient.

When should I contact Support for Tenants?

We welcome referrals from district and community nurses. If you have a patient whose rented home is in disrepair and affecting their health, call us to discuss.

Call us on 0800 030 4669. No upfront cost; patients only pay if we win.

Sources

• Section 11, Landlord and Tenant Act 1985 (legislation.gov.uk)
• Homes (Fitness for Human Habitation) Act 2018 (legislation.gov.uk)

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