For doctors in general practice: referring patients in housing disrepair

Doctors working in general practice see the health consequences of poor housing every day, chest infections that clear up and return, asthma that does not respond to inhalers, eczema that worsens despite treatment, patients who mention mould in passing during an unrelated appointment. This guide is for doctors and other clinicians working in primary care who want to know how to refer patients who may have a housing disrepair claim, and how to write a supporting letter if asked.

Why housing disrepair matters in general practice

A patient's home environment is a major determinant of health. Cold, damp, and mouldy housing causes and worsens a wide range of conditions that present regularly in primary care:

• Respiratory conditions: asthma, COPD, recurrent chest infections, wheeze
• Skin conditions: eczema and other allergic skin conditions linked to mould spores and dust mites in damp homes
• Cardiovascular conditions: cold homes are associated with increased blood pressure and increased risk of cardiac events
• Mental health: anxiety and depression are worsened by cold, disrupted sleep, and the ongoing stress of unresponsive landlords
• Children's development: cold, overcrowded, and damp homes affect children's sleep, school attendance, and long-term health outcomes

When a patient's presentation suggests a home environment that is damp, cold, or poorly maintained, asking about it directly, and knowing what to do when the answer confirms a problem, is part of a thorough approach to care.

How to identify a potential disrepair case

A brief question during a clinical encounter can reveal a housing problem: "How is your home? Any problems with damp, mould, or heating?" Patients often do not connect their housing and their health, and a professional prompt can make the link visible.

Signs that a patient may have a disrepair case include:

• Recurrent respiratory illness, particularly in children, that correlates with seasons or time at home
• Eczema or allergic skin conditions that worsen at home and improve when the patient is elsewhere
• Reports of mould, damp, or inadequate heating that have been raised with the landlord without result
• Mental health presentations where poor housing conditions are a contributing factor

How to refer to Support for Tenants

Support for Tenants is a housing disrepair claims management company working on a no win, no fee basis. We assess whether a patient has a disrepair claim and, if so, represent them to recover compensation from their landlord and secure the repairs.

Step one, check broad eligibility

Your patient is likely eligible for a free assessment if:

• They rent their home (council, housing association, or private)
• There is disrepair, damp, mould, broken heating, leaking roof, or similar
• They have reported the problem to their landlord and it has not been resolved
• The problem has persisted for some time

Step two, share our contact details

Give the patient our freephone number: 0800 030 4669. You can also direct them to our website at supportfortenants.co.uk or give them a leaflet from our free printed materials.

Step three, consider a supporting letter

A letter from you carrying weight to connect the patient's clinical presentation to the housing conditions is one of the most valuable pieces of evidence in a disrepair claim. You do not need to make legal assessments.

A useful letter includes:

• Your role and your clinical relationship with the patient
• The patient's relevant health history (diagnosis, duration, treatment, significant episodes)
• Your clinical view on whether the conditions described (damp, cold, mould) are plausibly contributing to or worsening the presentation
• The patient's account of the housing conditions and their attempts to report them
• Any periods of particular clinical concern that may correspond to worsening housing conditions

See our full guide on writing a medical evidence letter: /help-centre/medical-evidence-letter-for-housing-claim.

Consent and confidentiality

Before writing any letter, obtain the patient's informed consent. Explain what the letter will contain, who will see it, and what Support for Tenants does. A verbal consent documented in the notes, or a written consent form, is appropriate. Confirm the patient understands this is a separate process from any NHS referral.

Using the clinical record to support a claim

The patient's notes may show a pattern of recurrent presentations over months or years that, taken together, build a picture of chronic harm caused by housing conditions. If the patient asks you to provide a summary of their relevant clinical history, this can be done with consent and does not require you to make any legal judgment.

Dates matter, a pattern of worsening symptoms in winter months or correlating with the patient's account of when the disrepair started are the kind of detail that is valuable to a claim.

Free resources for your practice

We provide free leaflets and referral cards for primary care settings. To order materials call 0800 030 4669 or visit /help-centre/order-free-leaflets-and-posters-for-your-service.

Sources

• Landlord and Tenant Act 1985, Section 11 (legislation.gov.uk)
• Homes (Fitness for Human Habitation) Act 2018 (legislation.gov.uk)
• Understanding and addressing the health risks of damp and mould in the home (GOV.UK)

Related articles

• How to refer a patient to Support for Tenants
• Medical evidence letter, for housing claim
• Consent and confidentiality when referring to us
• Signs of disrepair, a quick checklist for professionals
• How damp and mould affect your health