Hospital discharge teams: referring patients with housing disrepair

When a patient is being discharged from hospital, the condition of their home is one of the most critical factors in whether they will remain well. For patients returning to rented homes with damp, mould, cold temperatures, or structural disrepair, the discharge is not the end of the problem, it may be the beginning of a preventable readmission. Hospital discharge teams are uniquely positioned to identify these risks and to connect patients with legal help.

This guide is for hospital discharge coordinators, discharge liaison nurses, social workers, and occupational therapists working in hospital discharge teams.

Why housing matters at discharge

Research consistently shows that patients returning to cold, damp, or structurally poor homes have worse outcomes. For the patient groups most likely to be in hospital, older adults, people with chronic conditions, people recovering from surgery or acute illness, the home environment is clinically significant.

Key risks include:

• Cold homes slow wound healing and increase infection risk
• Damp and mould worsen respiratory conditions including COPD, asthma, and post-operative respiratory complications
• Inadequate heating makes thermoregulation difficult for older, frail, or recently operated-on patients
• The stress of returning to a substandard home affects mental health and may worsen chronic conditions
• Patients who struggle with their home environment are more likely to present again to A&E within 30 days

Identifying housing disrepair before or at discharge, and connecting the patient to support, can reduce readmission risk and improve outcomes.

Who to consider referring

Consider a referral when:

• A patient is returning to a rented home with known damp, mould, cold, or structural problems
• The patient or family has raised concerns about the home during the admission
• A community occupational therapist, district nurse, or health visitor has previously flagged housing concerns
• You are completing a home environment assessment and identify conditions that fall below minimum standards
• The patient is in social housing or private renting and the disrepair has not been resolved despite previous reports to the landlord

You do not need to conduct a detailed investigation. A brief note of what was reported or observed is sufficient to support a referral.

What you can contribute to a referral

A brief clinical note:

• Describing the patient's diagnosis and the conditions they are returning to
• Your clinical view on how those housing conditions are likely to affect their recovery or ongoing health
• Confirmation that the patient (or their representative) consents to be contacted

This can be a short paragraph, you do not need to write a formal medical letter at the referral stage.

Consent and capacity

If the patient has capacity, they must consent to the referral. If capacity is in question, the patient's next of kin, legal representative, or care coordinator may be able to act on their behalf.

If the patient consents but is too unwell to handle correspondence directly, the family member or advocate they nominate can manage the process on their behalf.

Timing

Discharge is often the best moment to identify housing issues. The patient is in contact with a multi-disciplinary team, and there is a window of time during which concerns can be recorded and acted upon. A referral made at or just before discharge can be followed up in the community.

How to refer

Call us on 0800 030 4669 or contact us through our website. We will respond promptly and be sensitive to the patient's circumstances.

There is no charge to the patient unless we win. The fee comes from the compensation.

A message you can share with patients and families

"If your home is cold, damp, or in poor repair and your landlord has not fixed it, there may be a legal claim, and Support for Tenants can help. Call 0800 030 4669. There is no charge unless they win."

Sources

• Section 11, Landlord and Tenant Act 1985 (legislation.gov.uk)
• Care Act 2014 (hospital discharge and care needs) (legislation.gov.uk)

Related professional resources

• How to refer a patient to Support for Tenants
• Signs of disrepair, a quick checklist for professionals
• Medical evidence letter for a housing claim
• Occupational therapist, housing disrepair referral