For school nurses: referring children and families in housing disrepair

School nurses have a unique vantage point. You see children across many years of their development, you have access to health records that document patterns of illness, and you have established trust with families. When a child's health problems, recurrent chest infections, eczema, persistent absenteeism, poor sleep, correlate with a home environment that is damp, cold, or poorly maintained, you are often well placed to identify this link and to make a referral. Here is how to do it.

The school nurse's role in identifying housing-related illness

Housing disrepair affects children's health in ways that often show up in school health data before they are identified as housing problems. Common presentations include:

• Recurrent respiratory illness: chest infections, wheeze, and asthma-related absence that correlates with winter months or with time at home (worsening on weekends and school holidays, improving during term time when the child is in a heated building)
• Eczema and allergic skin conditions: both are strongly associated with mould spores and dust mites, which thrive in damp homes
• Poor sleep and fatigue: cold bedrooms and noisy, leaking, or deteriorating properties disrupt sleep significantly
• High rates of absence: children living in cold, damp, or overcrowded conditions miss more school due to illness
• Developmental and emotional concerns: overcrowded housing, parental stress driven by housing conditions, and lack of a quiet space for homework all affect development and wellbeing

Where you notice a cluster of these presentations in a single child, particularly alongside a family that reports damp, mould, broken heating, or other disrepair, the housing link warrants exploration.

How to refer to Support for Tenants

Step one, establish the housing situation

When you see a child with recurrent illness or related concerns, asking a brief question as part of your assessment ("How is your home, are there any problems like damp or heating issues?") can open the door. If the family reports disrepair and an unresponsive landlord, they may have a disrepair claim they are unaware of.

Step two, check broad eligibility

The family is likely eligible for a free assessment if:

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

Step three, share our details

Give the family our freephone number: 0800 030 4669. You can also share a referral leaflet or direct them to our website. We work on a no win, no fee basis. There is no cost to the family.

Step four, consider a supporting letter

A letter from you, as the child's school nurse, connecting the child's health record to the housing conditions carries meaningful evidential weight. You do not need to make legal assessments. A factual account of what you have observed clinically and what the family has reported is sufficient.

A useful letter might include:

• Your professional role and your contact with the child
• The child's relevant health history (recurrent respiratory illness, eczema, school absences, sleep problems)
• Your clinical view on whether the conditions described (damp, mould, cold) are plausibly contributing to the child's health presentations
• The parent's account of the housing conditions and what they have reported to the landlord
• Any other relevant context (younger siblings, family with health conditions)

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

Consent and confidentiality

Before referring or writing a letter, secure the parent or guardian's informed consent. Explain:

• What Support for Tenants does and how the no win, no fee process works
• What the letter will contain and who will see it
• That this is separate from any school or NHS referral

Where the child's housing situation also raises safeguarding concerns, follow your normal safeguarding pathways alongside any housing referral.

Using school health data to support a claim

School health records documenting repeated illness episodes, absences, and presentations over time are valuable evidence of the duration of impact on a child. If your records show a pattern of recurring illness over months or years, this can support a claim for compensation covering that period.

If a family has been pursuing a disrepair claim and asks for a letter to support it, you can provide one with consent. You are not making a legal judgment, you are providing a factual professional account of what your records show.

Resources for your service

We provide free leaflets and referral cards suitable for school health settings. To request materials for your service, call 0800 030 4669 or see /help-centre/order-free-leaflets-and-posters-for-your-service.

Sources

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

Related articles

• How to refer a patient to Support for Tenants
• Mould, making my child ill
• Medical evidence letter, for housing claim
• Consent and confidentiality when referring to us