Housing toolkit for patients whose health is affected by poor housing

The Housing Toolkit can help you support patients whose home environment is contributing to their respiratory symptoms. This page will help you recognise when housing may be affecting health and take practical steps to support your patients.

Housing and respiratory health

Poor housing can have a major impact on respiratory health, leading to the development and worsening of lung conditions. Damp and mould, cold homes, poor ventilation, overcrowding and exposure to indoor pollutants can all affect breathing and increase the risk of exacerbations, hospital admissions and poorer long term health outcomes.

Healthcare professionals can play an important role in identifying when housing may be affecting a person’s respiratory health and wellbeing.

The importance of safe, healthy housing has been highlighted nationally through the introduction of Awaab’s Law, following the tragic death of two year old Awaab Ishak in 2020, whose death was linked to prolonged exposure to damp and mould in his family’s social housing.
The law introduced new legal duties for councils and housing associations in England, requiring them to investigate and address damp and mould within set timeframes, helping to ensure tenants live in safer homes.

Although Awaab’s Law currently applies to social landlords in England, all UK nations have housing legislation and systems in place to address serious housing issues. Private landlords across the UK also have a legal responsibility to ensure properties are safe and fit to live in.

How to use the Housing Toolkit

The Housing Toolkit has been developed by NHS East of England ICB to support healthcare professionals when poor housing may be affecting a patient’s respiratory health. It provides a simple step-by-step approach to help you identify concerns, support the patient and take appropriate action.

Step 1: Ask

Find out if damp, mould or other housing issues may be contributing to your patient's respiratory symptoms or exacerbations. Make asking patients and their families about their housing conditions part of your routine care.  

Step 2: Assist

Offer help. Many patients may not know their housing rights, who to contact, or how to access help and advice for damp and mould.
Gain their consent and share advice and resources with the patient.

Step 3: Act

Use the appropriate template letter to raise housing concerns and help the patient access repairs, environmental interventions and wider support.
Make sure you use the correct template, as the level of patient identifiable and clinical information shared will differ depending on the recipient.
To do this, first find out who owns your patient’s property.

For patients living in housing association or council owned housing

•    Send the Housing Association and Council Letter directly to the housing association or council 
•    Provide a copy to the patient
•    Send a copy to your patient’s GP, requesting referral to a social prescriber for additional support 
•    Send a copy to the health visitor if a child in the family is aged under 5 years

Here’s an example letter to guide you.

For patients living in privately rented accommodation

•    Identify the patient’s local council, which can usually be found on their council tax letter
•    Send the Local Authority Letter directly to the council. 
•    If the patient agrees, you can also send the Landlord Letter directly to the landlord or provide a copy for the patient to share themselves.

Here are example letters to guide you.

Refer a patient to our helpline - or get advice as an HCP

Our helpline can provide additional support for patients affected by lung conditions and those caring for them.  

Our trained helpline advisors offer information and support to help patients live well with a lung condition. They can discuss a wide range of issues, including benefits, housing, work, emotional wellbeing and accessing local services.

For more complex clinical queries, our specialist clinical team includes respiratory nurses, a respiratory physiotherapist and a dietitian. Clinical support is provided through a callback service, which can be arranged by our helpline advisors.

All calls are confidential. However, if information is disclosed that raises concerns about a person's safety or the safety of others, we may need to share this with appropriate services in line with our safeguarding policy.

The helpline is available to anyone affected by a lung condition, including family members, healthcare professionals, friends and carers. If you or your patient would benefit from additional support, information or specialist advice, encourage them to get in touch using the contact details below.