The council letter is in a plastic wallet on the fridge. It asks for medical evidence. Someone has already photocopied the clinic summary that names the conditions, because that felt like the obvious thing to send. It describes the person in some detail. It does not mention the stairs. It has answered the wrong question.
A housing medical letter is not a second copy of your diagnoses. The assessor is deciding whether this home makes this illness worse, or whether this illness means this home cannot be used safely. Stairs, bathroom, heating, damp, overcrowding: the letter has to mention the property. Truthful is not the same as usable. Usable is written to the council’s question.
The real question is whether anyone who writes the letter has seen the rooms the council is being asked to judge.
Chest pain, signs of a stroke, severe breathlessness, heavy bleeding, a severe allergic reaction or symptoms of sepsis need 999 or A&E immediately.
What a housing medical letter should describe
The short version is this. Bring the council’s letter when you book in Palmers Green. I need their questions, their form, their deadline. Then I need the home, or a precise account of it, and an examination of the person who lives there. A paragraph that only lists asthma, arthritis, and low mood will read as a GP being kind. It will not tell a housing officer whether a third floor walk up is the problem.
Here is the longer version.
What I look at in clinic, and more often in the house, is the match between body and building. How many steps to the front door, and how many after that. Whether there is a lift, and whether it works. Where the toilet is, and whether getting there at night is a fall waiting to be written up after the event. Whether the bathroom can take a chair, a rail, a second person helping. Heating: who can work it, whether rooms are shut off because of cost, whether damp is a photograph or a smell in January. Overcrowding: who sleeps where, whether a child with a condition is sharing with two siblings, whether a carer has nowhere to lie down. Noise, if sleep is the medical issue. The kitchen, if nutrition and standing are the medical issue.
Then the person. What they can do today. What they could do a year ago in the same rooms. Breathlessness on the actual staircase, not on a flat clinic corridor. Pain after the actual transfer from chair to toilet. Confusion at dusk in a hallway with a dark corner. Incontinence when the only toilet is downstairs and the bedroom has moved to the front room. The pattern matters more than the single reading. A blood pressure in clinic does not tell me about 14 steps with shopping.
From our practice, the adult child is often the one who books. They have already spoken to the council. They have already been told to get a letter from the doctor. They are carrying two fears at once: that nothing will change, and that asking for a different property is a betrayal of a home their parent still loves. I am not a housing officer. I do not award bands. I can say, as a GP, how this illness interacts with these rooms. That is the useful sentence. The rest is theirs and the council’s.
The piece most people miss is the request. Councils do not all ask the same thing. Some want a form filled. Some want comments on medical priority. Some want an opinion on disabled facilities, overcrowding, or whether a move is needed on health grounds. Some want to know if a ground floor is required, or an extra bedroom for a carer, or whether damp is aggravating a chest. If you do not bring the letter, I am guessing, and guessed letters are how this work gets a reputation it does not need.
Clinic, or the house
It is worth saying plainly: for this document, the house is often the right room. A 30 minute clinic appointment at £100 can start the conversation, and I can take a history of the property. I cannot honestly describe stairs I have not seen if the whole case turns on those stairs. A home visit is £250 on a weekday, £325 at weekends and on bank holidays, and £450 for a start from 20:00, up to an hour, and that hour includes walking the rooms. That is not a luxury. It is how you avoid writing the wrong letter neatly.
I will not write that the family must be moved. I will write the functional effect of this accommodation, as I found it. I will not copy a draft from an adviser. I will not inflate. Housing teams read a lot of letters. The ones that mention the banister, the landing, and the time it takes to get to the toilet are the ones that could only have been written by someone who asked.
When to come in sooner
Come in sooner if the council has given a date, or if a review is already underway, or if you have been placed in temporary accommodation that is making the condition worse in a way nobody medical has yet written down. Bring their letter. Bring photographs of the stairs and the bathroom if a visit cannot be arranged before the date, and be honest that photographs are a substitute.
Come in sooner after a fall on those stairs, or after an admission that started in that bathroom, if the housing question is now live. The hospital discharge letter will name the event. It will not usually name the 14 steps.
Do not wait on a housing letter if the person is acutely unwell in that property tonight.
- Chest pain, stroke signs, severe breathlessness, heavy bleeding, a severe allergic reaction, or sepsis: 999.
- A fall with a suspected hip injury, or they cannot be woken: 999.
- Carbon monoxide concern, a fire, or you cannot heat the home in a way that is immediately dangerous: 999, then the council’s out of hours line.
- A person who is not safe, or has a plan to harm themselves: 999 or A&E.
- A child with a fever who is floppy, or a rash that does not fade: 999.
- Severe asthma or breathing that is getting worse hour by hour: 999, not a letter slot in the morning.
How we approach this at Clinique Alpa
Call 020 8882 8088, or send a WhatsApp enquiry to 447742163571 without sending the whole housing file through the chat. Say that you need a housing supporting letter, and whether we should come to the property. We confirm the fee in writing. A housing support letter is listed at £500, and a detailed housing report at £750, on the appointments and fees page. Clinic 30 minutes is £100 if you need advice first. Referral letters are included in the consultation fee after assessment if a specialist opinion is the next honest step.
I read the council’s questions. I assess the person. Where the property is the issue, I want to see it, or I will state the limits of an opinion given only in clinic. I write to their question, in plain English, as independent evidence. You receive the letter to send. I do not submit it to the council unless you have asked me to, in writing.
The wider reports process is on the medical reports page. If the assessment needs to be in the house, start with the home visiting GP route and tell us on the call that the letter is housing, so the hour is used on the rooms as well as the chest.
Bring the council’s letter. Then let someone look at the stairs, not only the notes.
A letter written to the property as well as the person, after assessment. Read our fees page, or call 020 8882 8088. Housing support letters listed at £500, detailed housing reports at £750, confirmed in writing. Home visits £250 weekday, £325 weekend and bank holiday, £450 from 20:00. In an emergency call 999. Subject to availability.
Written by Dr Mitesh Parmar, MBBS MRCGP, GP and founder of Clinique Alpa, 466 Green Lanes, Palmers Green, London N13 5PA. This article is general information, not personal medical advice. In an emergency call 999. For NHS advice call 111 or visit nhs.uk.