ADVISER: Prescribing medical evidence for homeless applicants

When David came to Housing Rights Service he had been sleeping on his sister’s sofa for a few years and was finding it hard to cope. David is single and has a 5 year old daughter who spends weekends with him. He had presented as homeless to NIHE but was found not to have Priority Need.

When I met with David he explained that he had been suffering from depression for 12 years. His medication dosage had recently increased due to the stress of not having a home. He had given NIHE a letter from his GP which confirmed his diagnosis. However, NIHE didn’t feel that this evidence was strong enough to show that David was vulnerable and that being homeless would cause a risk to him.

I felt David could have Priority Need and agreed to help him ask NIHE to review their negative decision.

Insufficient medical detail and opinion

The letter that David’s GP had given to NIHE was really short and didn’t give a lot of information. It said:-

“This patient is depressed. He tells me that he has been sleeping on his sister’s sofa and that he is finding this stressful.”

I knew that NIHE would need more detailed information to be satisfied that David was in Priority Need. There were a few problems with the letter:-

• the GP didn’t say how long David has been suffering from depression;
• the letter didn’t list what treatment David was receiving and whether his dosage was high or low;
• the letter didn’t include any information on what impact the housing situation was having on David’s medical condition;
• the letter gave David’s opinion on his situation instead of the doctor’s own medical opinion.

Making the case to medical professionals

I contacted David’s GP and explained that NIHE needed more detailed information about David’s condition and his medical opinion on whether David would be at risk if he became street homeless. I explained that as his doctor, he knew David’s difficulties and needs better than anyone and his input was critical in proving Priority Need.

It was important the GP was clear about what needed to be in the letter so it was helpful for me to put things into perspective for him. David’s GP has been treating him for years and was happy to do what he could to help him improve his housing situation. Getting this letter right was so important for David. It could be the difference between him being homeless and having a place to call home.

The second letter from David’s GP was much more useful. It still wasn’t very long but it had just the right information in it. This time he said:-

“This patient has been attending the surgery since he was a child. He has been suffering from depression for 12 years and has been on antidepressants for 8 years. I have attached a list of medications with dosages. He is currently on the maximum dose of his antidepressant. Not having a permanent home is having a detrimental effect on his mental health. If his sister were to ask him to leave, David would be street homeless and I would be very concerned about the risk that this would pose.”

This letter was the basis of the written submissions sent to NIHE asking them to review their decision that David was not in Priority Need. NIHE overturned their decision and David was made a Full Duty Applicant and placed on the waiting list for re-housing.

David has recently been allocated a property of his own where his daughter can come and stay with him. He was delighted with the outcome of his case and is doing really well in his new home.

Tips for Advisers

David’s case is a really good example of how important a good medical letter can be for an adviser in showing Priority Need. If you are contacting a health professional and asking for a letter to support your client, let them know why you are asking for it and what information you are looking for.

A useful letter should explain:-

• How the doctor or health professional knows your client and for how long;
• Your client’s diagnoses;
• Any medications that have been prescribed and the dosage;
• The effect that being street homeless might have on your client and why.

Some GPs will charge a fee for a medical report. If you explain that the letter only needs to be a few lines long they may not charge. Some GPs might ask NIHE to request the letter and ask them to pay. If this happens, you can still explain to the GP what kind of information should be in the letter.

Tools to help

• Keep an eye on our Training & Events calendar for any upcoming courses on homelessness reviews.
• Our Professional Resource on Challenging Homelessness Decisions contains all you need to know about the statutory review and appeal process.