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ECO4 Flex scheme - NHS referrals guide

Why do we need the help of health professionals?

Cold homes can be harmful to health and wellbeing, with cold conditions potentially causing serious long-term health conditions or making symptoms worse for those already affected. In 2019, the Local Government Association estimated the NHS spends £2.5 billion per year as a minimum on treating illnesses that are directly linked to cold, damp and unsafe homes.

Living in cold conditions can cause respiratory conditions, cardiovascular diseases, poor mental health, and dementia – and make these illnesses worse. Damp and mould are more common in cold homes and can irritate the lungs and exacerbate asthma. There's also a higher risk of falls in a cold home due to reduced strength and dexterity in low temperatures.

By improving the living conditions residents currently face, we can both lessen the burden on the NHS and improve the lives of residents across Greater Manchester.

What role can healthcare professionals play in making NHS referrals into the ECO4 Flex scheme?

Qualified health professionals - including doctors, nurses, and other clinicians working in a GP practice or NHS trust - can refer patients directly into the ECO4 Flex scheme, enabling them to receive free upgrades that will make their homes warmer and cheaper to heat. 

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Who is eligible?

Owner-occupiers and private tenants (excluding social housing tenants) on a low income OR vulnerable to the effects of living in a cold home with at least one of the following umbrella conditions:

  • A cardiovascular condition,
  • A respiratory disease,
  • Limited mobility, or
  • Immunosuppression.

The eligible resident must live in a property that is energy inefficient, with an energy performance certificate (EPC) band from D to G. It is not the responsibility of the health professional to check this as part of the referral process - this will be checked by the installer. 

How can health professionals refer a patient to the scheme?

To directly refer medically eligible patients with their permission, please complete the letter below and email it to - this needs to be sent from an NHS email address.

NHS ECO referral letter (Word - 53KB)

The scheme is currently open and accepting referrals.

Alternative referral routes

In addition to referral via health professionals, we operate an online portal which allows residents to self-refer under other eligibility routes such as low income, alongside checking the eligibility of their property: Energy Company Obligation Scheme - Greater Manchester Combined Authority (