Article:
Breathing Easier: Taking Energy and Welfare Advice into the NHS

Executive summary
In March 2026, Hope 4U launched a new project in partnership with the Cadent Foundation: the NHS Respiratory Safe & Warm Service. For the first time, Hope 4U advisers are working directly alongside respiratory clinical teams at Queens Hospital Burton and the Royal Derby Hospital, reaching patients at the point of care and addressing the home conditions that are making them ill. This article explains why we started it, what we are trying to solve, and what we have seen in the early weeks.

Why we started this project
Hope 4U has always worked from a simple principle: that people's energy, housing and financial circumstances cannot be separated from their health. For years, our advisers have seen the same pattern. A person is struggling to heat their home, missing out on benefits they are entitled to, and managing a chronic health condition that is being made worse by both. They are often referred to us late, after a crisis has already taken hold.
The opportunity with the Cadent Foundation was to get upstream of that crisis. Cadent's charitable foundation funds community projects focused on fuel poverty and vulnerable households across its network area. When we began conversations about embedding advisers within NHS respiratory settings, both organisations immediately recognised the potential. Cold, damp homes are a known driver of COPD exacerbations and asthma attacks. If we could be present in the hospital, at the moment a patient is already engaging with their health, we could reach people who would never find their way to a community advice service independently.

The NHS Respiratory Safe & Warm Service was the result. It launched on 2 March 2026 at Queens Hospital Burton and the Royal Derby Hospital, two trusts with dedicated respiratory wards, specialist consultants and Lung Nurse Specialists who immediately understood the value of what we were bringing.

What we are trying to solve
The hospitals refer patients living with conditions such as COPD and asthma to Hope 4U through a simple pathway. Our advisers hold appointments in a dedicated, confidential room within the hospital, run drop-in clinics alongside the existing clinical calendar, and carry out in-home assessments for those who need them most. The patient chooses the format that suits them.

What we are trying to solve is not one problem but several at once. Can this household afford to heat their home? Are they registered on the Priority Services Register? Are they claiming all the benefits they are entitled to? Is their home safe from carbon monoxide risk? Are there simple, practical measures we can install today that will make the property warmer and cheaper to run? Each of these questions feeds into the same outcome: a person with a respiratory condition living in a safer, warmer, more financially stable home, and needing their GP or hospital less often.
 

“For those patients who own their own homes, if you can help them improve their living conditions and warm their homes, this may help reduce the risk of exacerbations and hospital admissions. The scheme will help support reducing the economic divide in our patients, encouraging a more equitable standard of living.”

Sarah Hill, Specialist Respiratory Physiotherapist

Early impact: what we have already seen
We are only a few months into this project, but the early cases illustrate exactly why it is needed.
Mr and Mrs A are an older couple living with multiple serious health conditions, referred to Hope 4U at one of our hospital clinics. Mrs A has undergone two hip replacements and is awaiting a further knee replacement, alongside arthritis. Mr A lives with COPD, asthma, chronic kidney disease, a replacement heart valve and prostate cancer. His breathlessness is so severe that he frequently needs to return to bed during the day. The couple rely on each other for the most basic tasks.

During their initial appointment, a full benefit check identified that both may be eligible for Attendance Allowance. Our adviser arranged a dedicated follow-up appointment to complete both applications carefully, evidencing the full extent of their daily challenges. Both were awarded Attendance Allowance at the higher rate of £110.40 per week. That is £11,481 per year that this couple were not receiving before they walked through the hospital door and were pointed in our direction.

“You were very professional and very good for us. Made the application process for AA very smooth.”

Mr and Mrs A, project beneficiaries

Both were also registered on the Priority Services Register and provided with a personalised energy plan identifying improvements that could take their home from a D to an A energy performance rating. For a couple managing the health conditions they are living with, that is not a minor upgrade. It is the difference between a home that worsens their condition and one that helps them manage it.

What comes next
Over the life of this project we expect to support at least 850 individuals, with 1,000 referrals from health professionals and at least 250 in-home assessments. We will track health outcomes through a questionnaire adapted from an existing NHS framework, specifically measuring whether patients are better able to keep their homes warm and whether they are relying on healthcare services less frequently.
We believe this model has real potential beyond respiratory services and beyond the Midlands. If you are working in a health setting, an energy organisation, or a funder interested in what cross-sector collaboration looks like in practice, we would very much welcome the conversation.