NHS Referrals for ECO4 Grants - Guide for GPs

A Comprehensive Guide for GPs on NHS Referrals for ECO4 Grants

An Introduction to NHS Referrals by GPs

Imagine the difference you could make to the basic living conditions of a patient simply by completing a single form.

The ECO4 scheme offers very generous funding for patients whose health conditions are made worse by living in a cold home. This is where the patient’s home is classed as energy-inefficient, signified by an Energy Performance Certificate (EPC) rating of E, F or G.

GPs are uniquely positioned to identify and refer eligible patients. The Ofgem rules now equip GPs to complete a straightforward NHS referral form to enact a referral.

This guide is tailored to help GPs navigate the ECO4 scheme, understand the eligibility criteria, and refer qualifying patients. Armed with this knowledge, you’ll be able to make referrals which will make a massive difference to the quality of life for vulnerable people.

Overview of the ECO4 Scheme

The ECO4 scheme is the fourth phase of the Government’s Energy Company Obligation. The ECO4 scheme, financed by energy suppliers, offers fully-funded home improvements, including heating and insulation. With £4 billion allocated to the program, we are now at its midpoint. These improvements are designed to create warmer, healthier living environments, reducing the strain on patients’ health and potentially lowering their need for medical intervention.

The Critical Role of GPs in Patient Referrals

General practitioners play an integral role in recognising and referring eligible patients who can benefit from the ECO4 scheme. Your understanding of your patients’ medical histories and living conditions places you at the forefront of this initiative. Your proactive involvement in referrals of eligible patients will significantly enhance the quality of life for those individuals, making a meaningful impact on their health and well-being.

Understanding ECO4 Eligibility

To effectively refer patients to the ECO4 scheme, it’s essential to understand the eligibility criteria. The scheme targets those living in cold homes who suffer from severe and/or long-term health conditions. The primary criteria for eligibility are outlined below.

Criteria and Health Conditions

  • Identified by Health Professionals: Eligibility extends to those identified by a General Practitioner, a Health Board in Scotland or Wales, an NHS Foundation Trust, or an NHS Trust.
  • Health Conditions: Patients must suffer from conditions that could be severely impacted by living in a cold home, including:
  • Cardiovascular conditions: Such as heart disease, hypertension, and stroke.
  • Respiratory diseases: Including asthma, chronic obstructive pulmonary disease (COPD), and bronchitis.
  • Limited mobility: Conditions that impair physical movement and increase vulnerability to cold environments.
  • Immunosuppression: Conditions or treatments that weaken the immune system, making patients more susceptible to illness.

By applying these criteria, GPs can identify patients who would benefit most from the ECO4 scheme, thereby improving their living conditions and overall health. While we have a range of applicants qualifying through having health conditions made worse by living in a cold home, your involvement in the process could greatly improve their chance of being in a warm home sooner.

The GP’s Role in Referrals: A Step-by-Step Guide

As a GP, your role is pivotal in the ECO4 referral process. Your unique position allows you to identify and support patients who are eligible for the scheme. Here’s how you can play an active role:

Step 1: Identify the patient

  • Identify patients who meet the ECO4 eligibility criteria based on their health conditions.

Step 2: Documentation Preparation

  • Complete the referral form. These forms can be found at the following locations:
Download Link

NHS Referral form (PDF)


NHS Referral form (Word document)




Step 3: Check the Referral

Guidance for GPs –

Please ensure the form:

(i) is fully completed by the GP surgery, including the GP’s name, address and GMC Number.

(ii) includes the resident’s name and address and has the health condition box ticked.

(iii) is signed by the named GP, including their official GP stamp.

(iv) is printed/copied onto the GP Practice letter head.

(v) is returned electronically from a valid NHS email address. Please return the referral to hello@energysavinggenie.co.uk

Step 4: Send the Referral

The NHS referral must be returned electronically as part of Government rules (documented in Ofgem guidance). Please email the completed referral to hello@energysavinggenie.co.uk

Once the referral is received, the installer will arrange for the property to be assessed for home improvement assessments and installations.


Laura in Cheshire suffered from Anorexia and applied for a grant. We sent Laura the NHS referral and her consultant completed an NHS referral. When we spoke to the referring consultant, they said, “If we are going off the listed health conditions as umbrella reasons, then Laura’s diagnosis of Anorexia means that living in cold conditions was massively impacting her. The body not being nourished adequately can cause issues within all four of the health categories.” Laura’s application was accepted and she received a fully funded upgrade that included the installation of an A-Rated boiler, loft insulation, heating controls and ventilation.

Thanks to the referrals of GPs, we have had several successful applications from applicants with a range of health conditions, including cancer, stroke, mental health conditions that impact their mobility. Neither the installer nor the energy companies are medically trained, so they rely on qualified medical professionals to refer eligible applicants.

Encouragement for GP Participation

Your proactive involvement in the ECO4 scheme can make a significant difference in your patients’ lives. By identifying and referring eligible patients, you can help them access the support they need to improve their living conditions and overall health. The ECO4 scheme is a powerful tool in the fight against health conditions exacerbated by cold homes, and your participation is crucial.

Resources and Further Reading

For more information on the ECO4 scheme and how to make referrals, consider the following resources:

Frequently Asked Questions

Why are sections of the referrals crossed out?

For referrals through the health route 3, only that section of the referral should be completed. If you refer an application through route 2 (being vulnerable), the applicant has to meet other conditions detailed in the vulnerability route also.

My patient has a health condition that affects their mobility. Would they qualify?

Yes. We receive a wide range of referrals where patients have conditions that impact their mobility. The health practitioner has the medical training and so the scheme rules say that they can determine the applicant’s eligibility. If this is the case, the GP should complete the NHS referral for ECO4 funding.

Will my patient receive the grant if I refer them?

The referral to ECO4 Flex does not guarantee that measures will be installed. By referring a household to ECO4 Flex, the practitioner is stating, based on the evidence that they have seen, that the household may be eligible to receive measures. The decision on which measures, if any, are installed, rests with suppliers.

Where can patients check their EPC rating?

In England and Wales, EPCs are listed here and in Scotland they can be found here. Users can also check their EPC rating using our free grant checker which will connect them with registered installers with contracts to deliver funding in their area.

Can patients be charged for referrals?

No! In order to protect fuel poverty applicants, the Ofgem rules say that patients cannot be charged a fee for the referral to be completed. The referral must be free of charge.

Can installers be charged for referrals?

Yes – but they need to agree to any fees before they are incurred.

Can GPs refer other patients?

Yes. Please feel free to refer patients and, likewise, encourage your colleagues to become involved in the ECO4 referral process. Together, GPs can make a significant impact on public health by leveraging the resources available through the ECO4 scheme. Energy Saving Genie’s free grant checker assesses eligibility and connects applicants with registered installers with contracts to deliver the obligation.