1. Excess winter deaths and morbidity and the health risks associated with cold homes Chris Connell Implementation Consultant September 2015

2. Areas to cover Who we are and what we do The guideline - the context - who should take action - the recommendations Practical help Staying up to date and opportunities for getting involved

3. Health technologies: –technology appraisals –interventional procedures –medical technologies –highly specialised technologies Guidelines and quality standards: - clinical practice -public health -social care We produce national guidance covering

4. The guideline http://www.nice.org.uk/guidance/ng6 http://www.nice.org.uk/guidance/ng6 Aims of the guideline are to:- Reduce preventable excess winter death rates. Improve health and wellbeing among vulnerable groups. Reduce pressure on health and social care services. Reduce ‘fuel poverty’ and the risk of fuel debt or being disconnected from gas and electricity supplies Improve the energy efficiency of homes.

5. A system wide approach The guideline is aimed at all those with an interest in health and housing:- local authorities, the NHS or other organisations in the public, private, voluntary and community sectors. utility companies, particularly energy suppliers and energy distribution companies others responsible for providing and maintaining heating systems and insulation in the home.

7. Context (1) Excess deaths and illness is not just about very low temperatures. Although lower temperatures have a more significant effect on health, the ill effects from cold homes are seen when outdoor temperatures drop to around 6°C Because temperatures in this range are much more common, this is when the greatest number of health problems caused by the cold occur. A wide range of people are vulnerable to the cold

8. Factors linking cold temperatures to excess winter deaths and illness

9. Context (2) Most excess winter deaths and illnesses are not caused by hypothermia or extremes of cold. Usually ( but not only) caused by respiratory and cardiovascular problems during normal winter temperatures – when the mean outdoor temperature drops below 5–8°C The number of excess winter deaths varies between years – generally around 24,000 in England and Wales. The number of excess deaths in 2013/14 was 18,200 - relatively high by international comparisonsexcess winter deaths Age UK estimate the annual cost to the NHS in England due to cold homes is £1.36bn p.a (The cost of cold 2012 )The cost of cold

10. Guideline recommendations Health and wellbeing boards (HWBs) should develop a strategy to address the health consequences of cold homes They should ensure there is a single ‑ point ‑ of ‑ contact health and housing referral service for people living in cold homes They should provide tailored solutions via the single ‑ point ‑ of ‑ contact health and housing referral service for people living in cold homes Primary and home care practitioners should identify people at risk of ill health from living in a cold home

11. Guideline recommendations (2) Primary and home care practitioners should “make every contact count” by assessing the heating needs of people who use primary health and home care services Non-health and social care workers who visit people at home should assess their heating needs Discharge vulnerable people from health or social care settings to a warm home Train health and social care practitioners to help people whose homes may be too cold

12. Guideline recommendations (3) Train housing professionals and faith and voluntary sector workers to help people whose homes may be too cold for their health and wellbeing Train heating engineers, meter installers and those providing building insulation to help vulnerable people at home HWBs, Public Health England and Dept of Energy should raise awareness among practitioners and the public about how to keep warm at home Local authority officers should ensure buildings meet ventilation and other building and trading standards

13. Implementation – practical support Baseline assessment tool Costing statement Shared learning database Field team Into Practice Guide We provide a range of resources to help maximise uptake and use of evidence and guidance. www.nice.org.uk/about/what-we-do/into-practice

14. NICE Savings and Productivity and Local Practice Collections www.nice.org.uk/sharedlearning

15. pathways.nice.org.uk

16. Summary It is possible to prevent excess winter death rates Improve health and wellbeing among vulnerable groups Reduce pressure on health and social care services Reduce ‘fuel poverty’ and the risk of fuel debt or being disconnected from gas and electricity supplies Improve the energy efficiency of homes

17. NICE News- monthly e- newsletter on consultations, published and forthcoming guidance. Social care stakeholder update :- socialcaresh@nice.org.uk socialcaresh@nice.org.uk Chris.connell@nice.org.uk Staying up to date with NICE http://www.nice.org.uk/News/NICE-newsletters-and-alerts