1. Tackling Fuel Poverty Identified as a key priority in JSNA 2008 Tackling Fuel Poverty Identified as a key priority in JSNA 2008 ‘Likely to have the greatest impact in the long term in reducing health inequalities’ DH, 2003

2. Causes The main cause of fuel poverty in the UK is a combination of: The main cause of fuel poverty in the UK is a combination of:  low incomes  high energy prices  poor energy efficiency in homes

3. Fuel Poverty Health Headlines 1 in 5 Walsall residents live in fuel poverty which will increase in this current financial climate. 1 in 5 Walsall residents live in fuel poverty which will increase in this current financial climate. Walsall has experienced a 13% increase in deaths during winter months (02-07) Walsall has experienced a 13% increase in deaths during winter months (02-07) 80% of excess winter deaths are related to cold temperatures 80% of excess winter deaths are related to cold temperatures 20% difference in excess winter deaths between the coldest and the warmest home. 20% difference in excess winter deaths between the coldest and the warmest home.

4. Fuel Poverty Health Effects Exacerbation of asthma / COPD Exacerbation of asthma / COPD Increased rates of heart attack / stroke Increased rates of heart attack / stroke Increased accidents Increased accidents Worsening symptoms of arthritis Worsening symptoms of arthritis Mental health/wellbeing Mental health/wellbeing

5. Excess Winter Deaths index

6. Purpose To reduce health inequalities in patients with long term conditions To reduce health inequalities in patients with long term conditions Supports the delivery of: Supports the delivery of:  LAA  Vital Signs and WCC outcomes - Life Expectancy, CVD and COPD mortality  Health Inequalities Strategy

7. Actions To get insulation into the coldest homes To get insulation into the coldest homes Use primary care data to identify those in greatest need: the elderly at risk of falls, children with long term conditions Use primary care data to identify those in greatest need: the elderly at risk of falls, children with long term conditions To increase awareness and uptake of measures to improve health in fuel poverty households To increase awareness and uptake of measures to improve health in fuel poverty households Work in partnership with housing providers to improve access to those most at risk Work in partnership with housing providers to improve access to those most at risk Links to Food Coop, signposting benefits advice etc Links to Food Coop, signposting benefits advice etc

8. Target groups Elderly people at risk of falls and/ or with long term conditions. Elderly people at risk of falls and/ or with long term conditions. Children with chronic respiratory disease. Children with chronic respiratory disease.Engagement GPs and Practice staff consulted in set up of practice referral pilot, Breathe LIT, Falls Team GPs and Practice staff consulted in set up of practice referral pilot, Breathe LIT, Falls Team The public across the borough through ongoing fuel poverty work. The public across the borough through ongoing fuel poverty work.

9. Evidence for approach NICE 2005: Housing interventions involving energy efficiency measures positively affect health outcomes. NICE 2005: Housing interventions involving energy efficiency measures positively affect health outcomes. Warm Front Better Health: Health Impact Evaluation 08: ‘Insulation and central heating in eligible cost households were very effective in relation to morbidity and well being and CV mortality’. Warm Front Better Health: Health Impact Evaluation 08: ‘Insulation and central heating in eligible cost households were very effective in relation to morbidity and well being and CV mortality’.

10. Health Outcomes Expected From the NICE appraisal we can expect: 5% Reduction in the number of excess winter deaths 5% Reduction in the number of excess winter deaths 10% Reduction in the number of GP appointments and hospital admissions for serious cold or damp related illness. 10% Reduction in the number of GP appointments and hospital admissions for serious cold or damp related illness. 10% Reduction in re-admissions for LTC 10% Reduction in re-admissions for LTC

11. Programme Costs £100 per household benefiting from housing improvements £100 per household benefiting from housing improvements Match funding WHG, Walsall Council investing £1,001,400 to provide energy efficiency measures which reduce fuel poverty. Match funding WHG, Walsall Council investing £1,001,400 to provide energy efficiency measures which reduce fuel poverty. Projected savings to NHS Tackling excess cold in homes - £4,333,200 Tackling excess cold in homes - £4,333,200 Tackling damp in homes – £53,900 Tackling damp in homes – £53,900

12. Sustainability Proposal to PCT 2009/10 investment round Proposal to PCT 2009/10 investment round  Enable Walsall to participate in WM SHA tackling excess winter deaths and fuel poverty programme 09/10