GET WARM SOON Health Impacts of Fuel Poverty - PowerPoint Presentation

Slide1

GET WARM SOON Health Impacts of Fuel Poverty

How is the public health sector tackling the symptoms and causes of fuel poverty ?

R

egulatory framework in the UK

Examples of good practice – England and Northern Ireland

Jenny Saunders and Pat Austin NEASlide2

Scale of the problem

Around 4m fuel poor households in UK

Average 30k cold related deaths a year

£3.6m a day spent by NHS on cold related illnessesSlide3

GET WARM SOON?

Progress to Reduce Ill Health Associated with Cold Homes in

EnglandSlide4

Key findings from document review

Figure 4.

Performance rating of

HWBs to

address fuel poverty, excess

winter deaths and the NICE guidance according to their

JSNAs and health

and wellbeing strategies

NB:

The

maximum score a HWB could achieve was

6

. This means a HWB is prioritising both fuel poverty and EWDs in their strategy, as well as specifying actions to address the NICE

guidance Slide5

Area-based performance

NEA regraded areas to account for feedback received from stakeholders during

Stage 2.

Performance reflects that of an area

as a whole –

covering schemes

and initiatives addressing the

health impacts of cold homes which are in place locally but do not necessarily involve the HWB:

47 areas (31%) demonstrating minimal evidence of action to reduce ill health from cold

homes

105 areas (69%)

demonstrating

good

to excellent evidence

of action to

reduce ill

health from cold

homes

(performance varies markedly within this group)

31 areas (20%) demonstrated that they have local and strategic partnerships and action plans in place to coordinate and deliver services to address cold-related ill health

(R1)

Evidence of operating a single point of contact health and housing referrals service

(R2)

was collected for 45 areas (30%)

Evidence of discharge planning services (R7) was collected for 19 areas

(13%)Slide6

Conclusions and recommendations

KEY RECOMMENDATION:

Health and wellbeing boards update their joint strategic needs assessments and joint health and wellbeing strategies to apply the NICE guidance recommendations and quality standard on cold homes to their local

contexts

KEY RECOMMENDATION: The Department of Health, Public Health England and NHS England, along with boards themselves, consider how health and wellbeing boards can transition from a coordination to a commissioning role in order to deliver high-quality, cost-effective and joined-up health and housing services

KEY RECOMMENDATION:

Department of Health amend its statutory guidance on joint strategic needs assessments and joint health and wellbeing strategies to recommend that health and wellbeing boards review and refresh these documents annually, in order to inform yearly planning and commissioning cycles.

Public

Health England lead on improving the preparation and transparency of joint strategic needs assessments and joint health and wellbeing strategies. This should include establishing good practice guidance for the production of these

KEY RECOMMENDATION Health and wellbeing boards take steps to make sure initiatives which meet the relevant NICE recommendations are sufficiently funded. To support this Government must commit to substantive and sustainable levels of public health funding and health and wellbeing boards should transition to have a greater role in commissioning from integrated

budgets Slide7
Slide8

Programme Overview

Designed to align

with the recommendations set out in the

NICE guidance

and priorities

identified in the Fuel Poverty

Strategy for England

Aims to:

tackle excess winter deaths

& the

health risks

of living in a cold home

develop new

ways of

working with

health and social care practitioners

to

ensure fuel poor households at risk of cold related illness are referred to

assistanceSlide9

Current position

23

live projects across GB

Programme

aims to deliver energy efficiency interventions to

2,078

households by 31 March 2017Slide10

Partnerships programme

Funding

health

&

housing partnerships

to

provide

heating/insulation

measures Up to £4,000

per household

Eligibility criteria

targeting those with a health condition/disability exacerbated by living in a cold homeSlide11

Aligning with NICE

Developing referral routes with EHOs,

social prescribers, Adult

Social Care, Community Health Workers, District Nurses,

Patient Groups

etc.

LA/GP referral systems using risk stratification to identify patients with highest risk of hospital admission, triangulated with data on housing, income/benefits, fuel poverty and tenure

Providing a

single point of entry for referrals from health

, housing & frontline agencies

Piloting new referral techniques: patients at ‘high risk’ of cold-related conditions receiving birthday cards from their GP Practice

Raising awareness amongst

the

public on how to keep warm & well at homeSlide12

Provision for ‘at risk’ intervention

Householders are eligible via a low-income (£16,010)

or

qualifying benefit

Example

:

Referral came from Mrs B receiving a letter from her GP. Property’s 40 year old boiler was not

working an

extra radiator was needed in

the living room to maintain a healthy room temperature.

Mrs B suffer

with

COPD and Mr B has diabetes. Annual

household income is

£16,324.

The couple

had

no financial means to replace the boiler

.Slide13

Case Study: Derbyshire County Council

Mona

Leek is

77

, retired and lives alone in a bungalow. She was referred for assistance through her local authority as

her boiler kept

breaking down

and she was often left

with

no hot

water.

Mona is

living with a

heart condition

,

high blood pressure and

osteoporosis

. Due to this she

requires

the heating

on

during the

day,

leading to

energy bills

of £167

p/m. Using the NEA grant, Mona’s bungalow was fitted with a replacement condensing combi boiler and new heating controls. Mona now feels much happier, is sleeping better and feels more independent. Slide14

Case Study: Leicestershire County Council

Mr

&

Mrs P live with their 2

children. Their boiler was 15

years

old and often required numerous repairs,

leaving the family with no heating or hot water

. Due

to

the family’s low-income, they didn’t have the means to replace their boiler and were

considering a

loan.

The family were in a

stressful situation

having to boil kettles for hot water and use

expensive

portable electric heaters to keep warm.

The

difficulty in heating the home

was

affecting

Mrs P and her young daughter

who both have Asthma and in particular

her

son who is

Autistic.

The family were referred to Leicestershire’s project through their district council. Having met the eligibility criteria, a new gas boiler was fitted to provide affordable and reliable heating/hot water. Mrs P stated that the benefit was immediate as the family no longer needed to use any other form of

heating,

cutting

their electricity consumption. Slide15

Barriers to success

Intensive time & resource process to support vulnerable clients

Building

and maintaining referrals routes with health practitioners

Not

all projects have

the

same level of

strategic buy-in or £ support from PH or their CCGRevenue

funding Slide16

Community Engagement

72

resident events

delivered/attended as part of WHHF

Engaged and supported

987

residents across

England and WalesSlide17

NEA Training

1,100

frontline workers have received accredited NEA training as part of WHHF

Potential

reach per

yr

=

400,400

people

“I found the training really useful; it’s opened my eyes to the health implications of a cold home and helped me to recognise the signs of fuel

poverty

. I am now able to discuss these issues with service users that I visit and signpost them to the correct sources of help available.”

Community

Support WorkerSlide18

Social Evaluation Strategy

Objective-oriented approach – which objectives have been achieved and how well?

Unintended outcomes

Principally measure outcomes and delivery KPIs.

FORMATIVE

- Process

evaluation to improve and shape

- Inform

delivery and operational aspects of the programme over the delivery period.

- Provide

insight to how delivery could be enhanced, strengthened or adjusted.

SUMMATIVE

- Outcomes

focus

- Centred

on defined populations; principally households (beneficiaries) and local delivery partnersSlide19

Pat AustinDirector

NEA NISlide20

Overview of Fuel Poverty

800,000 Households: 42% Fuel Poverty (2011)

68% reliance on home heating Oil

870 Excess Winter Deaths (2014/15)

Different Energy Market:

Electricity

No competition

until 2010Natural Gas Not until

1996No competition until 2010Slide21

Current Interventions

Department for Communities

2004

Ending Fuel Poverty: A Strategy For Northern Ireland (no statutory target) £21million = Affordable Warmth

Northern Ireland Sustainable Energy Programme (NISEP) £7.9 Million

Boiler Replacement £4 Million

The Public Health Agency £400,000K

New Fuel Poverty Strategy PfG 2016-2021Slide22

Northern Exposure Project

Funded by the Public Health Agency (2009)

A positive legacy from Investing for Health strategy

Community Action based Project

Provides referral

pathways

Works with a range of partners including the Health sectorSlide23

Northern

Exposure

Research

Communications

Policy

Community events = 30

Awareness sessions = 60

Champions = 30

Since 2009 £1.5million in measures

Working through local community

infrastructure

Training health and social care health

staff

Outreach events with local community and statutory

agencies

Referring households to appropriate fuel poverty schemes

Navigating pathways from referral to installation of central heating and loft and cavity wall

installations

Establishing mechanisms for benefit uptake (one client recently received an additional £5,200 in unclaimed benefits)

400 householders per annum

65 Health Staff per annum

TrainingSlide24

Overview of Warmth at Home

Aim:

To improve health outcomes for patients with respiratory conditions who are living in a cold

home.

NEA provides frontline health practitioners within the Belfast Trust with awareness raising sessions;

Using an assessment form, health practitioners identify householders on discharge from hospital or point of community assessment for referral;

Patient assessed and referrals made to a range of interventions: EE, Grants, Benefits, Keep Warm Pack, Health and Safety checks, NI Chest Heart and Stroke

.Slide25

Case Study 1

Mr C is an owner occupier and lives in a ground floor

flat. He

wanted to know if he could get cavity wall insulation as the flat was quite cold. At assessment stage he was entitled to a fully funded heating replacement grant because his heating was Economy 7. He was initially concerned this would be an upheaval as he is aged over 90, however, having discussed this with NEA and his family, the referral was made and he now has gas central heating and cavity wall insulation

.Slide26

Case Study 2

Evelyn is a Housing Association tenant and had problems with draughts and rainwater leaking into the hall. We negotiated with her landlord

and as a consequence

her doors have now been replaced. Additionally she received a benefit entitlement check and now receives an extra £60 per week equating to over £3,000 per year

.Slide27

Case Study 3

Cathy is in the process of getting new windows via the Affordable Warmth Scheme. She has other

housing repair needs, which includes

needing a damp proof course. Through Warmth at Home, she was assisted in applying for a home repair assistance grant under exceptional

circumstances and is currently awaiting an upgrade to her heating system.Slide28

ConclusionWhy successful?

medical model meets social model

Continued success

evidence, evaluation, NICE (NG6)

Mainstreaming

campaign, demonstration,

leadershipSlide29

Thank You

Jenny Saunders

Jenny.Saunders@nea.org.uk

Pat Austin

Pat.Austin@nea.org.uk