Linking affordable warmth and health
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Linking affordable warmth and health
5th June 2014
John Kolm-Murray
Seasonal Health and Affordable Warmth Co-ordinator
London Borough of Islington
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The Islington picture
• 14th most deprived local authority area in England
• Significant inequality and low social capital
• High levels of long-term illness, particularly respiratory and cardiovascular illness
• 50-60 excess winter deaths each year and around 7 excess winter emergency hospital admissions per death
• Over 20% fuel poverty (GLA definition)
• Mostly ‘hard to treat’ stock – high-rise flats, solid walled houses etc.
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Delivering seasonal health and affordable warmth work locally
• Strong emphasis on year-round work
• Prevention as well as reaction
• Working with local teams/organisations to raise cold weather issues
• Winter outreach work with third sector partners
• Dissemination of cold weather alerts through existing channels & partners
• Not just fuel poverty
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Warm Healthy Homes Programme
• Over 19,000 homes improved since 2010
• Energy Advice Service and popular Energy Doctor in the Home service
• Well Winter Campaigns every year since 2011
• Seasonal Health Interventions Network (SHINE) – multidisciplinary approach to reducing excess winter mortality, morbidity & fuel poverty
• Boiler Replacement Programme – F and G rated boilers in private sector and small RSL homes being replaced
• Bunhill decentralised energy plant
• Solid wall insulation programmes
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SHINE: The story so far
• Over 6,400 referrals to date (2,830 in 2013/14 alone)
• Almost 29,000 seasonal health interventions to date
• Over £600,000 saved on energy bills annually
• Successful in targeting right groups – all clients referred older, disabled, long-term ill or are low income families with children
– 52% aged over 65– 56% are people with disabilities– 34% have respiratory or cardiovascular illness – 15% have children under 5
• Targets in Islington Corporate Plan
• Model adopted by Hackney, Lewisham, Wandsworth and Norwich
• Strong political backing locally
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SHINE Interventions
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Growth of SHINE
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Links with health service
• Included in COPD post-discharge early implementers project
• Suggested through Islington COPD Local Enhanced Services
• Referrals received from acute and community teams at local hospitals
• Increasing participation from paediatric services.
• Public Health and NHS Reablement funds supported development
• Limited number of referrals coming from GPs
• Included in JSNA
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Joint Strategic Needs Assessment
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Well Winter Campaign 2012/13
• Social isolation significant factor in EWD & illness
• Worked with third sector partners – Age UK Islington, Pillion Trust (homelessness project),
North London Cares, Friendship Phone Network, Groundwork London (Energy Doctor)
• Outreach work, door-knocking to target hardest to reach– 4,600 vulnerable residents reached – both young & old– Over 1,000 SHINE referrals received– 1,612 clients new to Age UK Islington identified – 192 hot meals provided by Age UK during level 3 alerts– ~1,000 residents seen by North London Cares outreach
work– 112 replacement boilers installed– 52 vulnerable young people accessed Pillion Trust
shelter– 43 isolated residents signed up for Friendship Phone
Network
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Key points
• Excess seasonal mortality and morbidity the result of a number of factors therefore require multi-disciplinary approach
• Many health and social care professionals receptive to discussing wider determinants of health
• Signposting loses vulnerable people
• Data protection a barrier to precision
• No magic bullet: dogged persistence needed
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Looking ahead
• Future inclusion in Joint Health & Wellbeing Strategy
• Clinical Commissioning Group and GPs engagement– Joint mailing pilot this autumn
• Further integration into care pathways
• Dampness and mould growth campaign
• Lobbying GLA and London Councils to roll SHINE-like programme across London
• Draft NICE guidance out 13th June– Excess winter deaths and illness; focused on cold homes
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Contact
John Kolm-Murray
Seasonal Health & Affordable Warmth Co-ordinator
020 7527 3800
Twitter: @shine_network