Linking affordable warmth and health
5th June 2014
John Kolm-Murray
Seasonal Health and Affordable Warmth Co-ordinator
London Borough of Islington
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.
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
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
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
SHINE Interventions
Growth of SHINE
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
Joint Strategic Needs Assessment
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
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
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
Contact
John Kolm-Murray
Seasonal Health & Affordable Warmth Co-ordinator
020 7527 3800
Twitter: @shine_network