16 July 2013

John Kolm-Murray

Seasonal Health & Affordable Warmth Co-ordinator

Integrated approaches to seasonal health

Islington: forget the stereotype

• 14th most deprived local authority area in England• Around 20% fuel poverty (After Housing Costs definition)• Excess Winter Mortality rate of 17% (19% England) (2008-

2011)• Relatively energy efficient homes but great deal of poverty• Two-thirds of homes hard to insulate• High level of long term limiting illness• Male life expectancy 2.6 years lower than England

average• Improved energy efficiency of 17,800 homes since 2010

Well Winter Campaign 2012/13

• Partnership with Age UK, North London Cares, Pilion Trust, Friendship Phone Network, Groundwork

• 4,592 unique contacts made (Nov-Mar)– 1,033 SHINE referrals– 1,612 clients new to Age UK– 1,000 residents reached by North London Cares– 345 Energy Doctor in the Home visits– 112 boilers replaced– 192 hot meals during coldest periods– Supported cold weather shelter for 52 young homeless people

• Very positive feedback from residents

SHINE

• Aims of SHINE to:– Tackle seasonal ill-health from all angles– Reduce excess winter mortality and morbidity

– Improve energy efficiency of homes (and thus reduce CO2 emissions)

– Reduce health and social care costs– Enable older people to live independently for longer– Reduce childhood illness and thus improve educational attainment– Reduce social isolation– Integrate disparate services

• Priority groups:– Older people, particularly those 75+– Low income families with young children– People with long term limiting illness

Seasonal Health Interventions

Success to date

• Recruited over 400 front line staff in housing, health, social care, third sector to network in Islington and Hackney

• In 2012/2013 we received 1,993 referrals, leading to over 9,000 interventions

• From December 2010 to June 2013 – 4,045 referrals, leading to around 19,000 interventions

• NEA Community Footprint Award 2012/13• European Prize for Innovation in Public Administration 2013• Integrated often disparate realms of health (acute, community and public),

housing and energy• Large amount of data for future programmes• Severe weather broadcast system

Health sector engagement

• Islington Public Health funded development stage

• NHS Reablement Fund paid for dedicated member of staff 2012-13

• Warm Homes Healthy People Fund in 2011/12 and 2012/13

• Several hundred referrals from NHS services

• Strong relationship with chronic respiratory service at Whittington Hospital

• Incorporation in LES for COPD and 75+ health checks

Challenges

• Health professionals not always conscious of or convinced of importance of housing and social environment for health

• Lack of acceptable evidence

• Reactive sickness service rather than proactive health service

• Siloes and territorialism

• Lots and lots of competing priorities

• Fatalism – “old people die in winter”

• Securing needed improvements for hard to insulate homes

The future

• New Public Health funding?

• Evidence for reduction in admissions

• Integration with social care early intervention

• Fuel debt prevention and financial capability

• Dampness and indoor air quality strategy

• Overheating responses

• More work on social isolation

Contacts

020 7527 3800

john.kolm-murray@islington.gov.uk

www.islington.gov.uk/seasonalhealth

www.twitter.com/shine_network