Linking affordable warmth and health

1. Linking affordable warmth and health 5th June 2014 John Kolm-Murray Seasonal Health and Affordable Warmth Co-ordinator London Borough of Islington

2. 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.

3. 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

4. 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

5. 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

6. SHINE Interventions • Initial energy advice • Home energy visitor service • Energy efficiency grants • Energy and water bill discounts • Telecare • Fire safety check • Home security check • Handyperson Service • Private sector housing support • Benefit check • Debt advice • Disabled Facilities Grant • Medication review • Flu jab • NHS Health Check • Message in a Bottle • Air pollution alerts • Falls assessment • Older people’s support services • Vulnerable utility customer register • Support for people with disabilities • London Taxicard • Befriending services • Mental health enablement service • Stop Smoking Service • Alcohol support

7. Growth of SHINE

8. 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

9. Joint Strategic Needs Assessment

10. 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

11. 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

12. 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

13. Contact John Kolm-Murray Seasonal Health & Affordable Warmth Co-ordinator 020 7527 3800 john.kolm-murray@islington.gov.uk Twitter: @shine_network