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In for a penny, in for a pound : tackling cold related ill health in County Durham. Tim Wright, Public Health Portfolio Lead. Overview. Context Background Warm & healthy homes Strenghts/weknesses What next?. Context.
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In for a penny, in for a pound: tackling cold related ill health in County Durham Tim Wright, Public Health Portfolio Lead
Overview • Context • Background • Warm & healthy homes • Strenghts/weknesses • What next?
Context • Excess winter deaths index of 19, 314 people. Not significantly different to England average • 22.7% children in poverty (sig.worse than England) • Disease prevalence by CCG is 20% greater than England for CHD, Stroke/TIA, COPD, LDs’
Context (cont’d) • Housing stock condition • 100 communities off gas network
Background • History early 2000s’ LAs’/NHS NRF • 2008 ‘Rights to Warmth’/Hotspots’ (early adopter of model of NG6). • Durham Dales ICO, 2009-11. • DH Warm & Healthy Homes funding. • NEPHO baseline (2009) and 2 year follow up reports, (2011) • NEA evaluation of Hotspots, 2013 • DECC Health booster fund
Warm & healthy homes • Reduce numbers of excess winter deaths • Reduce hospital emergency admissions • Improve the health and wellbeing of clients living in a cold, damp home • Provide warmer homes, lower fuel bills • Reduce levels of fuel poverty
Warm & healthy homes (cont’) • Eligibility criteria • Training/briefing of health/social care staff. • Menu of options • Annual report 2015/16
Strengths • Programme consistency • Well targeted • Strategically embedded • Advocates who push agenda • Engaged in national pilots eg ICO Dales/ funding bids • Cyclical feedback system • Utilisation of MECC
Weaknesses • Targeted intervention ? Scale • Outputs v outcomes • Small investment • Little CCG recognition/engagement • Not embedded into patient pathways. • Not promoted extensively • Tinkering at the edges
What next? • More robust links with primary care. • Targeted programme eg South Hetton. • Piggyback onto social prescribing. • ? Outcome based commissioning. • Loan based system • Private rented sector • Registered providers • FUSE supported seminar March 2017