The guideline is for commissioners, managers and health, social care and voluntary sector practitioners who deal with vulnerable people who may have health problems caused, or exacerbated, by living in a cold home.

It will also be of interest to clinicians and others involved with at-risk groups, housing and energy suppliers.

This guideline makes recommendations on how to reduce the risk of death and ill health associated with living in a cold home. The aim is to help:

  • Reduce preventable excess winter death rates.
  • Improve health and wellbeing among vulnerable groups.
  • Reduce pressure on health and social care services.
  • Reduce ‘fuel poverty’ and the risk of fuel debt or being disconnected from gas and electricity supplies
  • Improve the energy efficiency of homes.

Improving the temperature in homes, by improving energy efficiency, may also help reduce unnecessary fuel consumption.

A wide range of people are vulnerable to the cold. This includes:

  • people with cardiovascular conditions
  • people with respiratory conditions (in particular, chronic obstructive pulmonary disease and childhood asthma)
  • people with mental health conditions
  • people with disabilities
  • older people (65 and older)
  • households with young children (from new-born to school age)
  • pregnant women
  • people on a low income.

The health problems associated with cold homes are experienced during ‘normal’ winter temperatures, not just during extremely cold weather. Year-round action by many sectors is needed to combat these problems. This includes:

  • prioritising which homes are tackled first
  • shaping and influencing the decisions about how homes are improved
  • developing the research agenda.

This guideline was previously called excess winter deaths and morbidity and the health risks associated with cold homes.

Next review: To be scheduled

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommendations in this guideline is not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.

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