About this guideline

What does this guideline cover?

The Department of Health (DH) asked the National Institute for Health and Care Excellence (NICE) to produce this guideline on excess winter deaths (see the scope).

The absence of any recommendations on interventions that fall within the scope of this guideline is a result of lack of evidence. It should not be taken as a judgement on whether they are cost effective.

How was this guideline developed?

The recommendations are based on the best available evidence. They were developed by the Public Health Advisory Committee (PHAC).

Members of the PHAC are listed in membership of the Public Health Advisory Committee and the NICE project team.

For information on how NICE public health guidelines are developed, see the NICE public health guideline process and methods guides.

What evidence is the guideline based on?

The evidence that the PHAC considered included:

  • Evidence reviews:

    • Review 1: 'Factors determining vulnerability to winter‑ and cold weather‑related mortality/morbidity' was carried out by the London School of Hygiene and Tropical Medicine. The principal authors were: James Milner, Zaid Chalabi and Paul Wilkinson.

    • Review 2: 'Interventions and economic studies' was carried out by the London School of Hygiene and Tropical Medicine. The principal authors were: James Milner, Zaid Chalabi and Paul Wilkinson.

    • Review 3: 'Delivery and implementation of approaches for the prevention of excess winter deaths and morbidity' was carried out by the London School of Hygiene and Tropical Medicine. The principal authors were: James Milner, Zaid Chalabi and Paul Wilkinson.

  • Economic modelling:

    • 'Excess winter deaths: economic modelling report' was carried out by the London School of Hygiene and Tropical Medicine. The principal authors were: James Milner, Ian Hamilton and Zaid Chalabi.

  • Expert papers:

    • Expert paper 1: Alzheimer's and dementia in relation to cold homes and excess winter mortality and morbidity'. The principal author was Christine Liddell, University of Ulster.

    • Expert paper 2: 'Children's health and wellbeing and cold homes' by Christine Liddell, University of Ulster.

    • Expert paper 3: 'Benefit changes, fuel poverty and disability' by Carolyn Snell, University of York.

    • Expert paper 4: 'Working in local partnerships to address the impact of cold homes' by Martin Chadwick, Beat the Cold.

    • Expert paper 5: 'OFGEM's vulnerable consumer strategy and related initiatives' by Phillip Cullum, OFGEM.

    • Expert paper 6: 'The role of CCGs in addressing the impact of cold homes' by Tim Anfilogoff, Hertfordshire Valleys Clinical Commissioning Group and Neil Walker, Watford Borough Council.

    • Expert paper 7: 'Policy update and the ECO' by Gareth Baynham‑Hughes and Fern Leathers, DECC.

    • Expert paper 8: 'The role of energy companies in addressing the impact of cold homes' by Maria Wardrobe, National Energy Action.

Note: the views expressed in the expert papers above are the views of the authors and not those of NICE.

In some cases the evidence was insufficient and the PHAC has made recommendations for future research. For the research recommendations and gaps in research, see recommendations for research and gaps in the evidence.

Status of this guideline

The draft guideline, including the recommendations, was released for consultation in June 2014. At its meeting in September 2014, the PHAC amended the guideline in light of comments from stakeholders and experts and the fieldwork. The guideline was signed off by the NICE Guidance Executive in January 2015.

All healthcare practitioners should ensure adults have a high quality experience of the NHS by following NICE's recommendations in patient experience in adult NHS services.

All health and social care providers working with people using adult NHS mental health services should follow NICE's recommendations in service user experience in adult mental health.

The recommendations should be read in conjunction with existing NICE guidance unless explicitly stated otherwise. They should be implemented in light of duties set out in the Equality Act 2010.

The guideline is available on NICE's website. The recommendations are also available in a NICE Pathway for practitioners whose remit includes public health and for interested members of the public.

NICE produces guidance, standards and information on commissioning and providing high‑quality healthcare, social care, and public health services. We have agreements to provide certain NICE services to Wales, Scotland and Northern Ireland. Decisions on how NICE guidance and other products apply in those countries are made by ministers in the Welsh government, Scottish government, and Northern Ireland Executive. NICE guidance or other products may include references to organisations or people responsible for commissioning or providing care that may be relevant only to England.

Implementation

NICE guidelines can help:

NICE has developed tools to help organisations put this guideline into practice.

Updating the recommendations

This guideline will be reviewed 3 years after publication to determine whether all or part of it should be updated. Information on the progress of any update will be posted on the NICE website.

  • National Institute for Health and Care Excellence (NICE)