Quality statement 1: Year‑round planning to identify vulnerable local populations

Quality statement

Local populations who are vulnerable to the health problems associated with a cold home are identified through year‑round planning by local health and social care commissioners and providers.

Rationale

Local coordination helps to ensure that populations who are vulnerable to the health problems associated with cold homes can be identified. Planning for this should happen all year, for example through local joint strategic needs assessments, joint health and wellbeing strategies, and developing local versions of the Cold weather plan for England (Public Health England). The local plan should set out how statutory and non‑statutory local organisations can work together to identify populations vulnerable to the health problems associated with cold homes. This should include close partnership working with the housing, voluntary and community sectors to help reduce population vulnerability and support the planning and response to cold weather.

Quality measures

Structure

a) Evidence of local arrangements for multi‑stakeholder winter planning meetings for collaboration on year‑round planning to identify local populations who are vulnerable to the health problems associated with a cold home.

Data source: Local data collection.

b) Evidence of a local winter plan.

Data source: Local data collection.

c) Evidence of local action to support Public Health England's Cold weather plan for England.

Data source: Local data collection.

Outcome

Identification of local populations vulnerable to the health problems associated with a cold home.

Data source: Local data collection.

What the quality statement means for service providers, health, public health and social care practitioners, and commissioners

Service providers (such as local authority departments, local NHS providers, housing organisations and voluntary organisations) collaborate in year‑round planning with commissioners to identify local populations who are vulnerable to the health problems associated with a cold home. Long‑term, year‑round planning and commissioning to prevent cold home‑related harm should be considered core business.

Health, public health and social care practitioners (such as GPs, community nurses, health visitors and home care practitioners) ensure that they are aware of the populations who are vulnerable to the health problems associated with a cold home in their local area so that people receive the tailored support they need.

Commissioners (such as clinical commissioning groups, local authorities and NHS England) collaborate in year‑round planning with providers to identify local populations who are vulnerable to the health problems associated with a cold home.

What the quality statement means for patients, people using services and carers

People who may be vulnerable to the health problems caused by living in a cold home are supported by local services working together all year round to understand and identify which groups of people are vulnerable.

Source guidance

Definitions of terms used in this quality statement

Populations who are vulnerable to the health problems associated with a cold home

Some groups of people living in cold homes are more vulnerable to the associated health problems, including:

  • 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)

  • young children (under 5)

  • pregnant women

  • people on a low income

  • people who move in and out of homelessness

  • people with addictions

  • people who have attended hospital due to a fall

  • recent immigrants and asylum seekers.

[Adapted from Excess winter deaths and illness and the health risks associated with cold homes (NICE guideline NG6) and expert opinion]

Health problems associated with a cold home

Cold homes and poor housing conditions have been linked with a range of health problems in children and young people, including respiratory health, growth and long‑term health. In older people, cold temperatures increase the risk of heart attack, stroke and circulatory problems, respiratory disease, flu and hospital admission. They also lower strength and dexterity, leading to an increase in the likelihood of falls and accidental injuries. Home temperatures also have implications for mental health because cold is linked with increased risk of depression and anxiety.

[Adapted from Local action on health inequalities evidence review 7: fuel poverty and cold home-related health problems (2014) Public Health England]

Year‑round planning

Year‑round planning for commissioners and providers of health and social care, and local authorities includes, but is not limited to:

  • working with partner agencies to ensure that cold weather planning features in wider winter resilience planning and to identify those most at risk from seasonal variations

  • considering how their winter plans can help to reduce health inequalities, target high‑risk groups and address the wider determinants of health

  • ensuring engagement with local emergency preparedness, resilience and response, and other strategic arrangements

  • ensuring the organisation can identify those most vulnerable to cold weather and draw up plans for joined‑up support with partner organisations.

[Adapted from Cold weather plan for England (2015) Public Health England]