1. Tackling Fuel Poverty: National Context Karen Saunders Health and Wellbeing Programme Lead, Public Health England West Midlands karen.saunders@phe.gov.uk Coventry and Warwickshire Financial Inclusion Partnership, 22 Sept 2015

2. DWP Summer School 20152 Who are the Fuel Poor?

3. Dept. of Energy & Climate Change: Fuel Poverty and Health Fuel Poverty Strategy 2015 https://www.gov.uk/government/uploads/systhttps://www.gov.uk/government/uploads/system/uploads/a ttachment_data/file/408644/cutting_the_cost_of_keeping_ warm.pdf National Energy Action Survey and Catalogue of Health and Fuel Poverty Schemes https://www.gov.uk/government/publications/catalogu e-of-health-related-fuel-poverty-schemes https://www.gov.uk/government/publications/catalogu e-of-health-related-fuel-poverty-schemes Fuel Poverty and Health Booster Fund https://www.gov.uk/government/publications/the-fuel- poverty-and-health-booster-fund Evaluation of Health and Fuel Poverty Toolkit http://nhfshare.heartforum.org.uk/RMAssets/HealthyPlace s/FuelPoverty/ToolkitJan2015.pdf Health Impact of Domestic Energy Efficiency Measures https://www.ucl.ac.uk/energy-models/models/hideem

4. “Our principles are to prioritise the most severely fuel poor, and deploy cost-effective policies while having regard for the most vulnerable” Of the multiple benefits generated by improving the energy efficiency of buildings, positive outcomes for physical and mental health and well- being are particularly compelling DECC Fuel Poverty Strategy Cutting the cost of keeping warm Outcomes What are the impacts of living in a cold home and how does it affect the Health Service? 4

5. The health case: morbidity Cold-related morbidity Complex interactions, but persuasive evidence linking low temperatures with a range of health impacts from minor infections to serious respiratory and cardiovascular conditions in particular that can prove fatal. Who is vulnerable to cold-related morbidity? Three main groups: -Elderly people -Very young children -People with a long-term sickness or disability Fuel poverty and cold indoor temperatures The drivers of fuel poverty – notably low incomes – are a significant determinant of indoor temperatures. There is therefore a plausible chain of causation from drivers of fuel poverty to negative health outcomes.

6. Why We Care? Hills Review: Professor Hills found the health impacts of living in a cold home were part of the reason why fuel poverty is distinct from income poverty Prof Hills estimated (conservatively) that 10% of EWD were due to fuel poverty We know there are range of other health conditions exacerbated by living in a cold home This concern is embedded in the Fuel Poverty Strategy, committing us to helping the most vulnerable first Reducing burden of cold home related illness and burden on NHS Cutting the cost of keeping warm Outcomes 6

7. The New Target As many fuel poor homes as is reasonably practicable to achieve an energy efficiency rating of Band C by 2030 o as many … as is reasonably practicable to Band E by 2020 o as many … as is reasonably practicable to Band D by 2025 Non-statutory interim targets to get:

8. National Work Booster Fund - £1m funding to local fuel poverty schemes with a health focus. Learning from the variety of approaches being taken, both on focus and delivery mechanisms Evaluation – understand the impact on health and social care. Evaluating the Booster Schemes and developing an Evaluation Toolkit. Enable us to build up evidence base Evidence: learning more about the impact of local schemes and sharing findings, Hideem model allows us to model impacts of interventions of costs on NHS https://www.gov.uk/government/publications/catalogue-of-health-related-fuel-poverty-schemes Cutting the cost of keeping warm Outcomes 8

9. https://www.gov.uk/government/publications/cold-weather-plan-for-england https://www.gov.uk/government/publications/keep-warm-keep-well-leaflet-gives-advice- on-staying-healthy-in-cold-weather

10. Winter Health Watch https://www.gov.uk/government/ collections/winter-health-watch

11. What’s New for 2015? DWP Warm Homes Discount letter insert KWKW booklet updated Working with marketing colleagues to include cold in winter campaign Making plan ‘date neutral’ Content-checking against NICE EWD guidance Pregnant women as a vulnerable group? Highlighting new policy/resources FP strategy Care Act 2014

12. Timeline 10 th Sept - DWP letters start to be distributed over 10 weeks; updated KWKW asap 7 th Oct - Briefing note to PHEC/DsPH 13 th Oct – CWP launched, cover letter and links cascaded through PHE and partner networks 13 th Oct – Cabinet Office/Met Office launch ‘Get Ready for Winter’ 1 st Nov – CW alert season (winter) starts 5 th Nov – WHW bulletin starts (TBC!) 27 th Nov – ONS publish provisional 2014-15 excess winter deaths bulletin 31 st Mar – CW alert season ends Presentation title - edit in Header and Footer

13. Cost of Cold Homes to the NHS

14. The vast majority of the evidence on health relates to the impact of living at low temperatures and in poorly insulated dwellings. There is compelling evidence that the drivers of fuel poverty are strongly linked to living in low temperatures. The Marmot Review Team provided a comprehensive overview of the evidence linking fuel poverty related factors to poor physical and mental health as well as the effect of interventions to mitigate them. The Hills Review also provided a comprehensive summary of the literature. Evidence

15. Acknowledgements Angie Bone, PHE Carl Petrokofsky, PHE DECC 15Presentation title - edit in Header and Footer