1. Cathy Boyd, Snow Angels CIC Alison Paul, Cheshire & Wirral Partnership Trust

2. Winter Planning Primary objective – reducing excess winter deaths and emergency admissions http://snowangels.org.uk/media-coverage/ Primary target – older people living in Cheshire West Community support for vulnerable people Key health messages Further information and support

3. Keeping well in west Cheshire Strategic Planning Advance warning and advice during the winter months (next slide) Communicating with the public Communicating with service providers Engaging the community

4. Advance Warning Level 0 Long term planning – all year Level 1 Winter preparedness programme 1 November – 31 March Level 2 Severe winter weather is forecast – Alert and readiness Mean temperature of 2 C and/or widespread ice and heavy snow are predicted within 24 hours, with 60% confidence Level 3 Response to server winter weather – Severe weather action Severe winter weather is now occurring; mean temperature of 2 C or less and/or widespread ice and heavy snow Level 4 Major Incident – Emergency response Central government will declare a Level 4 alert in the event of severe or prolonged cold weather affecting sectors other than health

5. More about Excess Winter Deaths In England and Wales an estimated 31,100 excess winter deaths occurred in 2012-13 - a 29% increase on the previous winter. Cheshire West has one of the highest rates in the North West

6. Figures for last year saw a steep increase, an extra 50 in CWAC Cold weather and flu largely explain the trends. “many of these winter deaths are preventable” (DOH, 2012)

7. Target population Key findings in 2010/11, people were - more likely to be female - majority 75 years old and over - an increasing number of people under 75 years dying - Related medical conditions include respiratory and circulatory diseases.

8. Effects of Winter on the body Cold temperatures can cause physiological effects such as: - thicker blood - increase in blood pressure - tightening of the airways making people who already have chronic conditions even more vulnerable. Excess winter deaths are linked to low temperatures but hypothermia is not the main cause. The majority of such deaths are due to heart disease, stroke and respiratory illness.

9. Effects of Winter on the Body continued… Older people are particularly at risk as they do not feel the cold until their body temperature falls. People with Chronic Obstructive Pulmonary Disease (COPD) have a significantly increased risk of ill-health and hospitalisation during periods of cold weather, and high levels of circulating respiratory infections.

10. Health Impacts and Time

11. Mind and Spirit Winter can feel a particularly lonely time. Christmas and New Year may highlight that friends and family are not around. Winter may make it physically harder to catch up with people and there may be feelings of isolation. National Developments: Silver Line 0800 4 70 80 90 – free 24hours confidential helpline launched by Esther Ranzen (Nov 2013) Winter Friends Pledge – “NHS to raise army of Good Samaritans for winter” (Nov 2013) Aims have 100,000 people pledge to "take time out this winter to look in on an elderly friend or neighbour to make sure they are warm and coping well".

12. Key interventions to reduce EWDs – Keep warm – http://www.youtube.com/watch?v=9qVm-x4WG9U http://www.youtube.com/watch?v=9qVm-x4WG9U – Uptake of flu and pneumococcal vaccinations – Maximise income – Provision of annual medicines review (MUR) and annual medication review (every 6 months if taking 4 plus medicines) – Health interventions – Falls prevention – http://www.nhs.uk/video/Pages/Playgroundfortheover60s.aspx ?searchtype=Tag&searchterm=Older+people&offset=17& http://www.nhs.uk/video/Pages/Playgroundfortheover60s.aspx ?searchtype=Tag&searchterm=Older+people&offset=17& – Volunteer/neighbour schemes and contingency plans – Assistive technology and cold weather alerts

13. Communications Plan “Get ready for winter” and “Act now for winter” Press releases and media packs Choose Well this Winter NHS campaign Community champions for key messages Networks of local community organisers Key messages for geographical areas

15. Winter Wellbeing Messages Get Ready for Winter Get a flu jab ( its free if you are over 65, have a long term condition, or are pregnant) Review how you use your medicines ( service available at most pharmacies) Have your heating checked and serviced Check if you are entitled to any help with heating your home

16. Winter Wellbeing Messages Act Now for Winter Keep your house warm (between 18 and 21 C) Have hot meals and hot drinks throughout the day On cold days try and stay indoors when possible Tune in to local news and radio to check weather conditions

17. Winter Wellbeing Messages Be a good neighbour Keep an eye on older people during colder weather Offer a helping hand with shopping, collecting prescriptions, lifts, walking the dog etc. If clearing snow use grit or salt, never use water, and pile snow carefully.

18. 5 Ways to Wellbeing Connect with the people around you. Spending time with family, friends, colleagues, neighbours & others, can bring you support & enrich your day. Be active Go for a walk. Stretch! Play a game. Garden. Do some dusting! Exercising makes you feel good and improves your fitness. http://www.nhs.uk/video/Pages/Swimminginyour90s.aspx?searchtype=Tag&searchterm=Older+pe ople&offset=17& Take notice of the world around you and of your own feelings. Be curious. Notice the beautiful. Enjoy the moment. Reflect on your experiences and decide what matters to you. Keep learning Try something new! Set a challenge you will enjoy achieving. Explore the library for ideas. Learning new things will help you feel more confident as well as being fun. Give Do something nice for a friend or someone you don’t know. Smile. Thank someone. Listen. Giving helps you to feel good & can help other people feel good too. See how you link with the wider community. www.talkingwestcheshire.org/5wayswww.talkingwestcheshire.org/5ways

19. Keeping well in west Cheshire Twelve month programme Initial focus winter months Key target older people over 55 years old living in west Cheshire Range of interventions throughout the year Communications, community engagement, home visits, and volunteer support

20. More information Snow Angels Portal – Brief training programmes – Referrals to other organisations for help – Advice and Information – Sign up for Met Office alerts – Calendar of events – http://keepingwell.snowangels.org.uk http://keepingwell.snowangels.org.uk