1. Workshop 13 May 2015 Securing Health Service Funding to Address Cold Homes Anees Mank Service Manager – Housing Services

2. Confident Place, Confident People. Wigan Borough 317,849 population (Census 2011) 134,887 households (DECC LIHC 2012) 12,739 households in fuel poverty (DECC LIHC 2012) 9.4% households in fuel poverty (DECC LIHC 2012) A reduction of 1.9% from previous year Lowest level in Greater Manchester

3. Confident Place, Confident People. Successes Decent Homes programme in social housing High take-up of Warm Front in private housing Warm Homes Healthy People £1m DECC Fuel Poverty Fund £3m GM Green Deal Go Early £6m GM Green Deal Communities

4. Confident Place, Confident People. Affordable Warmth Access Referral Mechanism (In) District Nurses Midwives Health Visitors Occupational Therapists Hospital Discharge Social Workers GP’s Surgeries Children’s Centres Age UK CAB, HIA Fire Service

5. Confident Place, Confident People. Affordable Warmth Access Referral Mechanism (Out) Fire Safety Minor Adapt’s Income Advice Home Repairs Improvements Insulation Schemes Health Checks Heating Schemes Energy Switching Draught- proofing Fuel Debt Advice

6. Confident Place, Confident People. Funding for AWARM £15,000 from Wigan Council Public Health 125 households brought out of fuel poverty Needed to upscale to 1,000 households Target individuals with health conditions Reduce Excess Winter Deaths, hospital admissions and delayed discharge Unable to identify individuals directly due to data protection

7. Confident Place, Confident People. Targeting AWARM Wigan Council’s Joint Intelligence Unit overlaid: –Aged 65+ at risk of being admitted to hospital during winter due to circulatory or respiratory illness –Aged 65+ in receipt of Council Tax Reduction –Index of Multiple Deprivation Rank –Privately rented terraced houses Produced geographical hotspots to identify GP practices to target Identify patients suffering from a health condition caused or exacerbated by cold conditions

8. Confident Place, Confident People. Targeting GP Practices

9. Confident Place, Confident People. Anticipated NHS savings Modelled by Dr Paul Turner, Consultant in Public Health. Based on 200 excess winter emergency admissions for the 65+ age group in the Wigan borough during winter 2011-12. Resulted in 1,800 additional acute hospital occupied bed days costing around £1,000,000 (at £575 per bed day).

10. Confident Place, Confident People. Business Case for AWARM Effectiveness of the intervention % at-risk identified40%50% 60% 10% £40,000£50,000£60,000 20% £80,000£100,000£120,000 Invest to Save Business Case based on: –The effectiveness of identifying those at risk of a hospital admission due to fuel poverty –The effectiveness of the fuel poverty intervention preventing a hospital admission

11. Confident Place, Confident People. Bid for AWARM Endorsed by Wigan Council’s: –Director of Public Health –Senior Management Team –Health and Wellbeing Board –Health and Social Care Scrutiny Committee Presented to Wigan Council and CCG Joint Commissioning Group Focused on Early Intervention and Prevention Awarded £200,000 over two years to bring 2,000 households out of fuel poverty

12. Confident Place, Confident People. Implementation of AWARM AWARM officer based in large GP practice Signed data sharing agreements Access to GP patient health risk registers Possible trial of the RCGP’s single click referral module for SystmOne Set-up referral system for: –Extended Integrated Neighbourhood Teams –Healthy Living Pharmacists, Dentists and Opticians

13. Confident Place, Confident People. Fuel Poverty and Health Booster Fund £100,000 DECC grant to cover the shortfall in ECO funding for heating and insulation measures. This will help 120 households in fuel poverty, containing an individual who is suffering from a health condition caused or exacerbated by cold conditions.

14. Confident Place, Confident People. Training on AWARM Working with NEA on producing and delivering a training module on fuel poverty for primary care health professionals based on the UK Health Forum’s “Guide for primary care on fuel poverty: tackling cold homes and ill health” Discussions with RCGP on CPD accreditation of the course in order to drive take-up by GPs

15. Confident Place, Confident People. Evaluation of AWARM We hope to be able to access information about health service uptake by the individuals referred to AWARM, although this is yet to be tested. We are commissioning a formal academic evaluation of AWARM’s impact on health and well-being in conjunction with NICE and PHE

16. Confident Place, Confident People. Fuel Poverty Strategy

17. Confident Place, Confident People. NICE Guideline [NG6]

18. Confident Place, Confident People. Further information Reference library of links to reports on fuel poverty at: aneesmank.blogspot.co.ukaneesmank.blogspot.co.uk E-mail: a.mank@wigan.gov.uka.mank@wigan.gov.uk Twitter: @AneesMank@AneesMank

19. Thank you for your time and attention. Questions and Answers