angela mawle chief executive. ukheca national home energy conference wednesday 17 th may 2006
TRANSCRIPT
![Page 1: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/1.jpg)
Angela MawleChief Executive
![Page 2: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/2.jpg)
UKHECA National Home Energy Conference
Wednesday 17th May 2006
![Page 3: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/3.jpg)
The UKPHA Fuel Poverty Project
![Page 4: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/4.jpg)
Who we are
The UKPHA is an independent, UK-wide voluntary association, which brings together individuals and organisations from all sectors, who share a common commitment to promoting the public’s health.
The UKPHA is a membership organisation which aims to promote the development of healthy public policy at all levels of government and across all sectors, and to support those working in public health either professionally or in a voluntary capacity.
![Page 5: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/5.jpg)
Our priorities
• Combating health inequalities– Working for a fairer, more equitable
and healthier society• Promoting sustainable development
– ensuring healthy environments for future generations
• Challenging anti-health forces– Promoting health-sustaining
production, consumption and employment.
![Page 6: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/6.jpg)
What is Fuel Poverty?
• A fuel poor household is one that needs to spend in excess of 10 % of income on all fuel
• It is estimated that 22% of all households in England are classed as fuel poor *fuel poverty strategy, DETR (2001)
• Almost 9 million people live in these homes in the UK
![Page 7: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/7.jpg)
Health Effects of Living in a Cold Home
9º C
12º C
15º C
18º C
Discomfort and risk of respiratory disease, bronchitis etc
Risk of cardiovascular problems, strokes etc
Risk of hypothermia
Comfortable temperatures
![Page 8: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/8.jpg)
Fuel Poverty and the NHS
Costs to the NHSOver £1 billion per annumThousands of hospital beds taken upIncreased waiting times for treatments of other ailments
Alleviating fuel povertyReduced hospital admissions and re-admissionsLower treatment costsReduced waiting lists
![Page 9: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/9.jpg)
Excess Winter Deaths
What are excess winter deaths?Excess winter deaths are defined as deaths occurring in the winter months (December to March) minus the average of deaths occurring in the two non-winter periods (August to November and April to July)
Excess winter deaths by age group Adur, Arun and Worthing, 1998-2001
0
50
100
150
200
250
300
350
400
Adur Arun Worthing
Area
Nu
mb
er o
f ex
cess
dea
ths
0-64
65-74
75-84
85+
![Page 10: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/10.jpg)
“If just 5% of our clients were saved ten days’ in-patient care for illness caused by poor heating, the NHS would save £40m each year and release 150,000 bed days.”
DETR Fuel Poverty Strategy 2001
![Page 11: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/11.jpg)
Fuel Poverty Indicator(Centre for Sustainable Energy)
• Matches Census and English House Condition data– unemployed– Under-occupied (0.5 rooms per person)– no car– single pensioner– no central heating– private renter– lone parent– disabled
• Predicts the fuel poverty level of any given area
![Page 12: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/12.jpg)
02
55
07
51
00
12
51
50
Ca
rdio
vasc
ula
r d
ea
ths/
da
y
01jan1990 01jan1991 01jan1992 01jan1993 01jan1994
CVD deaths Mean temperature
LONDON, 1990 - 1994
![Page 13: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/13.jpg)
Attitudes to risk& behaviour
• Latitude differences in clothing behaviour
• How do older people respond to – Forecast of cold weather?– Cold weather?
• Do older people live in older houses?
• Should older people be taking aspirin in winter?
• Is our flu immunisation programme optimal?
![Page 14: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/14.jpg)
The Economics of Fuel Poverty
![Page 15: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/15.jpg)
1996 4.3 million
2001 1.7 million
2003 1.2 million
2005 2 million
2007 3 million?
Fuel Poverty:The impact of rising energy
prices
Source: William Gillis, presentation at HHFPF conference 07.03.06
![Page 16: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/16.jpg)
The Economics of Fuel Poverty
• A key issue is targeting those most in need
• Significant resources are availableWarm Front: £320 millionEEC £225 millionLocal authority programmes
Source: William Gillis, presentation at HHFPF conference 07.03.06
![Page 17: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/17.jpg)
The Health, Housing and Fuel Poverty Forum (HHFPF)
![Page 18: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/18.jpg)
HHFPF
• Launched in March 2005 by the UK Public Health Association, on behalf of the Health Sub Group of the Energy Efficiency Partnership for Homes.
• Aims to maximise the contribution which the health and housing sectors make to the delivery of energy improvements to vulnerable households.
• The Core Group brings together key players with strategic influence in different sectors. It meets four times a year to identify strategic opportunities to progress the forum’s purpose, and take appropriate action.
![Page 19: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/19.jpg)
The HHFPF Core Group
• Professor Rod Griffiths (Chair) President of the Faculty of Public Health
• Dr Mike Gill Regional Director of Public Health, South East Region, DoH
• Lindsey Hayes Head of Primary Care, Royal College of Nursing
• Duncan Sedgwick Chief Executive, Energy Retail Association (ERA)
• William Gillis Chief Executive, National Energy Action • Professor Carol Black President, Royal College Of
Physicians • Mervyn Kohler Head of Public Affairs, Help the Aged • Stephen Battersby Chartered Institute of
Environmental Health • Sue Adams Director, National Care and Repair • John Clough Chief Executive, EAGA Partnership • Peter Lehmann Chair, Fuel Poverty Advisory Group • Pam Wynne Head of Fuel Poverty Team, DEFRA
![Page 20: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/20.jpg)
2006 HHFPF Conference
The HHFPF conference on 7th March 2006 brought key players together to:
• Learn from the results of the latest research into the Health Impact of Warm Front led by Professor Geoff Green from Sheffield Hallam University.
• Explore how the HHSRS could be used to tackle fuel poverty
• Consider how the Single Assessment Process could be developed to include issues of fuel poverty.
![Page 21: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/21.jpg)
The Health Impacts of Warm Front
![Page 22: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/22.jpg)
Health Impact Evaluation of Warm Front
• Undertaken jointly by University College London, The London School of Hygiene and Tropical Medicine and Sheffield Hallam University over a four year programme.
![Page 23: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/23.jpg)
Energy efficienc
y
NutritionLower fuel use & cost
Increased disposable
income
Increased temperature
Alteredventilation
Indoor air quality
Mould growth
Cardio-respiratory
illness
Winter morbidity/mortal
ity
Psycho-social well-being
Reduced emissions
Local and global environmental
impacts
Use of spaceSocial interactionSense of control
VENTILATION
WARMTH
ENERGY USE
Thermal comfort
Source: Green et al, presentation at HHFPF conference 07.03.06
![Page 24: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/24.jpg)
MONTHS OF LIFE SAVED AND COSTS FOR WARM FRONT INTERVENTIONS
House-holder
Intervention
Cost*
20 year time horizon
Months of life saved per person
Average cost per
LY saved
Incremental cost per LY
saved
A marrie
d couple$
Pre- 0 - - -
Insulation £280 0.88 £3,816 £3,816
Heating £1130 1.73 £7,846 £12,031
Insul + heat
£1410 1.89 £8,965 £21,111
* – Based on averaging of NAO figures[2]$ – A married couple, both of 65 years of age
Source: Green et al, presentation at HHFPF conference 07.03.06
![Page 25: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/25.jpg)
Source: Green et al, presentation at HHFPF conference 07.03.06
![Page 26: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/26.jpg)
Benefits• improved and more controllable warmth/hot water• perceptions of improved physical health and comfort, esp. of
mental and emotional well-being• easing of symptoms of chronic illness• reports of improved family relations• expansion of the domestic space used during cold months• increased privacy within the home• improved social interaction• an increase in comfort and atmosphere within the home
But• as yet no evidence of change in health-seeking patterns• little evidence of substantially lower heating bills
Source: Green et al, presentation at HHFPF conference 07.03.06
In-depth Interviews
![Page 27: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/27.jpg)
“I shiver even thinking back to what I call the bad old days…I mean sitting here, I’ve got my telly going…and the [pre-intervention] heating’s on and I’m dreading going to the toilet, and I’m dying for a cup of tea, and I’m praying I hear the door opening and [it’s] one of my sons or my daughter so they can make me a cup of tea, cause that’s how bad it was, it was so cold, so cold.”
9819, LiverpoolSource: Green et al, presentation at HHFPF conference 07.03.06
![Page 28: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/28.jpg)
Health Impact Evaluation of Warm Front
1. Warm Front measured increased average living room temperatures by 1.6ºC and bedroom temperatures by 2.8ºC, taking them above recommended thresholds
2. This level of improvement will reduce excess winter deaths in the UK. The average cost per life year saved ranged from £4,000 for insulation to £21,000 for heating plus insulation over a 20 year horizon.
3. Higher temperatures, satisfaction with the heating system and less difficulty paying heating bills are all associated with better mental health and well-being.
4. Warm Front improvements are associated with more resident control over their homes, less insecurity, a greater feeling of safety and better mental health and well-being.
![Page 29: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/29.jpg)
• Energy efficiency may influence health through multiple routes
• WF heating + insulation up-grades increase temperatures by approx. 2˚C
• No evidence of adverse impact on air quality; there is reduction in mould
• Evidence of improved mental status & thermal comfort
• (Indirect) evidence of reduced risk of winter morbidity/mortality
• Interview evidence of benefits to social interactions, well-being
Source: Green et al, presentation at HHFPF conference 07.03.06
Conclusions
![Page 30: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/30.jpg)
Housing, Health and Safety Rating system (HHSRS)
![Page 31: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/31.jpg)
HHSRS
What is it?• Replaces the Housing Fitness
Standard from the 6th April 2006. • Formally considers the potential
risks to health and safety in residential accommodation arising from hazards in the home.
• The Local Authority is required to act upon referrals/reports to perform assessments of dwellings.
![Page 32: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/32.jpg)
HHSRS
Implications for Health, Housing and Fuel Poverty.
• Health workers have a formal route to report suspected poor housing.
• Local Authorities are now statutorily required to act upon reports.
• Interventions to improve housing conditions can be more strategic than before.
• Different hazards can be compared (prioritisation).
• Allows a proactive and preventative approach (targeting resources at the most in need).
![Page 33: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/33.jpg)
The Single Assessment Process
(SAP)
![Page 34: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/34.jpg)
Single Assessment Process
Aim :” to ensure that older people are treated as individuals and that they receive appropriate and timely packages of care which meet their needs as individuals regardless of health and social care boundaries.”
Source: William Gillis, presentation at HHFPF conference 07.03.06
![Page 35: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/35.jpg)
Single Assessment Process
• Methodology to assess the individual health and wider social care needs of individuals
• Introduced 2001 as part of the National Service Framework for Older People
• Implemented nationally in 2004• Now extended to other groups
Source: William Gillis, presentation at HHFPF conference 07.03.06
![Page 36: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/36.jpg)
Single Assessment Process
• SAP requires an integrated approach
• Includes an assessment of housing conditions
• Four types of assessment:- Contact- Overview- Specialist- Comprehensive
Source: William Gillis, presentation at HHFPF conference 07.03.06
![Page 37: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/37.jpg)
SAP
• Electronic storage and sharing of information
• Agencies have been allowed to design their own process or adopt a Health Service approved method
• No standardisation
Source: William Gillis, presentation at HHFPF conference 07.03.06
![Page 38: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/38.jpg)
SAP
The single heating question
• Will this question help to identify the fuel poor?
• Who answers the question – client or professional?
• Could a limited number of additional questions be drafted which would improve effectiveness?
Source: William Gillis, presentation at HHFPF conference 07.03.06
![Page 39: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/39.jpg)
SAP
The training and support issue
• What training and support do health professionals need to operated the process more effectively?
• Would additional guidance on identifying fuel poverty improve effectiveness?
Source: William Gillis, presentation at HHFPF conference 07.03.06
![Page 40: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/40.jpg)
The Referral Process
The referral process has been consistently identified throughout the March 2005 and March 2006 conferences and by the HHFPF core group as a major obstacle to help for vulnerable people living in cold damp homes.
![Page 41: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/41.jpg)
Models of delivery and referral processes
![Page 42: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/42.jpg)
Adding to Confusion in the Elderly
![Page 43: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/43.jpg)
![Page 44: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/44.jpg)
![Page 45: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/45.jpg)
![Page 46: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/46.jpg)
![Page 47: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/47.jpg)
Elderly SureStart –trialling more effective delivery models?
The HHFPF Core Group has identified the following key priorities for tackling fuel poverty
in the Elderly SureStart initiatives:
• Partnership development• Assessment tool for health partners• Streamlining and co-ordinating the
targeting and assessment processes • A one-point-of-contact referral system.
![Page 49: Angela Mawle Chief Executive. UKHECA National Home Energy Conference Wednesday 17 th May 2006](https://reader036.vdocuments.us/reader036/viewer/2022062714/56649cf95503460f949caedc/html5/thumbnails/49.jpg)
Angela MawleChief Executive