Agenda item

Report of the Director of Public Health and Wellbeing

The Board received a Briefing Note and Presentation of the Director of Public Health and Wellbeing regarding the approach being taken in Coventry to understand and address the impacts of living in the cold home.

In England, a household was in fuel poverty if the household’s energy efficiency rating (EPC) was B and D or below and their disposable income (after housing and fuel costs) was below the poverty line.  It was estimated that 28,525 (20.8%) of households in Coventry were living in fuel poverty.

There was a variance in levels of fuel poverty across the city.  Some Lower Super Output Areas (LSOA) had 57% of households living in fuel poverty compared to others with as low as 2.9%.  5 LSOA’s had proportions above 50%.  This was substantially higher than that national average of 13.1% and the average for the West Midlands of 18.5%.

A cold and damp home could result in a wide range of health impacts including:

·  Mould growth and inhalation of mould sports causing respiratory conditions.

·  The risk of heart disease, cardiac events and arthritis could be worsened or increased.

·  The impact on mental health, depression and anxiety.

·  Each year the NHS spends £1.4 billion on treating illnesses associated with living in cold, damp homes.  When wider societal costs were considered ie. Healthcare, the figure rises to £15.4 billion.

·  Cold homes and fuel poverty contribute to Excess Winter Deaths.  It was estimated 40% of winter deals were attributable to cardiovascular disease and 33% were attributable to respiratory disease.  The National Institute for Health Equity estimated 10% of excess winter deaths were directly attributable to fuel poverty and 21.5% were attributable to cold homes.

Coventry City Council had a longstanding commitment to delivering affordable warmth services to support vulnerable and fuel poor households.  The current focus was on adopting a population health management approach and the existing support schemes could be divided into 2 main groups:

·  Retrofit Schemes

·  Keeping Coventry Warm (Public Health) Schemes

The service provider for the public health schemes was Act on Energy and the current contract was due to end on 31 March 2025.  There was an opportunity to re-design the programmes and look at how delivery could be more effective.

The existing funding of the schemes was through grants however, the continuation of this funding was not guaranteed and other funding sources were required to be considered.

A Population Health Management collaboration involving Coventry and Warwickshire ICB, UHCW and Public Health had been set up to investigate and demonstrate the health impact of cold homes.  This analysis project linked data from the NHS on health indicators.  By pulling together multiple data sources, it was hoped to better understand the local groups most affected by cold homes and the impact this had on their health and wellbeing and the demand for local health and care services.  The benefits of this would:

·  facilitate the tailoring and design of support services to meet the needs of the groups most affected. 

·  ensure promotion of schemes and support services is targeted to those most affected. 

·  strengthen the case for funding by highlighting the value of support services and projecting future benefits based on data and evidence.

The next steps of this programme would be to carry out an appraisal of the existing provision of schemes locally benchmarking with other areas as well as identifying gaps and barriers to uptake.  Co-production would be central, and energy suppliers, energy charities, voluntary sector groups, people with lived experience and commissioners would all be involved in this assessment.   

New opportunities and funding streams would also be explored including linking with the Council’s strategic energy partner and Community Energy Champions bid team and connecting with possible research opportunities facilitated by the Coventry Health Determinants Research Collaboration (HDRC).

The benefit of adopting a multi-faceted, population health management approach in delivering affordable warmth schemes in Coventry was expected to be significant and play an important role in helping to reduce the health inequalities that existed across the city.

The Cabinet Member for Housing and Communities, Councillor Welsh referred to the pressures in housing need, interaction with Council’s enforcement team and directorates and the knowledge of the Household Support Fund and it’s co-ordination.

The Board asked questions, made comments and sought assurances on a number of issues, including:

·  Primary care were the key partners with future opportunities via the care collaboratives as it developed.

·  Residents may be reluctant to take up the improvement schemes due to high levels of stress and depression.

·  Act on Energy linked with the Council’s customer service centre to take referrals if additional support was required.

·  Advice was available to residents on cold and damp homes through a joined-up approach via the One Coventry Plan.

·  Some of the more affordable solutions eg. external cladding, triple glazing, did not always work. 

Members requested information to be made available to residents highlighting where advice could be sought regarding cold and damp homes.

RESOLVED that the Health and Wellbeing Board agreed to support the approach being taken in Coventry to understand and address the impacts of living in the cold home.