SHINE Presentation 23-01-2013

Presentation delivered at seasonal health inequalities event

Transcript

1. Reducing seasonal health inequalities in Islington and Hackney 23nd January 2013 John Kolm-Murray Seasonal Health and Affordable Warmth Co-ordinator
2. Background stats 121 excess winter deaths each year (average 2007-2010) Around 7 excess winter emergency hospital admissions per death High rates of COPD Over 20% fuel poverty (GLA definition) 2nd and 14th most deprived local authority areas in England Mostly hard to treat stock
3. Islington’s Warm Healthy Homes Programme • Council priority • 16,000 homes improved since 2010 • Popular home energy visitor service, Energy Doctor in the Home • Well Winter Campaigns in 2011/12 and 2012/13 • Energy Advice Team • Seasonal Health Interventions Network (SHINE) – multidisciplinary approach to reducing excess winter mortality and morbidity • Boiler Replacement Programme – 1,000 F and G rated boilers in private sector and small RSL homes to be replaced • Warm Healthy Homes Assessors – door-to-door identification of poor housing • CHP and solid wall insulation programmes
4. Reducing Seasonal Health Inequalities in Hackney • Energy Advice Line and Seasonal Health Intervention Network commissioned • Cavity and loft insulation for 7,000 Council owned properties since 2010 • Home improvement grants provided to vulnerable residents living in the private sector • Well Winter Campaign launched in 2012/13 • Energy Doctor in the Home programme for vulnerable residents launched in 2013 • CHP and solid wall insulation programmes delivered on Hackney Homes estates • SHINE
5. Seasonal Health Interventions • Initial energy advice • Energy Doctor in the Home • Energy efficiency grants • Telecare • Fire safety check • Home security check • Handyperson Service • Private sector housing support • Benefit check • Debt advice • Disabled Facilities Grant • Medication review • Medicines use review • Flu jab • NHS Health Check • Message in a Bottle* • airTEXT • Falls assessment • Older people’s support services • Free eye tests for housebound • Vulnerable utility customer register • Support for people with disabilities* • London Taxicard • Befriending services • Stop Smoking Service* * Islington only interventions
6. SHINE: The story so far • Over 3,250 referrals to date (1,249 in 2011/12 - Islington) • Around 14,000 seasonal health interventions to date • Successful in targeting right groups – all clients referred older, disabled, long-term ill or are low income families with children – 59% aged 55 or over – 40% aged 75 or over – 34% have respiratory or cardiovascular illness – 15% have children under 5* • Targets in Islington Corporate Plan to 2015 • Model adopted by Lewisham * Islington stats
7. Islington: links with health service • Included in COPD post-discharge early implementers project • Suggested through Islington COPD LES • Referrals received from acute and community teams at Whittington and UCL Hospitals. Increasing participation from paediatric services. • Public Health co-funded SHINE development and pilot • NHS Reablement funding secured to expand service – recruitment of dedicated advisor • Limited number of referrals coming from GPs but hopeful of receiving funding from CCG from 2013
8. Case study 1 77 year old man. Mobility problems and severe visual impairment. Had suffered stroke in recent years. Limited social support network. No central heating system, poorly insulated home in very poor state of repair. Assessed for SHINE interventions and referred for Energy Doctor visit, grant for heating, falls assessment, support from disability service and a fire safety check. When heating grant survey was carried out home was found to be in extreme disrepair and further assistance would be needed to make home safe and livable. Residents received £30,000 of grants for improvements to home.
9. Case Study 1 - images
10. Case study 2 Mr & Mrs H , an elderly couple, were referred by a family member as they were living in a cold and draughty home that they were finding it difficult to heat. Mrs H has Parkinson’s disease and a musculoskeletal disorder. They received a new, efficient heating system, draught proofing, loft insulation and other energy efficiency measures through a grant from the council and help from the Energy Doctor. They’ll also soon have level-access bathing facilities fitted. After a benefit check it was found that they qualified for £4,000 a year of Attendance Allowance. They were visited by the fire brigade who carried out a fire safety check. The couple are very happy with their warmer and safer home.
11. Key points • Fuel poverty rarely occurs as an isolated problem • Excess seasonal mortality and morbidity the result of a number of factors therefore require multi-disciplinary approach • Health and social care professionals often more receptive to discussing wider determinants of health • Signposting loses vulnerable people
12. Islington: looking ahead • Inclusion in Joint Health & Wellbeing Strategy • Clinical commissioning group funding • Environmental prescribing • Systematic and meaningful integration into care pathways • Climate resilience • Working with GLA and London Councils on a business plan to role SHINE-like programme across London
13. Contact John Kolm-Murray Seasonal Health & Affordable Warmth Co-ordinator 020 7527 3800 john.kolm-murray@islington.gov.uk