What is this guideline about?

Guidance

This guideline makes recommendations on how to reduce the risk of death and ill health associated with living in a cold home. The aim is to help meet a range of public health and other goals. These include:

Reducing preventable excess winter death rates.
Improving health and wellbeing among vulnerable groups.
Reducing pressure on health and social care services.
Reducing 'fuel poverty' and the risk of fuel debt or being disconnected from gas and electricity supplies (including self-disconnection).
Improving the energy efficiency of homes.

Improvements to make homes warmer may also help reduce unnecessary fuel consumption (although where people are living in cold homes because of fuel poverty their fuel use may increase). In addition, such improvements may reduce absences from work and school that result from illnesses caused by living in a cold home.

The health problems associated with cold homes are experienced during 'normal' winter temperatures, not just during extremely cold weather. (An increase in death rates due to a drop in temperature varies across England but can happen when temperatures drop below about 6°C.)

Year‑round planning and action by many sectors is needed to combat these problems. The guideline outlines a role for health and other practitioners in:

prioritising which homes are tackled first
shaping and influencing decisions about how homes are improved
highlighting the importance of research, implementation and evaluation.

A wide range of people are vulnerable to the cold. This is either because of: a medical condition, such as heart disease; a disability that, for instance, stops people moving around to keep warm, or makes them more likely to develop chest infections; or personal circumstances, such as being unable to afford to keep warm enough.

In this guideline, the term vulnerable refers to a number of groups including:

people with cardiovascular conditions
people with respiratory conditions (in particular, chronic obstructive pulmonary disease and childhood asthma)
people with mental health conditions
people with disabilities
older people (65 and older)
households with young children (from new‑born to school age)
pregnant women
people on a low income.

The guideline is for commissioners, managers and health, social care and voluntary sector practitioners who deal with vulnerable people who may have health problems caused, or exacerbated, by living in a cold home. It will also be of interest to clinicians and others involved with at‑risk groups, housing and energy suppliers. (For further details, see who should take action?). In addition, it may be of interest to members of the public.