Integrated approaches to seasonal health

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John Kolm-Murray, London Borough of Islington

John Kolm-Murray, London Borough of Islington

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  • Introduction to my team.
  • All young homeless people helped with more permanent accommodation and most helped into work or further education
  • Long term limiting illness particularly includes cardiovascular, respiratory illness, dementia etc


  • 1. 16 July 2013 John Kolm-Murray Seasonal Health & Affordable Warmth Co-ordinator Integrated approaches to seasonal health
  • 2. Islington: forget the stereotype • 14th most deprived local authority area in England • Around 20% fuel poverty (After Housing Costs definition) • Excess Winter Mortality rate of 17% (19% England) (2008-2011) • Relatively energy efficient homes but great deal of poverty • Two-thirds of homes hard to insulate • High level of long term limiting illness • Male life expectancy 2.6 years lower than England average • Improved energy efficiency of 17,800 homes since 2010
  • 3. Well Winter Campaign 2012/13 • Partnership with Age UK, North London Cares, Pilion Trust, Friendship Phone Network, Groundwork • 4,592 unique contacts made (Nov-Mar) – 1,033 SHINE referrals – 1,612 clients new to Age UK – 1,000 residents reached by North London Cares – 345 Energy Doctor in the Home visits – 112 boilers replaced – 192 hot meals during coldest periods – Supported cold weather shelter for 52 young homeless people • Very positive feedback from residents
  • 4. SHINE • Aims of SHINE to: – Tackle seasonal ill-health from all angles – Reduce excess winter mortality and morbidity – Improve energy efficiency of homes (and thus reduce CO2 emissions) – Reduce health and social care costs – Enable older people to live independently for longer – Reduce childhood illness and thus improve educational attainment – Reduce social isolation – Integrate disparate services • Priority groups: – Older people, particularly those 75+ – Low income families with young children – People with long term limiting illness
  • 5. Seasonal Health Interventions
  • 6. Success to date • Recruited over 400 front line staff in housing, health, social care, third sector to network in Islington and Hackney • In 2012/2013 we received 1,993 referrals, leading to over 9,000 interventions • From December 2010 to June 2013 – 4,045 referrals, leading to around 19,000 interventions • NEA Community Footprint Award 2012/13 • European Prize for Innovation in Public Administration 2013 • Integrated often disparate realms of health (acute, community and public), housing and energy • Large amount of data for future programmes • Severe weather broadcast system
  • 7. Health sector engagement • Islington Public Health funded development stage • NHS Reablement Fund paid for dedicated member of staff 2012-13 • Warm Homes Healthy People Fund in 2011/12 and 2012/13 • Several hundred referrals from NHS services • Strong relationship with chronic respiratory service at Whittington Hospital • Incorporation in LES for COPD and 75+ health checks
  • 8. Challenges • Health professionals not always conscious of or convinced of importance of housing and social environment for health • Lack of acceptable evidence • Reactive sickness service rather than proactive health service • Siloes and territorialism • Lots and lots of competing priorities • Fatalism – “old people die in winter” • Securing needed improvements for hard to insulate homes
  • 9. The future • New Public Health funding? • Evidence for reduction in admissions • Integration with social care early intervention • Fuel debt prevention and financial capability • Dampness and indoor air quality strategy • Overheating responses • More work on social isolation
  • 10. Contacts 020 7527 3800