Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
Commissioning to Prevent Excess
Winter Deaths through Cold
Tim Anfilogoff
Programme Manager Older People
Herts Valleys CCG
The Strategic Context
• 600k population
• single CCG plan delivered through four distinct
localities
• s...
Our Vision
• Commissioning health care for the people of
West Hertfordshire with:
– No inequality in service delivery
– No...
Sequence of health effects
It can take over a month for death rates to return to normal after a cold spell
Health Costs of Cold Dwellings
• Estimate of dwellings associated with excess
cold in EoE = 68,000
• Cost to the NHS of NO...
A Classic Whole System Issue
• Prevention (vulnerability to cold of older
people, stroke, cardiovascular, COPD)
• Issues a...
Health and Wellbeing Strategy
2011-13
• Hertfordshire County
Council led partnership
which accessed warm
homes funding for the
last two winters
• Trying...
What happened last year in West
Hertfordshire…
• £400K from DH for the county
• More planning possible than
for winter 201...
What happened last year in West
Hertfordshire (2)…
• Groundwork visits 462
homes for energy checks
(twice as many as whole...
Helping those with Long Term
Conditions in 2012-13
District
Households with
longterm conditions
Dacorum 89
Hertsmere 69
St...
Case study, Mr & Mrs Ryder
• Mr and Mrs Ryder, Stevenage
(real names and photo of couple,
happy to be identified)
• In the...
Our Target Groups
• Over 75
• Frail
• Young children
• Living in deprived circumstances
• Elderly people living on their o...
Simplifying the message
• Worked with Public Health at the
DH to simplify key message
• We recommend that all vulnerable
p...
Support includes…
• Extra working capacity amongst
all CABx in Herts
• Home energy visits from
Groundwork Hertfordshire
• ...
Home visits – what we do
• Checking residents heating systems
• Supplying emergency radiators
• Checking loft and cavity w...
Home visits – what we do
• Explaining energy bills
• Applying for the Warm Home Rebate of £120
• Explaining how to use the...
Referrals… referrals
• All referrals routed via
HertsHelp via a call or simple
tick-box card completed and
mailed Freepost...
• Primary Care
awareness of
HertsHelp improving
• CCG focus on
prevention and self
care
• Signposting by busy
primary care...
Next Steps
• Discussions between
Public Health, Social
Care and CCG to put
together funding
package
• One off basis this
y...
tim.anfilogoff@hertsvalleysccg.nhs.uk
07900 161673
Upcoming SlideShare
Loading in …5
×

Commissioning to Prevent Excess Winter Deaths through Cold

423 views

Published on

Tim Anfilogoff, Herts Valleys Clinical Commissioning Group

Published in: Health & Medicine
  • Be the first to comment

  • Be the first to like this

Commissioning to Prevent Excess Winter Deaths through Cold

  1. 1. Commissioning to Prevent Excess Winter Deaths through Cold Tim Anfilogoff Programme Manager Older People
  2. 2. Herts Valleys CCG The Strategic Context • 600k population • single CCG plan delivered through four distinct localities • strong joint working with LA • £626m income - £22.5m QIPP challenge • Ageing population • Life expectancy difference of 8 years • Largely good health outcomes but low patient satisfaction, rising trend in admissions
  3. 3. Our Vision • Commissioning health care for the people of West Hertfordshire with: – No inequality in service delivery – No needless pain, disease or death – No feelings of helplessness amongst users and staff – No unwanted delay or waste
  4. 4. Sequence of health effects It can take over a month for death rates to return to normal after a cold spell
  5. 5. Health Costs of Cold Dwellings • Estimate of dwellings associated with excess cold in EoE = 68,000 • Cost to the NHS of NOT improving these dwellings = £15m • Discussing methodologies with District Councils on demonstrating impact of Keep Warm and other interventions in terms of cost benefit
  6. 6. A Classic Whole System Issue • Prevention (vulnerability to cold of older people, stroke, cardiovascular, COPD) • Issues around admission to hospital (and readmission if discharged into cold homes) • Fuel Poverty • Cultural issues (healthy to have window open) • Complex range of types of support without a co-ordinating function • Private home ownership • New responsibilities for wellbeing
  7. 7. Health and Wellbeing Strategy
  8. 8. 2011-13 • Hertfordshire County Council led partnership which accessed warm homes funding for the last two winters • Trying to build in some sustainability while system changes • Winter comes every year!
  9. 9. What happened last year in West Hertfordshire… • £400K from DH for the county • More planning possible than for winter 2011/12 • CABx in Hertfordshire gave extra 9,249 clients energy saving benefits and debt advice and helped them access about £233k extra income in West Herts KEEP WARM STAY WELL
  10. 10. What happened last year in West Hertfordshire (2)… • Groundwork visits 462 homes for energy checks (twice as many as whole county in 11/12) • 70 older people got £130 rebates energy providers • Hertfordshire Community Foundation made 186 emergency grants • 2004 referrals to other community and preventive services
  11. 11. Helping those with Long Term Conditions in 2012-13 District Households with longterm conditions Dacorum 89 Hertsmere 69 St Albans 49 Three Rivers 20 Watford 61 288 • Visits by Groundworks in W Herts = 462 • 288 were to people with at least one long term condition or disability reside
  12. 12. Case study, Mr & Mrs Ryder • Mr and Mrs Ryder, Stevenage (real names and photo of couple, happy to be identified) • In their 70s and live in own home in Stevenage. Mr Ryder has mobility issues and registered disabled • Mrs Ryder early stage dementia • Home very draughty so referred for free draught proofing which has helped enormously • Groundwork Hertfordshire explained energy bills and tariffs and helped them save money • They also received a Warm Pack with thermal mugs and hot water bottles they now regularly use.
  13. 13. Our Target Groups • Over 75 • Frail • Young children • Living in deprived circumstances • Elderly people living on their own • Homeless or people sleeping rough • Pre-existing cardiovascular or respiratory illness + other chronic medical conditions • Severe mental illness • Dementia • Learning difficulties • Arthritis, limited mobility or otherwise at risk from falls • Living in homes with mould • Fuel poor (needing to spend 10% or more of household income on heating their home) • Carers • The rurally isolated • BME Groups
  14. 14. Simplifying the message • Worked with Public Health at the DH to simplify key message • We recommend that all vulnerable people heat their living room to 21ºC during the day and their bedroom to 18ºC at night • Promotion by thermometer cards which • Media focus on fuel price rises doesn’t help • Public perception that it is extreme cold that kills • Anyone that needs help or assistance to heat their home is advised to call HertsHelp.
  15. 15. Support includes… • Extra working capacity amongst all CABx in Herts • Home energy visits from Groundwork Hertfordshire • Extended opening hours in homeless shelters etc • Small grant scheme via the Community Foundation • ‘Blue light’ response service – heat for those without, draught- proofing, warm packs, etc. • Frontline staff awareness training + engagement of GPs and other professionals over the impact of cold and about this project
  16. 16. Home visits – what we do • Checking residents heating systems • Supplying emergency radiators • Checking loft and cavity wall insulation • Referring for draught proofing • Referrals for boiler replacements • Applying for grants
  17. 17. Home visits – what we do • Explaining energy bills • Applying for the Warm Home Rebate of £120 • Explaining how to use thermostats • Advice on ideal temperatures • Energy saving tips and advice • Advice on avoiding condensation and mould
  18. 18. Referrals… referrals • All referrals routed via HertsHelp via a call or simple tick-box card completed and mailed Freepost for a call-back • Web www.hertsdirect.org/hertshelp • Email info@hertshelp.net • Telephone 0300 1234 044 • Minicom 0300 456 2364 • Via Skype Skype – HertsHelp • Text 81025 • FREEPOST RSAK-JZGA-UJSJ, Keep Warm, Stay Well, HertsHelp, Hertlands House Primett Road, Stevenage SG1 3EE
  19. 19. • Primary Care awareness of HertsHelp improving • CCG focus on prevention and self care • Signposting by busy primary care to local community groups needs further development
  20. 20. Next Steps • Discussions between Public Health, Social Care and CCG to put together funding package • One off basis this year – more sustainable approach thereafter
  21. 21. tim.anfilogoff@hertsvalleysccg.nhs.uk 07900 161673

×