• Health workers – such as social prescribers rather than GPs – are prescribing ‘warmth’ to vulnerable people in the pilot study – helping the NHS avoid the cost of hospital care.
• At least 10,000 people die each year due to a cold home³, while treatment costs the NHS around £860 million² in England alone.
• The scheme also helps identify “hard to reach” homes that are eligible for funding to improve insulation and energy efficiency.

[This post was published on 22 November 2022]

Warm Home Prescription is an innovative new service being piloted by Energy Systems Catapult and the NHS helping vulnerable people with both cold-sensitive health conditions and low incomes, to stay warm and well at home, and out of hospital – by paying their energy bills over winter.

Millions of people in the UK have health conditions – such as respiratory and cardiovascular illnesses – that are made worse by living in a cold home. With over 10,000 people dying each year in England and Wales as a result of living in cold homes.

This pilot study aims to determine whether it is more cost-effective overall to help pay the heating costs of vulnerable people than it is to pay for their health care if they fall ill – saving the NHS money and reducing pressure on frontline staff.

An additional benefit of Warm Home Prescription is the ability to identify “hard to reach” homes that are eligible for funding to improve insulation and energy efficiency, cutting running costs and CO₂ in the longer term (e.g. via ECO).

Last winter, Energy Systems Catapult successfully ran a pilot in Gloucestershire working with NHS social prescribers and a local energy charity, Severn Wye. Between December 2021 and March 2022, twenty-eight patients were “prescribed” warmth to reduce the risk that the cold would cause harm and hospitalisation.

In the same period, over 2,000 people⁵ with similar health conditions in Gloucestershire fell ill and were admitted to hospital for emergency treatment, costing the NHS over £6m⁵ and adding pressure to front line staff.

The Warm Home Prescription 2021/22 pilot study found the service was:

• Quick and easy to prescribe,
• Immediately impactful – meaning people didn’t have to choose between heating and eating,
• Positive for recipients – with people saying they felt warmer, healthier, less stressed about bills and less likely to visit GPs or hospital,
• Integrated easily with other health and energy efficiency services, further improving health.

Gloucestershire were expanding the scheme during winter 2022/23, with up to 150 people across the county with cold-sensitive health conditions set to receive support – with energy bills paid between November 2022 and March 2023. The initiative is being funded through innovative use of the Government’s Housing Support Fund.

Energy Systems Catapult are testing a scaled up version of Warm Home Prescription this winter with around 1,000 people to be supported across the Tees Valley in England and Aberdeenshire in Scotland.

Dr Hein Le Roux, from the NHS in Gloucestershire, said: “People with conditions such as COPD, emphysema, or chronic bronchitis are at particular risk from complications associated with living in cold housing.

“The Warm Home prescription allows us to be more proactive in supporting some of the most vulnerable people in our county. We want to stop people from becoming unwell and help them to stay healthy at home in housing that is safe and warm.”

Owen Callender, Head of Affordable Warmth at Severn Wye Energy Agency, which handled the client facing aspects of the service, said: “Delivered alongside fuel poverty schemes that incorporate energy efficiency interventions, the impact of this project will be huge.

“Working with social prescribers means we’re able to support clients we’ve never been in touch with before, reducing their bills and their fuel stress. At a time when the NHS is recovering from the impact of the pandemic, this project will have enormous social, environmental, and economic impacts, but most importantly it will allow us to improve the wellbeing of some of society’s most vulnerable people.”

Professor Sarah Scott, Executive Director, Adult Social Care, Communities and Wellbeing at Gloucestershire County Council, said: “With the increase in fuel costs and winter fast approaching, it’s important to look at the bigger picture and do what we can to ensure people with certain health conditions don’t have to experience the cold because they can’t afford to heat their home.

“By coming together as One Gloucestershire health, care, and voluntary sector partners to pool our resources and address fuel poverty in a joined-up way, we can support some of our most vulnerable residents to stay warm and well this winter.”

Dr Rose Chard, Fair Futures programme lead at Energy Systems Catapult, said: “Living in cold homes puts millions with health conditions at risk of real harm. It costs the NHS around £860 million each year in England alone, and causes 10,000 deaths every winter. And it’s set to become an even bigger challenge this year as energy prices rise and household budgets fall.

“There has to be a better solution to help the most vulnerable. If we buy the energy people need but can’t afford, they can keep warm at home and stay out of hospital. That would target support to where it’s needed, save money overall and take pressure off the health service. The scheme will also find homes we can insulate to cut running costs and emissions in future.”

Warm Home Prescription also helped the local energy charity Severn Wye to find “hard to reach” homes that were eligible for funding to improve insulation and energy efficiency, cutting running costs and CO₂ in the longer term (e.g. via ECO).

Gloucestershire Warm Home Prescription Scheme 2022/23:

To be eligible for the expanded Gloucestershire scheme, people must be diagnosed with chronic lung conditions such as emphysema, chronic bronchitis and bronchiectasis. They also must be either under 60 and in receipt of free NHS prescriptions, or over 60 and struggling to pay their heating bill.

Health and care teams, including social prescribers, district nurses and complex care teams, supported by GPs, will work together to identify eligible patients and prescribe them a warm home, with charity Severn Wye following up the referral to credit peoples’ energy accounts and arranging home energy upgrades where possible.

The service will prescribe a heating plan to keep homes at temperatures recommended by public health guidance, support people with further energy efficiency information and signpost to other services that could help.

Key Statistics:

• Before the current energy crisis, around 13% of households in England⁶ struggled to pay their heating bills – even with the Government Energy Bills Support Scheme, it is estimated around 7 million homes or over 25% of households could be in fuel poverty by end of 2022.
• The government spends around £2.55 billion each year trying to tackle fuel poverty⁴ (which includes ECO, Warm home Discount, Cold weather payments, Winter fuel payment). Only 16% of that annual spending reaches fuel poor households who are most in need⁴.
• Millions with health conditions (particularly respiratory/cardiovascular) are vulnerable to harm if they live in a cold home (this causes over 10,000 deaths per year in England and Wales³).
• Treatment for patients living in cold homes costs the NHS in England around £860 million each year².
• In Gloucestershire (the pilot area), hospitals spend £2.7 million per month on respiratory conditions alone⁵.
• In the UK, GP consultations for respiratory illness in older people increase by as much as 19% for every degree the outdoor temperature drops below 5°C⁷.

1 COPD, emphysema, chronic bronchitis or bronchiectasis

2 The cost of poor housing in England (Building Research Establishment; 2021)

3 UK Fuel Poverty Monitor 2019-20 (National Energy Action and Energy Action Scotland) – p44

4 Committee on Fuel Poverty Annual Report (2021) – p6

5 NHS Gloucestershire figure

6 Fuel poverty in the UK (House of Commons library; 2022)

7 Minimum home temperature thresholds for health in winter – A systematic literature review (Public Health England; 2014) – p8