An escalating global energy crisis and rising consumer bills have put one question front and centre for government: how do you support the people who suffer the most when they cannot pay their bills? We think a big part of the answer lies in NHS data – using it to target energy bill support, deliver it through the Warm Home Discount, track its impact on health and society, and make it the first step on a retrofit journey for the most vulnerable.
While the conflict in Iran has triggered the same symptoms for UK bill-payers as Russia’s invasion of Ukraine, the same prescription can’t be written twice. Chancellor Rachel Reeves said as much last week, pledging targeted support and ruling out a repeat of the blanket payments that cost taxpayers around £50 billion in 2022.
Households trapped in leaky, inefficient homes face a difficult winter, against a background of changing Government schemes to support retrofit. Yet the stakes go beyond this winter. An energy transition that leaves the most vulnerable behind, risks missing clean energy targets – and deepening fuel poverty. The numbers are stark: without intervention, the latest statistics suggest at least 14,000 more households could be pushed into fuel poverty.
We agree with Reeves – support must reach the most vulnerable. But identifying them and delivering that support effectively is where the real challenge lies. Which is what we have been working on over the past few winters.
Right now, energy bill support is targeted using benefits data – a rough, but imprecise proxy for energy needs. Income doesn’t tell you how draughty someone’s home is, or whether they’re on mains gas or off-grid fuel. The result is a system that misses many of the people struggling most with their bills.
And it also misses why it matters most – health. More than half of fuel poor households include someone with a health condition or long-term illness, and the NHS spends an estimated £900 million a year treating conditions caused by living in a cold or damp home.
The link between energy costs and health is direct and immediate, and the vulnerable people at the sharp end are exactly who support should reach.
We believe a big part of the solution already exists. It’s called Warm Home Prescription – and we’ve spent years rigorously testing it with real patients and energy customers. Energy Systems Catapult developed an approach that uses health data to identify the people most at risk, and we work with the energy sector to make sure they get the support they need to have a warm home.
To date, we have helped more than 2,500 people across England and Scotland, working alongside more than ten NHS areas to reduce bills and improve homes. We have delivered the service across three major energy partnerships: with BP in 2022 for large-scale social impact; with Scottish Power in 2025 to test how energy company obligations could drive health outcomes; and with SGN in 2025–26 to deliver on fuel poverty reduction and safety obligations. The service could scale much more rapidly.
The health conditions most aggravated by cold homes are severe respiratory and cardiovascular disease. This is well documented and clearly visible in NHS data, from electronic health records to emergency respiratory clinic data. If you keep these people out of hospital, the potential savings are significant.
And the opportunity to identify people whose illnesses are caused by cold or damp homes is growing. As the NHS moves to standardise data sharing between neighbourhood health services and hospitals, the ability to identify and reach vulnerable households becomes faster, more accurate and more impactful.
Identifying the right households is half the challenge, getting support to them quickly and reliably is the other.
Vouchers have proved ineffective. Nearly two million went unclaimed in 2022 thanks to administrative hurdles (and because life is already complicated enough). The best, low-risk and high-impact alternative is applying credits directly to vulnerable people’s energy accounts. The support arrives without the household having to do anything at all. Just as the government’s current Warm Home Discount scheme does.
We have built a digital system that achieves this while safeguarding personal data. People referred into the system have received energy bill support and retrofit referrals. This allows health, energy advice and energy suppliers to work together seamlessly.
Crucially, the outcomes are visible, tracked and can be linked to other data. Every £1 invested in the service generates £5 in social return on investment.
A key piece of the puzzle to unlock this support is having the government facilitate data sharing. It already has powers through the Digital Economy Act to share data between government departments and energy suppliers for specific scheme support including the Warm Home Discount. This delivers £150 to households automatically based on benefits data from the Department of Work and Pensions.
Encouragingly, it is also reviewing consultation responses on widening the pool of public authorities able to share data for fuel poverty support — a change that could significantly extend the reach of schemes needed to provide targeted support. But the crisis offers an opportunity and an urgent need to fast track this change.
Of course, direct bill support is a short-term remedy, not a cure.
A lasting solution is making homes less leaky and installing technologies so they generate their own energy. This would help permanently reduce bills, help the NHS, benefit our energy networks as more clean power is added to the grid, and improve energy security by eroding our exposure to geopolitical events outside our control.
Until now, the path to that outcome has been somewhat obstructed. Upfront costs are a significant barrier for low-income households, and even those who can engage often encounter complex customer journeys and poor quality installations. The result is patchy uptake for a challenge demanding rapid roll out to help those that need it the most.
On top of this, identifying the right households is one of the most expensive parts of delivering energy efficiency schemes with search costs alone accounting for up to an estimated 10% of scheme budgets. But our evidence suggests that targeted bill support, delivered using health data, solves two problems at once. It gets immediate help to those who need it most – and it opens the door to retrofit.
Three quarters of recipients of the Warm Home Prescription have told us they would be more likely to welcome home energy improvements after receiving direct bill support, because they now value living at warm healthy temperatures. The same data that targets bill support can help seed the retrofit pipeline, again getting help to those who need it the most.
The government’s Warm Homes Plan, including a budget of over £5 billion for low-income households, represents a serious commitment to improving the UK’s leaky housing stock and harnessing the potential of low carbon technologies to cut bills.
Innovative models such as social outcomes contracting, community energy service companies (ESCos) and Energy as a Service offer further potential to tie energy efficiency directly to health outcomes. So, the Department for Energy Security and Net Zero’s call for evidence on how these approaches could work to deliver the Warm Homes Fund is a welcome step in the right direction.
Taking all of that into account, the government could take four urgent key steps to target bill support at those who need it most and mitigate some of the risks of high energy costs:
Warm Home Prescription has proven what is possible (The Catapult has also shown how energy supplier obligations can deliver health outcomes and has developed retrofit business models that incorporate health savings. We’ll be publishing the results in Spring).
If the government does not take this up, any partners – networks, local authorities and industry – who want to work with us to test and scale these models this winter, get in touch.
Find out more about how Energy Systems Catapult can help you and your teams
Find out more about how Energy Systems Catapult can help you and your teams