Integration can help tackle fuel poverty

• Written by: Norman Kerr OBE — Energy Action Scotland — Director
• Published: 17th June 2018

Fuel poverty has a very real impact on health and social care in Scotland.

But there are green shoots of hope to show that, conversely, the integration of health and social care can support progress in tackling fuel poverty.

Like so many organisations, Energy Action Scotland (this link will take you away from our website) shared the historic frustration of health care, social work and social care professionals unable to have the type of conversations that could lead to the support of households and individuals.  We have trained 10,000 workers who work at the front line and we know how hard it is to find ways of joining up services around people to keep them well and at home when that home is hard to heat, cold and damp.  It is, however, inspiring to hear how people are beginning to find ways of doing just that, in some Health and Social Care Partnership areas faster and better than others, but change is happening and that will save lives and support crucial services where it works.

GPs need support to recognise the health effects of fuel poverty.  From cold and damp at the better understood end of the scale to the inability to cook or refrigerate food at the other.  Social care workers need to be alert to the signs of a home that is difficult to heat to better anticipate the health problems that are likely to result.

The stark facts are that fuel poverty kills six people in Scotland every day of winter. For every one degree drop in temperature below five degrees centigrade, GP consultations for respiratory illness in older people increase by 19%.  Add to that the fact that 9% of hypertension in Scotland could be prevented by maintaining an indoor temperature above 18 degrees centigrade and we can clearly see why services struggle to cope when 649,000 households in Scotland live in fuel poverty.

Away from primary care, Energy Action Scotland hears from front line workers involved in resolving delayed discharge caused by an unplanned hospital stay resulting in disconnection for individuals on pre-payment meters.  We hear too of delayed discharge caused by a patient’s self-disconnection, meaning that they are unable to return home with equipment that requires electricity or medication that requires refrigeration.

In some parts of Scotland, fuel poverty advisers are part of the team working alongside community links practitioners, multi-disciplinary primary care and community discharge teams. These are areas that acknowledge the impact of fuel poverty on households and communities and are actively seeking solutions for households that make the choice between heating and eating every day, households that suffer from respiratory and other conditions caused by damp and mould.

The long term, sustainable solutions will come from housing working more closely with Integrated Authorities. Local strategies like the ‘fabric first’ approach to make homes in a community easier to heat will reduce the burden on health services, keep people out of hospital and enable them to return home faster when they do. These are the areas where we need to speed the pace of change.  649,000 households and the lives of everyone in each of those make that an urgent priority.

Energy Action Scotland can be found on Twitter at: @EAS_Scotland (this link will take you away from our website).

Norman’s Opinion is part of the ALLIANCE’s ‘We Need To Talk About Integration’ anthology which is available at the link below.

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