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GPs must help patients in cold homes - but Health and Wellbeing Boards should act, too

GPs have an important role to play in identifying patients who are at risk of health problems from living in a cold home, argues NICE guidelines committee co-chair Dr David Sloan

GPs know only too well that cold weather kills. In a typical year, around 24,000 more lives are lost in the winter months compared with the rest of the year.

This is because cold homes can be a killer. It is not surprising who is at risk: people living in fuel poverty who cannot afford to heat their homes, children and adults with chronic conditions like asthma, heart disease and COPD, those who are immobile, and people aged over 75.

The mercury does not have to drop too far for danger to rise.

It may be a surprise that moderately cold temperatures (below 6ºC) kill. They have a direct effect on the numbers of heart attacks, strokes, cases of respiratory diseases, flu and falls.But these early deaths and injuries can be prevented.

A family doctor is often at the sharp end of spotting people who are sick because of winter weather. But as we all know, GPs are pushed for time. It’s simply not possible for a family doctor always to visit someone’s home who they suspect is at risk from the cold.

The committee saw a collective role for people who come into contact with vulnerable people living in cold homes. This includes primary health and home care workers, but also heating engineers, charity workers and volunteers ready and able to help and stop needless suffering and death.

We want to see every area equipped for the task. Health and Wellbeing Boards should ensure that a single point of contact is prepared to help people who live in cold homes. This will provide vital support to people on the frontline working with the vulnerable and take on the work needed to warm up people’s homes, such as new boilers, double glazing and getting the best fuel tariff.

Currently these one-stop services are patchy. But local authorities are not starting from scratch - they can pull together services that already exist and help target the people who need them.

As well as helping to tackle the causes of ill health by warming homes, we also need to address commonly held misconceptions, for instance that a shot of whisky or other alcoholic drink can somehow root out the cold, that hypothermia is the main risk posed by the cold, or that sleeping in a cold bedroom is good for your health.

The rewards are worth the investment. These plans would stop the vicious circle that sees people living in cold homes admitted to hospital, treated for their condition but discharged back into the environment that made them sick in the first place. It would reduce pressure on primary and secondary care and save the time of all the professionals who become involved in getting the person back on their feet.

Dr David Sloan, former GP and director of Public Health, was the co-chair of the NICE committee behind new guidance aimed at preventing deaths caused by the cold

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Readers' comments (16)

  • Which would prefer?
    Listen to your cigarette chest (free)
    or fix your boiler - not that free!

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  • I think, as is often the case, some of the responses are a little bit negative. It's all a question of extent isn't it? It seems unlikely a GP is going to be prosecuted and executed for failing to report a cold house. However, if a service is put in place for a GP to report via a phone number poor heating in a vulnerable patient's house where is the harm in that? We assess risk factors in patient's lives all the time.

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  • Anonymous at 5:31PM:
    Sorry mate, I am not sure if you have tried contacting social services yourself. Takes eons. And one would have thought we already report concerns to said social services. Just imagine your workload once you have qualified

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  • This comment has been removed by the moderator.

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  • a lot of patients must get down from not having bmw's - why not allow GPs to issue a bmw on prescription - imagine how much it will help folks' mood?

    i've got loads more ideas like that - NICE please hire me !

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  • Azeem Majeed

    Although people's housing is clearly important for their health and well-being, it is an issue that should be dealt with by local and central government - for example, by giving older people and other vulnerable individuals who have problems such as cold homes a direct access service that they, or their friends and relatives, can contact which offers rapid assessment and resolution of their housing problems.

    We also need to consider why people would choose to live in a home that is so cold it may adversely affect their health. Presumably, they cannot afford to heat their homes adequately and are trying to save money, in which case the problem should be addressed through the welfare and benefits system rather than by GPs.

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