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NICE guidelines on winter deaths – key recommendations for GPs

Primary health and home care practitioners should:

  • In collaboration with relevant local authority departments, use existing data, professional contacts and knowledge to identify people who live in cold or hard-to-heat homes. This includes people who are particularly vulnerable to the cold.
  • Include this information in the person’s records and use it (with their consent) to assess their risk and take action, if necessary.
  • Ensure data sharing issues are addressed so that people at risk can be identified.
  • At least once a year, assess the heating needs of people who use their services, whether during a home visit or elsewhere, taking into account the needs of groups who are vulnerable to the cold.
  • Use their time with people to assess whether they (or another member of the household) are experiencing (or are likely to experience) difficulties keeping their home warm enough.
  • Be aware that living in a cold home may have a greater effect on people who have to spend longer than an average amount of time at home. This could include those with chronic health conditions (including terminal illnesses) or disabilities.
  • Be aware that people may not want to admit they are having difficulties paying for heating and may try to hide this. (For instance, they might only put the heating on when expecting a scheduled home visit.)
  • Give people at risk, and their carers, information about how living in a cold home can affect their health. They should also tell them about services that can help and refer them if necessary. Ensure recipients can understand and act on the information they are given.
  • If a cold home is a risk to someone’s health and wellbeing, assess the likely effect and identify how the situation could be improved.
  • Make sure relevant services are aware who will take action and when. This could include: referral to the local health and housing service; referral to a health service (for instance, to ensure the person is offered flu vaccinations at the start of the winter); Record assessments and actions in the person’s notes or care plans. Make this information available to other practitioners, while respecting confidentiality.

Source – NICE guidelines: Excess winter deaths and morbidity and the health risks associated with cold homes

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