Agenda item

-        Fuel Poverty (Catherine Homer to present) (Pages 28 - 45)

 

-        Dementia (Kate Tufnell to present) (Pages 46 – 64)

 

The Health and Wellbeing Board considered the following reports and presentations:-

 

(A)  Fuel Poverty

 

Further to Minute No. 20 of the meeting of the Health and Wellbeing Board held on 10^th July, 2013, the Board noted that Fuel Poverty and Excess Winter Deaths remain key national priorities and are both indicators contained in the Public Health Outcomes Framework. Fuel poverty levels in Rotherham are higher than the national average and occurs throughout the Borough area, not only in areas of high deprivation.

 

Catherine Homer, Health Improvement Specialist, gave a presentation about fuel poverty:-

 

Why is Fuel Poverty a priority?

-          Current definition – when householders need to spend more than 10% of their income to heat their home adequately

-          Causes of fuel poverty: energy efficiency of the property; fuel costs; behaviours and knowledge, characteristics and household income

-          Fuel poverty is a serious problem from three main perspectives – poverty, health and wellbeing and carbon reduction

-          Heat or Eat

-          Cold weather kills – living in a cold home has significant implications on the health and wellbeing of residents across our Borough particularly the most vulnerable

-          People with an existing chronic health condition or disability, the very young or older people are more at risk from the negative impacts of living in a cold home

-          Children living in cold homes are likely to have poorer attendance and attainment in school

 

The private and social cost of Premature Death and Illness related to Cold Homes

-          Source of evidence

English Housing Conditions Survey

Mental Health and Housing Conditions in England, National Centre for Housing Research 2010

Housing Health and Safety Rating System

-          Economic model mapping cold, damp and mould to probability of harm

-          Probability of harm further mapped to economic and NHS cost

-          Probable this is an underestimate of effect since the model assumes only one person per dwelling

 

Rotherham

-          Fuel poverty levels above national average (16% of households in Rotherham, compared to 14% nationally)

-          The rise in fuel prices – energy costs have risen 96% since 2004 or an average of £700 over the same period

-          Average of 144 Excess Winter Deaths per year 1990-2010

-          17,800 Council properties have been supported through Carbon Energy Reduction Target (CERT)

-          400 Council properties have received solid wall insulation through CERT

-          1,049 private sector properties have received solid wall simulation through the Community Energy Saving Program (CESP)

-          1,649 non-traditional build properties in the Borough

-          Green Deal including Energy Company Obligation

 

Strategic Objectives

-          Reduce levels of fuel poverty across the Borough

-          Significantly reduce levels of cold-related illness and excess winter deaths

-          All of Rotherham’s occupied private rented housing stock has an Energy Performance rating of E and above

-          Target all Council stock not improved under Decent Homes because of resident choice

-          Raise awareness of fuel poverty and associated interventions amongst Council staff, partner organisations and householders

-          Meet vision and ambitions set in the Rotherham Warmer Homes Strategy

-          Creation of electoral Ward profiles

 

What do we need to do?

-          Continue to engage new and existing stakeholders through the Rotherham Warmer Homes Strategy

-          Set up and deliver the Green Deal/Energy Company Obligation Framework

-          Continue to utilise existing intelligence and support development of new research

-          Raise awareness of links between health and fuel poverty

-          Use ‘Make Every Contact Count’ (MECC) as a tool to ensure more departments/staff raise issues of fuel poverty

-          Maximise personal assets, capability and behaviour

-          Adopt a whole system approach to reduce levels of fuel poverty

 

Challenges

-          Causes of fuel poverty

-          Structural and organisational change (dealing with competing priorities)

-          Reliance of new Policy as main vehicle

-          Lack of engagement and understanding

-          Most vulnerable and hard to reach populations most likely to be in fuel poverty

-          Welfare Reform

-          Climate impacts

 

What can the Health and Wellbeing Board do?

-          Professionals consider the effect of cold on patients/clients and use the principles of MECC to signpost and advise eg: Willmott Dixon

-          Support the use of the Winter Warmth England toolkit www.winterwarmthengland.co.uk

-          Support Green Deal as a Council priority – eg: ensure that householders properly understand how to use the heating controls

-          Support and attend the ‘Warm Well Families Feedback’ event and ‘Abacus’ workshop

 

Discussion ensued on the presentation with the following issues/comments raised:-

 

: the connection between ‘heat or eat’ – eg: demands for food;

 

: voluntary sector work – ‘warm homes – healthy people”;

 

: the Warm Well Families feedback event takes place on Wednesday 2nd October, 2013 at the Town Hall, Rotherham.

 

Catherine was thanked for her informative presentation.

 

(B)  Dementia

 

Further to Minute No. 17 of the meeting of the Health and Wellbeing Board held on 10^th July, 2013, the Health and Wellbeing Board considered a report about the cross-cutting theme of Dementia, which has been identified as a key priority for the future provision of services. The expectation is that there will be an increasing demand, within the next three years, for services both for people suffering dementia and also for their carers.  Kate Tufnell, Head of Contracts and Service Improvement, NHS Rotherham Clinical Commissioning Group, gave a presentation about the Dementia priority:-

 

Overview

-          Overseen by Older People’s Mental Health Group

-          4 ways you can support the Programme

 

What is the Problem ?

-          Dementia was now the greatest health concern for people over 55 and the economic cost of Dementia was more than Cancer, Heart Disease or Stroke

-          Rotherham – 1,688 people on the GP Dementia Register (3,034)

-          By 2025 the number of people in Rotherham with Dementia could rise to 4,397 (Joint Strategic Needs Assessment 2011)

 

The Cost of Dementia

-          Dementia was an expensive condition with a considerable cost to both public and private finances

-          a large proportion of the cost of caring for a person with Dementia was borne by the carer

-          In the UK = £23 billions per year

 

Symptoms of Dementia (examples)

-          Memory loss

-          Difficulties of completing familiar tasks

-          Confusion of time and/or place

-          Trouble with visual images – eg: colours and contrasts

-          Language difficulties – unable to follow conversations

-          Misplacing items

-          Changes of mood and personality – eg: depression; aggressiveness

-          Withdrawal from hobbies and leisure activities

-          Self-care problems

-          Difficulties posed for carers of people with dementia

 

Dementia Programme

-     The Programme incorporates four workstreams:-

Dementia - Prevention Group

Dementia – Early Diagnosis Group

Living Well with Dementia Group

Dementia and End of Life Care Group (eg: care planning)

 

Six Priority Outcomes

-          Prevention and early intervention (RMBC bronze to platinum programme, for the care of people with dementia)

-          Expectations and aspirations

-          Dependence to independence

-          Healthy lifestyles

-          Long term conditions

-          Poverty

 

Four ways in which the Board can support the Programme

-          Continue the Dementia Workforce Development Programme

-          Strong leadership to break down barriers on joint working

-          Continue to support the further development of the Dementia Pathway

-          Support the development of a Dementia Friendly Community and Dementia Alliance in Rotherham

-          Partnership work with the Yorkshire Dementia Alliance and with the business community

 

Challenges

-          This is everyone’s business

-          Increase demand on Service to be delivered within same resources

-          Complexity of Pathway and independencies

-          Variation across the system and potential inequalities

 

Discussion ensued on the presentation with the following issues/comments raised:-

 

: the priority given to the issue of dementia, by the Prime Minister;

 

: the likelihood of a significant increase in the number of people suffering dementia, with consequential pressure upon resources and services;

 

: Alzheimer and dementia champions in Rotherham and in Doncaster (National Alzheimer’s Programme) – provision of training.

 

Kate was thanked for her informative presentation.