NICE calls on health service to do more to tackle cold home deaths and illnesses

New NICE guideline published with clear recommendations for action

5 March 2015

The health service can and should be doing much more to help tackle the root causes of health problems resulting from people living in cold homes. That’s the key message of a new guideline published today (5 March) by NICE, the National Institute of Health and Care Excellence.

CSE’s Chief Executive Simon Roberts served as a topic expert on the NICE advisory committee which has reviewed the evidence and drawn up the guideline, the first of its kind in the UK.

The guideline makes a wide range of recommendations including:

  • Establish a single-point-of-contact health and housing referral service to help vulnerable people who live in cold homes gain access to services which can lower the cost of keeping warm.
  • Primary health and home care practitioners should identify people at risk of ill health from living in a cold home, and make every contact count by assessing the heating needs of people who use health and care services.
  • Discharge vulnerable people from health or social care settings to a warm home. Assess soon after admission or when planning a booked admission whether the person is likely to be vulnerable to the cold and if action is needed to make their home warm enough for them to return to.
  • Train heating engineers, meter installers and those providing building insulation to help vulnerable people at home, and to be able to spot if someone is at risk because of a cold home, and know who to call if there is a problem.
  • Raise awareness among practitioners and the public about how to keep warm at home, including addressing commonly held misconceptions, such as that drinking alcohol can help keep someone warm, that hypothermia is the main health problem caused by the cold, or that sleeping in a cold bedroom is good for your health.

At the NICE press conference launching the guideline, CSE’s Simon Roberts said:

“This guideline is a really important step forward in integrating the work of health and social care sectors into wider efforts to tackle the annual cycle of misery, ill health and premature death which we know is linked to cold homes. Living in a routinely cold home is bad for your health and wellbeing and makes existing health problems worse. That in turn causes avoidable burden on the health service.

The good news is that, as the guideline makes clear, there are simple steps that can be taken to address this, starting with the health service recognising the problem and putting in place systems to refer patients to local initiatives that can help to tackle their cold homes – and thereby reduce the harm done to their health.”

Professor Gillian Leng, Deputy Chief Executive of NICE, said “Deaths and illnesses linked to living in a cold home are preventable. NICE recommends that health and wellbeing boards should ensure that a single-point-of-contact health and housing referral service is commissioned to help vulnerable people who live in cold homes. Anyone who comes into contact with vulnerable groups should be able to refer people to the service, including health and social care staff, safety services staff and workers from charities and voluntary organisations. Properly using this huge number of contact opportunities can make a big difference in preventing illness and saving lives.”

CSE is now embarking on the ‘Preventing Illness by Tackling Cold Homes’ project, as part of Bristol 2015 European Green Capital, to implement this new guideline across Bristol. This will be done in partnership with the local health service and with other organisations providing services which help householders reduce the cost of keeping warm.


An example of the sort of impact this approach could have is described in this case study from Lisa Evans, one of CSE’s energy advisors.

As part of Bristol Green Capital, CSE has received funding to enable the implementation of the NICE guideline on cold homes in Bristol. Read about our PITCH (Preventing Illness by Tackling Cold Homes) project here.

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