Evaluating the impact of Citizens Advice’s Winter Resilience pilot
25 April 2018
Citizens Advice set up the Winter Resilience project to design and pilot the implementation of a single point of contact for housing and health referral services, as recommended by the National Institute for Health and Care Excellence (NICE) guideline for tackling ill health due to cold homes (see www.nice.org.uk/guidance/ng6). They provided a small amount of seed funding to seven local Citizens Advice offices to learn about what works by trialling and testing different referral pathways.
CSE's independent evaluation of the pilot considers the project’s impact and its viability for wider rollout. The impact analysis focuses on two of the local offices - Manchester and Stockton - which were able to collect sufficient baseline and follow-up data to measure impact.
CSE's Nicky Hodges was the lead author of the report. She said "The Manchester and Stockton pilots demonstrated two different referral pathways from health practitioners to an integrated advice service. These pilots reached people with very poor health and a high dependency on health services, though numbers reached were fewer than hoped."
Over the period of the impact evaluation, the pilot showed that changes can be made to improve the energy efficiency of homes, increase the income of households, reduce the share of income spent on heating costs, increase confidence in using heating controls and register vulnerable clients for additional support from their supplier.
"We observed that only modest improvements in average wellbeing were achieved and that, by some measures, average health had worsened," added Nicky, "However, without the efforts of the advice staff in Manchester and Stockton, the improvements may have been more modest still, and the decline in average health even worse. This result needs to be understood in terms of the very poor health of clients at baseline, the influence of other significant changes to clients’ circumstances, limited sample size and limited elapsed time for other changes to be felt in terms of wellbeing benefits."
The report made a string of recommendations which include recommendations for service delivery:
- Local Citizens Advice wishing to develop cold home referral services similar to those provided by Manchester or Stockton should recognise the importance of partnership building, using skilled case workers and investing in training. This has time and resource implications.
- Home visits are of key importance for any future service. They allow demonstration of how to use heating and more tailored advice in relation to the condition of the home. However, home visits are expensive and may need to be limited to consumers in particularly vulnerable circumstances.
- Ongoing casework following a home visit also appears to be an important contributor to clients achieving successful outcomes. Again, case work is resource intensive and may need to be limited to those consumers who are considered unable or unlikely to take recommended actions themselves without additional support.