SHINE / Warm homes and lower fuel bills: just what the doctor ordered

Context

Living in a cold, damp home makes respiratory illnesses and many other chronic health conditions worse. The London Borough of Islington’s Seasonal Health Intervention Network (SHINE) links up 86 local organisations in an integrated approach to tackling fuel poverty and improving the wellbeing of its most vulnerable residents. Member organisations, from GP surgeries and health visitors to housing and community organisations, refer vulnerable people to the SHINE team. The team then steps in with advice on fuel debt and energy efficiency, as well as helping residents access discounts on fuel bills and grants for new boilers. With residents saving an average of £200 each on annual fuel bills, SHINE is also easing the pressure on local health budgets.

Impact

Over 3,600 Energy Doctor home visits have been completed, while the total number of interventions of any sort is over 38,000 for more than 8,400 people. CO₂ savings are difficult to estimate for SHINE’s work, but are thought to be in excess of 3,200 tonnes annually, while the financial savings achieved by households through reduced energy use and bill discounts are about £700,000 annually. Most homes in Islington that can be easily insulated  already have been, so very few further insulation installations have been facilitated by SHINE. There are still many homes with old, inefficient boilers though, and 285 of these have been replaced by SHINE using council funds since 2011.

Elements of SHINE have already been replicated in Hackney, Lewisham, Wandsworth, Norwich and Hertfordshire, and with the inclusion of much of SHINE’s learning in the NICE guidelines on excess winter deaths, further replication is expected.

Future plans

SHINE is working to encourage neighbouring boroughs in London to follow its lead in tackling fuel poverty, so its partners in the referral network aren’t limited by the geographical boundaries of Islington when they are making referrals.

Details

SHINE’s referral network includes over 80 partners – the largest example of such a network in the UK. Not only does this allow SHINE staff to access extra help for households in fuel poverty, it also helps them identify households that they may not have otherwise found. For example, their close links with the local NHS staff mean that people suffering from falls, respiratory complaints and heart problems are referred to SHINE to see if they need help heating their home to a safe and comfortable level. The council provides practical help to referred households through its ‘Energy Doctor in the Home’ programme, through which trained energy advisors spend up to half a day helping a household work out what physical and behavioural changes they can make to reduce their energy usage.

As a result of SHINE’s outstanding work, its staff have been involved in developing the guidance on reducing excess winter deaths published by the National Institute for Health and Care Excellence (NICE) in March 2015.

SHINE referral network

The SHINE referral network was launched in 2010, inspired by the harsh winter of 2008-9 and by guidance provided from the Health Inequalities National Support Team on reducing excess winter deaths. It operates on the principle that most people affected by fuel poverty also face other problems relating to health, finance or their home, and could well come to the attention of some other agency than the fuel poverty team. By involving many different agencies in SHINE, and training their staff to spot the signs of fuel poverty, the likelihood of vulnerable households being identified and promptly helped is significantly increased. Referrals work in both directions – so the fuel poverty team can refer people for other interventions, for example to tackle health problems or bring their home up to a decent standard.

SHINE’s links with the NHS are particularly notable. GPs can write directly to SHINE when they are concerned about a patient, acute and community teams at local hospitals can make referrals, and SHINE can make referrals for people at risk of falls, reviews of medication and assistance in stopping smoking. SHINE’s work with the health sector has resulted in a growing appreciation amongst NHS staff that the home environment of their patients is critical to recovery from illness and continuing good health. As a result, health practitioners are now quicker to get in touch with SHINE and leverage the extra resources available to help their patients.

All our clients rave about SHINE’s Energy Doctor visits because they get lots of help and advice on saving energy, and therefore saving money.

John Warby, Team Leader, Help On Your Doorstep

Energy Doctor in the Home

SHINE’s programme of ‘Energy Doctors’ visiting homes helps households to achieve sustainable reductions in their energy use and cut their bills as well. The Energy Doctors are provided by a delivery partner, Groundwork, and visits take up to half a day per household, including advice on changing behaviour to cut energy use and bills, information on tariffs and signing people up for the Warm Home Discount. Simple energy saving measures can be installed and also a household energy monitor in some cases. The Energy Doctor also helps households understand how to use their heating controls more effectively, which is especially useful for electric storage heaters – SHINE’s research shows that many people do not know how to use them to achieve a comfortable temperature without incurring excessive electricity bills.