Cheshire and Merseyside Health and Care Partnership has made significant progress since the launch of a fuel poverty programme, which uses population health technology to identify and support people facing fuel poverty.
The first project – ‘St Helens Warm Homes for Lungs’- was rolled out in February 2023. Since then, more than 1300 individuals at risk of developing serious health issues due to fuel poverty have been identified using Cheshire and Merseyside’s population health platform – provided by Graphnet Health.
The focus so far has been on patients with severe COPD residing in deprived areas, and who are at high risk of a hospital admission due to cold and damp living conditions.
Patients have been contacted through the St Helens Warm Homes for Lungs project and referred to St Helens Council’s Home improvement team – giving them access to the Wellbeing and Pulmonary Rehabilitation Teams, the COPD Telehealth Service, and for many, access to household support funds.
Payments totaling £106k have been made to patients, who have been reviewed by the specialist nursing team and offered a pulse oximeter and a warm home pack – including a vitamin D Voucher.
Diane Green, a community respiratory nurse at Mersey and West Lancashire Teaching Hospital, and lead COPD nurse for the St Helens Community COPD Rapid Response, has noticed the significant impact the work has had on patients under her care.
“Through the fuel poverty dashboard, we’ve been able to identify patients in need and target them in a completely different way. As nurses, at the click of a button, we now have all the information that we need for those patients to truly help them. We can see whether they’ve been immunized, whether they are still smokers, whether they’re on the best treatment, and what quintile of poverty they are actually living in. That has helped us to prioritise and identify the people that are most in need.”
According to Dianne, the fuel poverty programme has been transformative.
““It is hard not to cry when speaking about the importance of this work, and how it has helped the patients that I support. It is truly proactive,” she explained.
I’ve been a nurse since 1986, and we’ve never transformed lives like this. As a community nurse, we regularly go into patients houses but they never tell us that they can’t afford a light bulb upstairs, they never tell us that they’re really struggling to pay the bills…. The difference that we’ve made by looking at them and their lives through different eyes, using this population health technology, is unbelievable.”
Lucy Malcolm, Senior Digital Transformation and Clinical Improvement Manager for Cheshire and Merseyside Health and Care Partnership, added:
“Much has been learned during the course of the programme, namely that there is value in testing and learning from small pilot projects to support scaling up of work going forward. It has also emphasised that the people involved are crucial.
“The technology provides the data that is needed, but it’s the people from health, social care, and other sectors, who have put their hands up to get involved, who are the heart of the programme, harnessing those insights to provide vital, life-improving support to Cheshire and Merseyside’s most vulnerable residents.”
The next priority for Cheshire and Merseyside is to use the fuel poverty dashboard to identify and support more vulnerable groups.
In December 2023, a ‘Preschool Wheeze’ project – for children aged 0-4 with a respiratory wheeze – was launched. It identifies and supports young children at risk of negative health implications (including asthma) due to cold homes.
Cheshire and Merseyside will also be expanding the COPD programme and rolling it out further across St Helens, Knowsley, and Warrington.
Local resident’s story – Paul
Paul lives in St Helens with his wife and his daughter.
Despite being visited by community nurses supporting him with his mental health, he had never told them that he was sleeping on the couch – and his daughter was having to share a bed with his wife – due to the spare bedroom having a hole in the floor, and the upstairs being covered in mould.
He opened up to his care coordinator, Stacey, and told her about the mould problem. Stacey immediately referred Paul to the Affordable Warmth Team.
As a result, Paul has now had the hole in the floor fixed, new windows fitted, the mould is gone. What’s more, he’s been given £500 to help heat his home. He is now sleeping in his own bed again.
Prior to being provided with this support, Paul had been in hospital three times. Since the project team intervened, he has not required hospital care.
Paul and his wife told the community nursing team that the support has transformed their lives.
