A review of how the NICE Guideline NG6 is delivering warm and safe homes, and what more can be done for vulnerable and terminally ill people.
Since its publication in 2015, the National Institute for Health and Care Excellence’s (NICE) NG6 guideline has been recognised as a landmark resource for understanding and deploying appropriate action to support those at risk of worsening health because of cold homes and fuel poverty.
Despite being recognised as a key resource for tackling the health impacts of cold homes, there is limited understanding of the extent to which the guidance has been implemented and related successes and challenges of delivery.
Further, there has been little consideration of the delivery and impact of NG6 in relation to key vulnerable groups, for example, those at the end of life – a group we know can experience a vicious cycle of fuel poverty.
This report takes steps to close this gap in understanding.
It details collaborative research undertaken by National Energy Action and Marie Curie to examine how the recommendations in NG6 are being delivered, with specific consideration of what this means for people at the end of life in England and Wales.
Examining existing research, publicly available resources and reports and resources shared in response to Freedom of Information requests, the research provides a snapshot of what is happening in relation to the NG6 recommendations. It draws on the work of local authorities, health and wellbeing boards, integrated care boards, government, and other national bodies such as public health. It focuses on NG6 recommendations considered more or most pertinent to those at the end of life or with a terminal illness, including the development of a strategy, establishment of a single point of contact, processes for safe discharge to a warm home, and efforts to raise public awareness.
While positive examples of how NG6 is being implemented were identified, the research shows that more action is needed. Progress to date has been patchy and inconsistent. In many cases, there is little to no data or detail on the implementation of NG6, which are a mandatory set of guidelines in England, and this means that either there are gaps in existing activity, or that work is happening but is not known about, making scaling up or learning from examples of best practice difficult.
We make the following recommendations for policy and practice:
- Further analysis is needed to understand the extent to which fuel poverty is having health consequences for vulnerable groups, including people living with terminal illness especially considering the impacts that the cost-of-living and energy price crisis is likely to have had.
- People with a terminal illness need to be explicitly identified as a category of ‘vulnerable group’ by NICE.
- Further research is critically needed to better understand the finer details of specific successes and challenges of schemes and services that are delivered under NG6.
- A review of work aligned with NG6 recommendations across the UK nations is needed, particularly to better understand and highlight that which is already happening in Wales (and other UK nations)
- Critical localised and strategic documents, such as Joint Strategic Needs Assessments and Health and Wellbeing Strategies need to go further and outline solutions and strategic activity to minimise winter deaths, as well as be more readily and easily available.
- NG6 implementation should complement existing strategies and plans, specifically in the context of terminal illness, for example, in end of life or palliative care plans.
- Opportunities to modify or expand training for frontline professionals should be identified to ensure that the needs of vulnerable households, including people living with terminal illness and their families are factored into wider energy and fuel poverty training offers.
- To reach the most vulnerable people, energy-related advice and support must be available in multiple formats and settings, therefore in-person and in-home support must be protected and expanded and the value of this recognised in policy.
- There is a need to better understand barriers in accessing support that people with a terminal illness face and implement awareness raising campaigns and targeted support for this vulnerable group specifically.
For more information, please contact Danielle Butler email@example.com.
You can find out more about National Energy Action’s health-focused research and policy work here.