Clinical update

Act now to avoid winter deaths ALAMY

Essential facts Cold weather has a direct effect on the number of people experiencing heart attacks, stroke, respiratory disease and flu. According to the Office for National Statistics, an estimated 31,100 excess winter deaths occurred in England and Wales in 2012/13 – a rise of 29 per cent compared with the previous year. Of these people, 25,600 were aged 75 or above.

Excess winter deaths and illnesses: guideline consultation NICE (June 2014) tinyurl.com/mszb23u Excess winter mortality in England and Wales, 2012/13 Office for National Statistics tinyurl.com/pfhyepj

What’s new The National Institute for Health and Care Excellence (NICE) is developing a public health guideline, Excess winter deaths and illnesses: identifying and supporting vulnerable children and older people. The aim is to reduce these preventable deaths and ill health.

Causes/risk factors Living in a cold home increases significantly the risk of someone becoming ill or dying especially during the winter months, so year-round action is needed to improve living conditions, says NICE. As well as those who are already living with an existing respiratory or circulatory disease, people most likely to be affected often have a low income or a home that is difficult to heat. People aged over 65 and children with asthma are at risk.

Prevention Recommendations include identifying those at risk, ensuring that a referral can be made for insulation or heating improvements if necessary, and raising awareness of local systems and services to help people who are living in homes that are too cold. People need

Expert comment Caroline McGraw is a lecturer in public health at City University London

Find out more

Spread the warmth campaign Age UK (2012) tinyurl.com/6kru7we to be aware of how the cold affects their health and where they can seek help if needed.

How you can assist your patient Use existing data, professional contacts and knowledge to identify people who live in a cold or difficult-to-heat home, or are particularly vulnerable to the cold because of a medical condition. This information should be included in the person’s records and used to assess risk, and action should be taken where necessary. Those who are responsible for arranging a patient’s discharge from hospital should co-ordinate efforts to ensure the person’s housing is warm enough. This could include simple measures, such as turning on the heating before discharge, and providing advice on the ill effects of cold on health or how to use the heating system.

‘Some 19 per cent of UK households are in fuel poverty. Community nurses see first-hand the adverse effects that living in cold, damp homes have on older people, young children and people with long-term conditions. ‘The new model for district nursing, launched by the Department of Health last year, sets out a role for community nurses in delivering health and wellbeing

The cost of cold – why we need to protect the health of older people in winter Help the Aged (2012) tinyurl.com/p5o5bcw Cold enough – excess winter deaths, winter fuel payments and the UK’s problem with the cold Strategic Society Centre (2013) tinyurl.com/nnxea66 Reducing harm from cold weather Local Government Association (2013) tinyurl.com/qdjr5rt

interventions at caseload and local population levels. This means they are well placed to assess for fuel poverty during first contact assessments and ensure early intervention – such as flu vaccination, falls screening, medication review and referral to home energy efficiency schemes. They can also work with community groups to promote “keep warm, keep well” information campaigns.’

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Act now to avoid winter deaths.

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