Fuel Poverty (Target, Definition and Strategy) (Scotland) Bill and Fuel Poverty Strategy: health impact assessment

10. How can we reach more people living in cold homes?

The new fuel poverty strategy recognises that partnership engagement both at a national and local level has a critical role to play in identifying people who are living in cold homes and may be experiencing fuel poverty.

However, many individuals in fuel poverty are "hidden" and unaware, reluctant or unable to seek the support and help that is available to them. This can be for a number of reasons including difficulties with digital engagement, reluctance to seek help as they don't want friends and families to know they are struggling to heat their homes, in smaller communities individuals may be unwilling to identify themselves as they don't want their neighbours to know, and there may be language and/or cultural barriers preventing help being sought.

However, these individuals may present themselves to and be identified in a number of settings in health, social care and community sectors.

• community based child health staff (midwives, health visitors, school nurses);
• district nurses;
• GP services and hospital services;
• family nurse practitioners;
• non- GP services such as community pharmacies;
• Food banks;
• Carer's support groups;
• Support groups linked to specific medical conditions
• Local energy advice providers
• Local authority fuel poverty advisors

Through close working with partners and stakeholders, we can create more opportunities to raise awareness of the impacts of living in a cold home and take further action to increase uptake of the support available by effective signposting and referral mechanisms. We also recognise the importance of flexibility to enable partnership approaches to respond to local needs.

The Scottish Government funded Home Energy Scotland ( HES) advice network provides free, impartial, tailored advice and support to all Scottish households, including specific support for fuel poor households to help them reduce their fuel bills, make their homes warmer and more comfortable and increase their income.

HES already works at both a strategic level, with Scottish Government and NHS Health Scotland, and at a local level, with GP practices and NHS Boards as well as other local partners, to enable patients and NHS staff to access support from Home Energy Scotland. The arrangements between HES and health sector partners involve data sharing agreements to allow individual patient/householder data to be shared with the householder's consent. A key tool is the HES online referral portal, which is available for use by all organisations who work with fuel poor households and provides a fast, secure route to referring households and patients to HES for advice and support. In addition, the portal allows the referral to be tracked from initial contact to the end of the customer journey and the resulting outcome.

Examples of HES partnership work with the NHS

NHS Greater Glasgow and Clyde

HES have had a partnership agreement in place with NHS Greater Glasgow and Clyde since mid-2015. The initial focus of the partnership was on HES providing energy advice directly within the Victoria, Queen Elizabeth and University Hospitals through their patient information centres. HES have been attending one of these three patient information centres every fortnight to deliver energy advice directly to patients. In addition, this activity has resulted in growing numbers of referrals of patients to HES from NHS staff working in these hospitals.

NHS Grampian

Since September 2015, HES has been providing advice within Aberdeen Community Health and Care Village. The Community Health and Care Village is run by NHS Grampian and is an urban community hospital (without inpatient beds) delivering diagnostic and treatment services for the people of Aberdeen and Grampian.

HES joint staffs the stand with the local financial support referral service Cash in Your Pocket ( CIYP) – so that patients benefit from HES's energy and income maximisation advice as well as referral to local and national energy efficiency schemes, whilst at the same time receiving financial support through CIYP.

Supporting young families in fuel poverty

HES has provided content to NHS Health Scotland for health visitor training developed in support of the Universal Health Visiting Pathway, which identifies fuel poverty as an issue that health visitors should identify and be offering families routes to support on. The information includes how to identify people who could benefit from fuel poverty advice services, how to make a referral through the Home Energy Scotland portal and case studies. This information has been included in the NHS financial inclusion toolkit and e-learning module on child poverty.

NHS Greater Glasgow and Clyde ( NHSGGC) is linking fuel poverty with financial inclusion work, asking patients if they have money worries and offering a direct referral to advice services.

NHSGGC has service level agreements with money advice services and partners with Home Energy Scotland ( HES), to provide energy advice and access to support to help deliver affordable warmth.

NHSGGC- HES's Action Plan supports patients, carers and staff and includes:

• Primary Care - staff referring to money advice who refer on to HES
• Acute - Direct online referral mechanisms to HES introduced within hospital Family/Support and Information Services and proactive linking with NHS