Although a formal committee of Brighton & Hove City Council, the Health & Wellbeing Board has a remit which includes matters relating to the Clinical Commissioning Group (CCG), the Local Safeguarding Board for Children and Adults and Healthwatch.
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Title: Brighton and Hove City Council Winter Cold Weather Plan 2020/21
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Date of Meeting:10 November 2020
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Report of: Becky Woodiwiss - Public Health Principal, Public Health, HASC Annie Sparks – Regulatory Services Manager
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Contact: Tel: 07767 613460 |
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Emails: becky.woodiwiss@brighton-hove.gov.uk Annie.sparks@brighton-hove.gov.uk
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Wards Affected: All
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FOR GENERAL RELEASE
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Executive Summary
The BHCC winter cold weather plan is updated annually. This year, planning for the winter of 2020/21 is in the context of the COVID-19 pandemic, its health and socio-economic impacts, resulting services changes, an expanded seasonal Influenza Vaccination Programme and the UK’s scheduled exit from the EU on the 31st December 2020. The BHCC plan localises the Cold Weather Plan for England and both aim to prevent avoidable harm to health, by alerting services and people to the negative health effects of cold weather and enabling all to prepare and respond appropriately.
The CWP also aims to reduce pressure on the health and social care system during winter through improved anticipatory actions with vulnerable people. This year these pressures may include seasonal surge pressures, the impact Flu, Covid-19 or other wider circumstances such as the impact of the end of the EU Transition Period from 1st January 2021 onwards.
The preparation and response for Winter 2020/21 is being coordinated with the Sussex Resilience Forum (SRF) and partners across Sussex
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Glossary of Terms
CWP = Cold Weather Plan EWD = Excess winter deaths COVID-19 = coronavirus illness in humans caused by SARS-COV-2 infection. CVD = Cardio-vascular disease SWEP = Severe Weather Emergency Protocol SRF = Sussex Resilience Forum VCS = voluntary and community sector EU = European Union
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1. Decisions, recommendations and any options
1.1 That the Board approves the content of the report and the actions to be taken by the Council services and partner organisations.
2. Relevant information
2.1 On average, there are around 25,000 excess winter deaths each year in England. Excess winter deaths (EWDs) are the observed total number of deaths in winter (December to March) compared to the average of the number of deaths over the rest of the year.
The EWD Index is as a percentage increase of the expected deaths based on non-winter deaths. EWD index for Brighton & Hove was 31.9% equivalent to 212 EWDs[1]. This is higher than England (30.1%) and fifth highest of the 19 local authorities in the South East region (30.2%) and third for CIPFA comparators.[2]
2.2 There is strong evidence that many of these winter deaths are related to cold temperatures, living in cold homes, respiratory illnesses, and cardiovascular conditions as well as infectious diseases such as influenza.
People live in cold homes often due to fuel poverty [3]. A household is considered to be fuel poor if it has higher than typical energy costs and would be left with a disposable income below the poverty line. Fuel poverty is driven by 3 main factors: household income, high or unmanageable energy costs and the energy efficiency of a home.[4]
2.3
Brighton & Hove has the (shared) highest proportion of homes in
fuel poverty at 11.2, in the southeast,(SE ave at 7.9), and higher
than the England Average of 10.3.[5]
The map below shows the distribution across the city.
[6]
The high rates in Brighton and Hove are likely due to a
combination of factors; levels of deprivation, high cost of
housing, age and structure of the housing stock, the number of poor
conversions in Houses of Multiple Occupation. 
The EU funded SHINE project provides energy efficiency and fuel poverty advice to council tenants, including home energy advice visits. Due to the COVID19 pandemic the SHINE project has been extended until the end 2020.
2.4 Those at greater risk from the ill health effects of cold weather are similar population groups as those at high risk of COVID-19 infection, morbidity or mortality. These are the over 70s, those with chronic health conditions especially respiratory and CVD, those clinically extremely vulnerable, pregnant women and people living in areas of higher deprivation and experiencing ongoing health and/or socio-economic inequalities.
Specifically, the cold weather affects thermoregulation and with ageing there is reduced thermoregulatory control and thermal perception, this is magnified in certain conditions e.g. dementia. The effects of cold weather start at outdoor temps below 8°C and indoor temps below 18°C. Living in cold environment increases blood pressure and the risk of blood clotting (cholesterol and fibrinogen). Negative respiratory effects are seen from 18OC and increase as temperatures lower.
Questions about people ability to heat their homes are now included in assessment processes at discharge from hospitals and care settings. Information on where to get further help will also be shared as relevant. The same questions and information is also included as part of assessment for COVID19 support through Community Hub, and other ASC services. certain VCS services and support projects will also be including these.
As part of the ongoing management of the COVID-19 pandemic people will need to self-isolate in their homes for periods of time. Additional support will be needed for those with cold homes or who are living in fuel poverty.
All services delivered in preparation for, or in response to the cold weather will follow the COVID19 infection prevention and control guidance relevant for their service and appropriate for the recipient and community context.
2.5 The objectives of this plan are to:
1. To define the partners engaged with the implementation of this Plan
2. To ensure the requirements of the National Plan are complied with locally, by clearly stating the work-streams agreed to be relevant and those partners engaged in their delivery.
3. To set out the coordination and oversight / assurance arrangements in support of the plan.
4. To understand and mitigate, as far as possible, the impact of cold weather on the community and those most vulnerable to cold weather.
5. To safely deliver this Plan in the context of COVID19 guidance.
6. To support those self-isolating as a result of COVID-19 illness or Test
and Trace Service instructions, to keep well and warm at home.
7. To review any implications for this Plan of the EU exit and access to relevant supplies’
2.6 The BHCC CWP sits alongside the NHS trusts Winter Plans that are about increases in service demands during the cold weather. each plan sits as an Appendix to the other.
2.7 The Plan is implemented via a system of cold weather alerts – linked to the existing winter weather warning system developed by the Met Office ‘National Severe Weather Warning Service’ (NSWWS) – which will trigger appropriate actions up to a major incident. A Cold weather health watch system operates in England from the 1 November to 31 March every year. The alerts take account of temperature along with other winter weather threats such as ice and snow. Alerts are cascaded to Council services and all wider stakeholders and local service providers. The CWP summarises actions at each level to be taken by different Directorates, services and partner organisations.
2.8 Of specific relevance this winter are those relating to those our most vulnerable residents such as rough sleepers, those living in care settings, those in fuel poverty and self-isolaters in cold homes.
2.9 Actions include arrangements for:
· Support for vulnerable people self-isolating with COVID-19 via the Community Hub
· Maintaining highways and gritting in the ice and snow,
· Emergency heating provision for council tenants,
· Transport Hub of 4x4 vehicles to maintain domiciliary home care services,
· Warmth For Wellbeing programme focussing on reaching marginalised and isolated communities, to identify and engage with those who are at elevated health risk due to living in fuel poverty and/or a cold home.
· The Severe Weather Emergency Protocol’ (SWEP). activates when the temperature feels like 0 degrees for 1 night, The SWEP service offers overnight shelter to rough sleepers.
· the Seafront Office will issue a warning email to seafront businesses if the Met Office weather warnings identify a specific risk of overtopping or coastal flooding in Brighton & Hove.
· Promotion of the annual flu programme.
Initiatives with the VCS include support to neighbourhoods and Brighton & Hove Energy Services Co-operative working with the vulnerable in hard to heat homes.
· Communications and campaign for the public and partners such as ‘stay well this winter’ alert and inform city residents.
2.10 This year there is an increased focus and support for the care sector with the
Adult social care: our COVID-19 winter plan 2020 to 2021 which sets out commitment and actions relating to the increased pressure the winter may bring with the combinations of cold weather, COVID-19 and Flu.
2.11 The Sussex Resilience Forum (SRF) provides a coordinated multi agency response to emergencies and this includes working with agencies and partners in Sussex on winter preparedness, and ensuring that there is resilience and risk management when responding to concurrent events as described above. This includes exercising of this plan.
3. Important considerations and implications
3.1 Legal
The Council’s input into the production and delivery of the winter plan across
the Brighton and Hove area is part of the Council’s joint working arrangements with its partners for the improved delivery of care to Brighton and Hove residents.
Lawyer consulted: Nicole Mouton Date: 20/10/20
Finance:
3.2 Any additional costs resulting from the planning undertaken by the Sussex Resilience Forum will need to be met from within current budget resources.
3.3 Winter pressures causes significant financial strain across Health & Social Care. Current budget forecasting accounts for anticipated increased demand over this period. However, budget forecasts are subject to considerable uncertainty due to the implications of covid-19.
Finance Officer consulted: Sophie Warburton Date: 16/10/2020
Equalities:
3.4 We have considered equalities in the Winter Cold Weather Plan. This includes a focus on how cold weather impacts on older people, vulnerable people, and those living in fuel poverty. This forms part of a wider assessment on ‘seasonal weather impacts’ which is being undertaken in a holistic way consider the different needs and provide the relevant support to the most vulnerable communities in the city.
Equalities Officer consulted: Anna Spragg Date:20/10/2020
Sustainability:
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The sustainability aspects of heating cold homes are considered in the related actions of the Fuel Poverty & Affordable Warmth Steering Group.
3.5
Health, social care, children’s services and public health:
Covered in paper
3.6 Supporting documents and information
Appendix1:
Appendix 2:NHS/CCG Brighton & Hove Winter plan
