Chapter 3 – Health

3.4 Examples

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3.4 Examples

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The Active Wellbeing Society

The Active Wellbeing Society (TAWS) runs programmes to increase physical activity in the Midlands and beyond. Originally part of Birmingham City Council, TAWS now operates as a separate community benefit society. Their Big Birmingham Bikes scheme, which won an Ashden Award in 2017, has now expanded into areas outside of Birmingham and evolved into the ‘Big Bike Project’. As part of the Active Communities Initiative at TAWS, and in partnership with Solihull Council, the project has launched a new Bike Hub. This, along with sessions offering cycling lessons and led rides through the local area, aims to encourage more people in Solihull to take up cycling, spend time outdoors and meet new like-minded people. By making cycling more accessible and safer, it hopes to also improve Solihull’s air quality and congestion levels. TAWS has also partnered with Bikeability, a national cycling award scheme, offering free cycling training sessions for school children and adults in Birmingham. As of 2021, they worked with Bikeability to deliver training in over 70 schools and to over 8,000 people, providing them with the confidence to start cycling safely.

A group of people in multicoloured clothing and hi-vis jackets cycle down a street.

Oldham Warm Homes

The Warm Homes Oldham scheme was set up by Oldham Council, NHS Oldham Clinical Commissioning Group (CCG) and Oldham Housing Investment Partnership (OHIP) in 2013. It offers advice, support and energy saving measures to residents in fuel poverty. Sheffield Hallam University have evaluated this programme, considering savings to the NHS as well as wider economic benefits, using self-reported health outcomes. An investment of £250,000 per year from Oldham CCG resulted in a monetary benefit from an increase of Quality Adjusted Life Years (QALYs) of between £399,000 and £793,000 depending on the method used. The study reported £178,000 of extra GDP due to higher employment rates, £37,700 of extra GDP due to reductions in sickness absence, and £137,300 of reductions in benefits claims.

An elderly individual stands in their kitchen next to a boiler.

Liverpool Healthy Homes

Liverpool City Council have been running their Healthy Homes programme since 2010 and targets the private rented sector. Over 25,000 priority homes have been surveyed with ‘cold home hazards’ removed in over 1000 homes. The Healthy Homes team works in partnership with Citizens Advice Bureaux at 39 health centres to refer residents. The programme cost was initially £1.3m per year but since 2013 the budget runs at £650K per year. The Building Research Establishment (BRE) evaluated the programme and estimated that the programme could save the NHS and wider society £55m over 10 years. Details are included in NICE’s shared learning database.

SHINE – lessons from a successful fuel poverty scheme

Ashden award winner, SHINE (Seasonal Health Intervention Network), based in Islington, works with over 80 partners including GP surgeries, health visitors, and housing and community organisations to refer vulnerable people for energy efficiency interventions and advice. John Kolm-Murray, who set up SHINE and now leads on fuel poverty for the GLA, offers the following advice for making the most of health co-benefits:

A woman sits on a colourful sofa holding up a small flyer advertising energy bill savings.
  • Engage with the right health professionals – specialists in respiratory disease and mental health are most likely to see benefits; there is less evidence for impact on cardio-vascular conditions.
  • Guarantee delivery of interventions – if a GP refers a patient for a hip replacement, they know that it will happen eventually. But if a new boiler is prescribed, but the energy company paying for interventions has hit their ‘boiler cap’ then there is no treatment, and trust between health professionals and energy officers can be lost. So understand what you can definitely deliver and provide regular feedback to referrers on outcomes.
  • Ensure ventilation as well as insulation – otherwise health gains from warmer homes may be lost due to poor air quality. The GLA has put forward extra money for ventilation since this is not something that can be funded through ECO (the Energy Company Obligation).
  • Learn the language of health professionals – understand what the clinical priorities and targets are for your local CCGs and other health professionals and align the benefits from your programme to those.
  • Find a champion – health professionals are more likely to be persuaded by other health professionals.

To date, SHINE has helped 25,000 households across London, with its team delivering advice and services to over 5,000 Londoners at risk of fuel poverty every year.

Islington – targeting support at vulnerable households

About 30% of Islington’s residents are faced with the dilemma of heating their homes or eating properly. Organisations, from GP surgeries and health visitors to housing and community organisations, refer vulnerable people to the SHINE team. SHINE then gives advice on fuel debt and energy efficiency, and helps residents access discounts on fuel bills and grants for new boilers. This has led SHINE to save 3,200 tonnes of CO2 and £700,000 annually for its beneficiaries.

Cosy Homes in Lancashire

A street of terraced houses that have been retrofitted with external wall insulation.

Cosy Homes in Lancashire (CHiL) won an Ashden Award in 2016. Lancashire’s Public Health directors recognised the effect of cold homes on people’s health and, in 2014, helped fund the creation of CHiL, a partnership between 14 local authorities in the county, with the goal of improving the energy efficiency of privately owned and privately rented homes.

By pooling the members’ resources, CHiL has been able to improve domestic energy efficiency despite government programmes such as the Energy Company Obligation (ECO) being scaled back. Thousands of residents have benefited from warmer homes and have reported improvements in both physical and mental health.

Michael, aged 59, is a former lorry driver who has lived in Preston for most of his life. He lived alone in a house with no central heating, with a single gas fire to keep him warm. Michael’s mental health was poor and he says he had a fixation with “putting up a tent with a sleeping bag to keep warm”. He also had vitiligo and regular chest infections in winter. CHiL installed a new boiler and cavity wall insulation in Michael’s home.

After the work Michael said “Since I’ve had heat, I keep my home at 20 degrees. My mental state has changed which is a surprise. I had formed an addiction to gambling and that has fallen away. I no longer have a chest infection and my vitiligo has started to fill in.”

Newcastle City Council’s Green Infrastructure Delivery Framework

Map of Newcastle upon Tyne and Gateshead. Map Key indicates area colors dedicated to urban core, neighborhood area, and rural and village area.

Newcastle City Council published a detailed Green Infrastructure Delivery Framework in December 2018. Newcastle was a demonstration city for the Blue Green Cities Research Consortium, leading research into cutting edge techniques for advancing Blue-Green approaches to combat flood risk. The Framework builds on this work, identifying co-benefits of green infrastructure including mental and physical health improvements.

A green infrastructure steering group has been established with representatives from across the council, planning, sport and leisure, the Lead Local Flood Authority, and transport. A detailed delivery and monitoring plan is included to ensure that these co-benefits are delivered.

Exeter City Council – Passivhaus

Exeter City Council has taken a planned approach to low energy development for ten years. The council has already developed over 103 certified Passivhaus homes, with more in the pipeline, which provide a high level of occupant comfort while using very little energy for heating and cooling. Thermal comfort is achieved solely by post-heating or post-cooling the fresh air flow required for good indoor air quality, without the need for additional recirculation of air. There are multiple other low energy projects in the pipeline including a recently completed leisure centre (the first UK leisure centre to be built to Passivhaus standards), offices and care homes.

Key factors that shape their developments are low energy Passivhaus, climate readiness and improving health through building biology, including elements of permaculture landscape. (Permaculture is an approach to land management and settlement design that adopts arrangements observed in flourishing natural ecosystems.) Working with Exeter University and the Met Office (which is based in Exeter), Exeter Council have tested building designs against predicted future climate conditions to ensure resilience to 2080 and beyond. This approach is already delivering benefits, with residents reporting significant health improvements and better air quality.

Wirral’s Joint Strategic Needs Assessment

Wirral Council’s Joint Strategic Needs Assessment includes a detailed section on climate change and health. Wirral have identified the groups that will be most vulnerable to climate change and the specific health impacts such as increased respiratory diseases, cardio-vascular illnesses, skin cancer and mental health.

Waltham Forest – using Section 106 funding to increase walking and cycling

People walk down a high street with colourful shop fronts and good pedestrian access in Waltham Forest.

Ashden Award 2019 winner Waltham Forest Council have allocated Section 106 health funding to increasing walking and cycling as part of its Enjoy Waltham Forest programme. Developers of new housing pay Section 106 funding to upgrade existing infrastructure and facilities to support the additional population. Across England, Section 106 funding paid by housing developers provides around £150m each year to ‘community’ funding, much of which goes on health (Ministry of Housing, Communities and Local Government, 2018).

In Waltham Forest, £500k of section 106 money was identified for funding health ‘prevention’ initiatives in 2017. Childhood obesity in the borough is higher than the national average, and the Commissioning for Prevention group led by Waltham Forest’s public health team decided to allocate some of this funding to initiatives that promote active travel, providing a useful source of additional money. (Source: personal conversation with Waltham Forest public health team, 2019.)

Nottingham Good Food Partnership – improving health and cutting the carbon footprint of food

Part-funded by Nottingham City Council, the Nottingham Good Food Partnership is an ever expanding coalition of over 50 member organisations working together to transform the sustainability of Nottingham’s local food system. As part of the Sustainable Food Cities (SFC) Network and as a key consulting partner to the City Council in their plan to become carbon neutral by 2028, the Partnership aims to improve the health and well-being of all and to create a more connected, resilient and sustainable Nottingham. It is addressing six key issues including: promoting the importance of healthy and sustainable food to the diverse local communities; and working towards a circular food economy, radically reducing the ecological footprint of the food system and aiming for zero edible food waste.

Examples include its Nottingham NeighbourFood project, which offers communities local, sustainable produce which they can conveniently order online and collect at a weekly meet-up; and the Super Soups project, which not only prevents fresh surplus food from ending up in landfill, but improves the health and wellbeing of older residents by providing both nutritious soups and the opportunity to socialise with young people through the co-creation of recipes.

A group of young children joyfully hold up onions that they have harvested at an allotment.

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3.5 Useful resources

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