District nurses, GPs and social workers will need support in identifying patients that are vulnerable to cold-related illness and death this winter and making changes to care plans, Public Health England has advised local NHS organisations.
These vulnerable groups include people over 75 years old, children under the age of five, those with pre-existing chronic medical conditions, people with mental ill-health that reduces their ability to self-care, and people living in deprived circumstances.
PHE said service providers should be supported to reduce cold-related harm, for example, by “supporting GPs, district nurses and social workers to identify vulnerable patients and clients on their practice lists, by providing them with toolkits and sharing examples of good practice”.
The recommendation comes as part of the agency’s Cold Weather Plan for England 2014, which provides information for healthcare workers, local authorities and patients on how to prevent risks to health during the colder season.
PHE estimates there are around 25,000 excess winter deaths each year in England, with the cold weather increasing the risk of heart attacks, strokes, lung illnesses, flu and other diseases, as well as injuries from falls in icy conditions.
“There are too many avoidable deaths each winter in England primarily due to heart and lung conditions from cold temperatures”
The plan also reminds workers in hospitals, care and nursing homes to monitor indoor temperatures and ensure patients have access to at least one room that meets recommended heating levels.
Following a revision of the indoor temperature guidance, a minimum threshold during winter is now 18º Celsius, while rooms where infants sleep should be between 16 and 20ºC, the plan states.
Midwives, health visitors, community health practitioners and school nurses, meanwhile, should provide advice to parents with young or disabled children about the health risks these children are susceptible to from low indoor temperatures and how to heat their homes affordably, the plan adds.
Health and care staff must also keep themselves fit and well during the winter by taking part in schemes such as the staff flu immunisation programme, PHE has said. Workers should also encourage patients to be vaccinated, it added.
The Cold Weather Plan will be in operation over the same period that weather alerts are sent out by the Met Office, from 1 November to 31 March. The national weather service will issue alerts when temperatures reach two 2ºC or less and/or when heavy snow and ice is expected.
In her foreword to the plan, professor dame Sally Davies, chief medical officer for England, said: “There are too many avoidable deaths each winter in England primarily due to heart and lung conditions from cold temperatures rather than hypothermia.
“The reasons why more people die in winter are complex and interlinked with fuel poverty, poor housing and health inequalities as well as circulating infectious diseases, particularly flu and norovirus, and the extent of snow and ice,” she said.
She added: “The winter period not only sees a significant rise in deaths but also a substantial increase in illnesses.
“The Cold Weather Plan for England therefore helps to raise the public’s awareness of the harm to health from cold, and provides guidance on how to prepare for and respond to cold weather which can affect everybody’s health.”