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The Cold Weather Plan for England: Protecting health and reducing harm from cold weather

Since the publication of the first Cold Weather Plan for England in 2011, the impact of cold weather on health has been recognised. 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 more people die in winter are complex and interlinked with inadequate heating and poorly insulated housing and health inequalities as well as circulating infectious diseases, particularly flu and norovirus, and the extent of snow and ice.

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 awareness of the harm to health from cold, and provides guidance on how to prepare for and respond to cold weather. It is now clear that in an average winter, most of the health burden attributable to cold occurs at relatively moderate mean outdoor temperatures (from 4-8°C depending on region). This is why we must ensure our responses include year round and winter through actions, as well as emergency responses to extreme winter weather, to protect the vulnerable in our society, as described in this plan.

The Cold Weather Plan is complemented by new NICE Guidance on Excess winter deaths and morbidity and the health risks associated with cold homes. Both documents offer strategic and practical recommendations for the NHS, public health, social care and other community organisations, to support vulnerable people who have health, housing or economic circumstances that increase their risk of harm. Communities and civil society can also help their neighbours, friends and relatives to protect against avoidable harm to health in winter.

To inform and encourage action, the Public Health Outcomes Framework, first published in January 2012, includes indicators to reduce excess winter deaths and address fuel poverty. Strong local leadership and partnership working at all levels across sectors is therefore vital to tackle the range of causes and reduce the number of ‘excess’ deaths that are observed each winter.

Cold related deaths represent the biggest weather-related source of mortality. Although temperatures are gradually rising with climate change, cold weather deaths are still expected to be high by 2050, due to the ageing and increasing population. So we are going to need the guidance in these pages to protect the public from the effects of cold for many years to come.