Brighton & Hove

Cold Weather Plan 2022

 

                                 

Protecting Health and Reducing Harm During Winter

 

 

 

(To be read in conjunction with the Cold Weather Plan for England & supporting guidance)

 

 

 

 

 

 

 

 

 

 

 

Document Control

 

Version	V2.0 draft
Drafted by:	Becky Woodiwiss Public Health Principal and Barbara Hardcastle Public Health Specialist Public Health, Health & Adult Social Care Directorate, Brighton and Hove City Council and Brighton & Hove Clinical Commissioning Group
Reviewed by: Approved by:	Health and Adult Social Care Directorate Management Team October 2021 B&H Health Protection & Screening Forum, September 2021
Date Issued:	October 2022
Review Date:	September 2023
Target Audience:	Brighton & Hove City Council Health & Adult Social Care, other Directorates, partner agencies and Local Health Economy. Including The Health Protection & Screening Forum, NHS secondary and community providers, NHS Sussex Brighton and Hove, Primary care, Out of Hours (OOHs) Provider, & Brighton & Hove City Council, Community and Voluntary sector
Mandatory / Statutory guidance Requirements       Winter guidance and advice	Civil Contingencies Act 2004 http://www.legislation.gov.uk/ukpga/2004/36/contents NHS EPRR Framework & associated guidance http://www.england.nhs.uk/ourwork/gov/eprr/ Public Health England Cold Weather Plan for England http://www.gov.uk/phe/cold-weather-plan BHCC Covid19 Local Outbreak Plan https://new.brighton-hove.gov.uk/local-covid-19-outbreak-plan NHS Community Health guidance https://www.england.nhs.uk/coronavirus/ Annual seasonal influenza (flu) vaccination programme https://www.gov.uk/government/publications/national-flu-immunisation-programme-plan Keep Warm Keep Well - NHS Choices (www.nhs.uk) https://www.gov.uk/government/publications/keep-warm-keep-well-leaflet-gives-advice-on-staying-healthy-in-cold-weather Met Office Weather Ready pages ‘Are you ready for winter ? https://www.metoffice.gov.uk/weather/warnings-and-advice/weatherready Excess winter deaths and morbidity and the health risks associated with cold homes https://www.nice.org.uk/guidance/ng6 Preventing excess winter deaths and illness associated with cold homes Quality standard [QS117] Published date: March 2016 https://www.nice.org.uk/guidance/qs117/chapter/Quality-statement-5-Identifying-people-vulnerable-to-health-problems-associated-with-cold-homes-on-admission Cutting the cost of keeping warm https://www.gov.uk/government/publications/cutting-the-cost-of-keeping-warm

 

Version Control

 

Plan Version	Pages	Details	Date	Author
1.0		Final draft	01/09/2020	B Woodiwiss
2.0		Updated draft	14/09/2021	B Woodiwiss
2.0		Amended draft	06/10/2021	B Woodiwiss
2.0		Updated draft	27/09/2022	B Woodiwiss

             

 

 

 

 

 

 

 

 

 

 

 

Contents

1.                       Introduction  6

1.1              Planning for winter 2022/2023  6

1.2              Impact of cold weather 6

1.4              The Cold Weather Plan for England 8

1.5              Key messages for action  8

2.                       The Brighton and Hove Cold Weather plan aims & objectives  9

2.1               Aim   9

2.2              The objectives  9

3.                       Cold Weather alerts  9

3.1 Alert Levels  11

3.2               Level 0 – year round planning  12

4.                       Actions for the alert levels  13

5. Indoor room temperatures  19

6.                       Governance and Assurance  19

7.                       Cascading Cold Weather Level Alerts  20

7.2              Local cascade arrangements within B&H   20

8.                      At-risk groups  21

9. Seasonal Vaccination Programmes  22

9.1 Influenza vaccination programme 2022/23  22

9.2 Covid-19 Autumn Booster and Evergreen Offer Vaccination programme  24

10 Arrangements in local providers  24

10.1  BHCC Health and Adult Social Care  24

10.2  BHCC Families, Children and Learning Directorate  26

10.3  BHCC Seafront Team   27

10.4  Cityclean  27

10.5  The BHCC Highways Winter Service Plan 2022-23  28

10.6  BHCC Flood Management 29

10.7  BHCC Housing  29

10.8  BHCC Emergency Planning and Resilience team (EP&R) 30

10.9  NHS Sussex  30

10.10  University Hospitals Sussex NHS Foundation Trust 31

10.11  Sussex Community NHS Foundation Trust 31

10.12  IC24 (NHS Out of Hours Provider) 32

10.13  British Red Cross  32

10.14  Community and Voluntary sector 32

10.15  Brighton & Hove Energy Services Co-operative  33

11                     Communication  33

11.1            Three areas of communication  33

11.2            Awareness  33

11.3            Warning  34

11.4  Local Warning and Informing  34

11.5            Staff information  34

Appendix 1 Action Cards  35

Appendix 2 NHS Winter Plan 2022-2023  35

Appendix 3 Key Public Health messages  35

 

 

Table of figures

 

Figure 1  Cold Weather Plan Alert Levels. 11

Figure 2  Summary cold weather actions for health and social care organisations and professionals, communities and individuals. 15

Figure 3 Indoor room temperatures. 16

Figure 4 Met office cascade system Fig5 those at greater risk of harm from cold weathe. 18

           

 

 

             

 

1.   Introduction

 

1.1      Planning for winter 2022/2023

 

Planning for the Winter of 2022/23 is in the context of the economic downturn, cost of living increases, political changes, climate change and the continuing demands of COVID-19, its health and socio-economic impacts, and seasonal Influenza .

 

 

1.2      Impact of cold weather

 

In recent previous years there have been significant periods of severe and sustained cold weather. This has highlighted the need to have effective plans in place to mitigate the effects of cold weather on health.

 

 

The Department of Health and Social Care research [1] found that negative health effects start at relatively moderate outdoor temperatures of around 4-8°C. Although the risk of death increases as temperatures fall, the higher frequency of days at moderate temperatures means that the greatest health burden in absolute numbers of deaths, occurs at these moderate temperatures. This means that action to prevent excess winter morbidity and mortality should not be restricted to the very cold days, but should be carried out throughout the year tailoring solutions to protect the most vulnerable.

 

 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. Excess deaths are not just deaths of those who would have died anyway in the next few weeks or months due to illness or old age. There is strong evidence that many of these winter deaths are indeed ‘extra’ and are related to cold temperatures, especially for those living in cold homes. Most EWDs are due to respiratory and circulatory deaths, such as stroke and coronary heart disease, as well as infectious diseases such as influenza. Other health conditions associated with, or exacerbated by, the cold and cold housing include mental ill-health, arthritis and rheumatism.

Indirect health impacts of cold housing and fuel poverty include a negative effect on: children’s educational attainment, emotional wellbeing and resilience; adult and children’s dietary choices; and the risk of accidents and injuries in the home. This is predominantly in the older age groups, those with chronic illnesses and very young children.

Heavy snow and ice has a small direct effect on health, predominantly as a result of falls and injuries. Additionally, it causes disruption to the delivery of health, social care and other services.

 

Although there are several factors contributing to winter illness and death, in many cases simple preventative action could avoid many of the deaths, illnesses and injuries associated with the cold. Many of these measures need to be planned by services and undertaken in advance in preparation for cold weather.

 

People live in cold homes often due to fuel poverty^[2]. The Government released a new national Fuel Poverty strategy^[3] in February 2021, which included a new definition for Fuel Poverty measurement. The Low Income Low Energy Efficiency (LILEE) measure finds a household to be fuel poor if it:

 

·         Has a residual income below the poverty line (after accounting for required fuel costs); and,

·         Lives in a home that has an energy efficiency rating below Band C.

 

The latest available figures released in May 2022 using this new definition, estimate that in 2020 (there is a standard two-year lag in the data), 12% of households in Brighton & Hove were in fuel poverty. This equates to 15,814 households in the city. Although the new definition of fuel poverty does not take account of energy costs directly, it can be assumed that the number of households in the city struggling to pay their energy bills has increased significantly over recent months due to the significant increases in energy tariffs and the general costs of living.

 

Living in a cold home as a result of fuel poverty has a disproportionate impact on the health of certain groups. Exposure to cold temperatures increases blood pressure and risk of blood clotting, heart failure/attack and stroke. It also suppresses the immune system, diminishes the lungs’ capacity to fight off infection and increases constriction of the airways, increasing the risk of bronchitis and pneumonia. When a house is damp as well as cold, mould is likely to occur. This increases the risk of respiratory illness, particularly asthma.

 

Therefore, people living in cold homes during the winter months are at increased risk of negative health outcomes, including winter deaths. Local and national excess winter mortality is highly variable year on year, so five year rolling averages are used, and show no clear trend. For winters 2014/15 to 2018/19 the EWD Index in Brighton & Hove was 21.4% equating to 144 extra deaths each year. This is the same as England (21.4%) and similar to the South East (21.3%).[4]  For just one year 2019/20, the EWD for 85+ at 19% is more similar to England (20.8%) and SE (20.7%) [5].

 

 

1.3 The cold and seasonal respiratory infections

 

Those at high risk of Flu and COVID19 infection, morbidity or mortality are similar population groups as those at greater risk from the ill health effects of cold weather (Fig 4). These are the over 70s, those with chronic health conditions especially respiratory and CVD, those clinically extremely vulnerable, pregnancy and people living in areas of higher deprivation and experiencing ongoing health and/ or socio-economic inequalities Unlike for Covid19, very young children are also at higher risk of greater ill health from Flu and childhood respiratory infections.

 

A combination of factors are likely to exacerbate the situation further over the colder months, the continued vulnerability of the population, and poorer weather, may mean that people spend more time in their homes, where transmission may be more likely. The impacts of the cost of living increases and socioeconomic downturn will cause greater fuel poverty and much colder homes. This may also mean people burn fossil fuels to help manage fuel bills and the associated increase in indoor and external air pollution, with greater impact for those with poorer respiratory health.  If many services continue to have staff working from home, fewer people will be visiting people in their homes, so there will be less opportunities to notice a home is cold, damp or hard to heat.[6]

 

1.4      The Cold Weather Plan for England [7]

 

The Cold Weather Plan for England (CWP), published annually since 2011 aims to prevent avoidable harm to health, by alerting people to the negative health effects of cold weather and enabling services and the public to prepare and respond appropriately. It also also aims to reduce pressure on the health and social care system during winter through improved anticipatory actions with vulnerable people.

 

The Cold Weather Plan for England is at https://www.gov.uk/government/collections/cold-weather-plan-for-england  this page contains links to the national plan, health risks of cold homes, a supporting ‘making the case’ document, and an easy-read summary document, action cards for all groups involved, ‘Keep Warm Keep Well’ leaflet and supporting guidance.

 

The National CWP acknowledges the roles of Local Authorities, Directors of Public Health, NHS England Regional Office, Integrated Care Partnerships , Health and Wellbeing Boards (HWB’s), NHS Trusts, GP’s, Emergency Planning Officers, and others.

 

1.5      Key messages for action

 

This Brighton and Hove Cold Weather Plan is a local good practice guide and the actions denoted within it are illustrative. There are five key messages recommended to all local area:

 

1.    All local organisations should consider this document and the national Cold Weather Plan (CWP) for England and satisfy themselves that the suggested actions and Cold Weather Alerts are understood across the system, and that local plans are adapted as appropriate to the local context.

2.    City Council and NHS commissioners should satisfy themselves that the distribution of Cold Weather Alerts and the National Severe Weather Warning Service (NSWWS) which provides information on type of weather, likelihood and potential impact levels, will reach those that need to take action.

3.    City Council and NHS commissioners should satisfy themselves that providers and stakeholders will take appropriate action according to the Cold Weather Alert level in place, their professional judgements and remain COVID-19 safe.

4.    Opportunities should be taken for closer partnership working with the voluntary and community sector to help reduce vulnerability and to support the planning and response to cold weather.

5.    Long-term planning and commissioning to reduce cold-related harm both within and outside the home is considered core business by health and wellbeing boards and should be included in joint strategic needs assessments[8] and B&H Joint Health and Wellbeing Strategy 2019-2030.[9]

 

2.  The Brighton and Hove Cold Weather plan aims & objectives

 

2.1 Aim  - The aim of this plan is to set out the procedures and work-streams to be implemented within Brighton and Hove City Council, the local health economy (LHE) and with key city partners in support of the National Cold Weather Plan for England.

 

2.2            The objectives of this plan are to:

 

·         To define the partners engaged with the implementation of this Plan

·         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.

·         To set out the coordination and oversight / assurance arrangements in support of the Plan.

·         To understand and mitigate, as far as possible, the impact of cold weather on the community and those most vulnerable to cold weather.

·         To understand this plan within the context of climate change understand the mitigations needed to continue to work towards the commitment as a city to become carbon neutral by 2030

·          

·         To safely deliver this Plan in the context of COVID19 guidance.

 

3.      Cold Weather alerts

The Plan is linked to a system of cold weather alerts – generated by the  Cold weather health watch system  developed by the Meteorological Office including the  ‘National Severe Weather Warning Service’ (NSWWS). This comprises five levels of response based on cold weather thresholds. The thresholds have been developed to trigger an alert when severe cold weather is likely to significantly affect people's health and they also take account of temperature along with other winter weather threats such as ice and snow.

 

The Cold Weather Watch system operates in England from 1^st November to 31^th

March every year, in association with  UK Health Security Agency (UKHSA) and Office for Health Improvement and Disparities (OHID). However, should thresholds for an alert be reached outside of this period, an extraordinary heat-health alert will be issued and stakeholders are advised to take the usual public health actions. The alerts take account of temperature along with other winter weather threats such as widespread ice[10] and heavy snow[11].

 

 

3.1 Alert Levels

The levels are set out in the table below:

 

Level 0	Year round planning to reduce harm from cold weather	This emphasises that year-round planning is required to build resilience and reduce the impact of cold weather. This level of alert relates to those longer-term actions that reduce the harm to health of cold weather (e.g. housing and energy efficiency measures, and long-term sustainable approaches to influence behaviour change across health and social care professionals, communities and individuals.)
Level 1	Winter preparedness and action	Level 1 is in force throughout the winter from 1 November to 31 March and covers the moderate temperatures where the greatest total burden of excess winter death and disease occur. This is because the negative health effects of cold weather start to occur at relatively moderate mean temperatures (4-8°C depending on region) and there are normally many more days at these temperatures each winter.
Level 2	Alert and readiness	Level 2 is triggered when the Met Office forecasts a 60% chance of severe winter weather, in one or more defined geographical areas within 48 hours. Severe winter weather is defined as a mean temperature of 2°C or less and/or heavy snow and widespread ice
Level 3	Severe weather action	This is triggered as soon as the weather described in Level 2 actually happens. It indicates that severe winter weather is now happening, with snow and ice, and an impact on health services is expected A NSWWS warning is highly likely to have been issued as well
Level 4	National emergency	This is reached when cold weather is so severe and/or prolonged that its effects extend outside health and social care, and may include for example power or transport problems, or water shortages, and/or where the integrity of health and social care systems is threatened. At this level, multi-sector response at national and regional levels will be required.

 

 

Figure 1  Cold Weather Plan Alert Levels

 

The decision to go to a Level 4 is made at national level and will be taken in light of a cross-government assessment of the weather conditions, co-ordinated by the Civil Contingencies Secretariat (Cabinet Office)

3.2       Level 0 – year round planning  

 

·         Strong local leadership and partnership working at all levels across sectors and is vital to tackle the range of causes and reduce the health harms and number of “excess” deaths that are observed each winter.

·           Long term strategic planning and commissioning to reduce cold-related harm.  This is considered core business by Health and Wellbeing Boards (HWBs) and joint strategic needs assessments (JSNAs).  Responses to cold weather are to be considered as part of business continuity plans.

·           To alert all City stakeholders to the availability of the action cards and see Appendix 1[12]  for:

ü  Commissioners in the Local Authority and the NHS Sussex Brighton & Hove

ü  Frontline Health & Social Care staff in community & care facilities

ü  GP’s & Practice Staff and Community Pharmacies

ü  Community & Voluntary Sector organisations

ü  Provider Organisations

ü  Other relevant organisations in the city

ü  Individuals.

 

·         To ensure there is a link to the City’s Vulnerable People Plan and other Emergency Planning Resilience and Response plans.

·         The Public Health Outcomes Framework includes indicators to reduce excess winter deaths[13] and address fuel poverty[14]

·         Working with partners to ensure that a strategic approach to the reduction of EWDs and fuel poverty . In particular:

ü  To develop a shared understanding of EWD’s and what partners can do to reduce them.

ü  To identify those most at risk from seasonal variations.

ü  To improve winter resilience of those at risk via a locally annually agreed programme.

ü  To ensure a local, joined-up programme is in place to support improved housing, heating and insulation, including uptake of energy-efficient, low-carbon solutions.

ü  To achieve a reduction in carbon emissions and assess the implications of climate change.

ü  Work with Communities Equalities and Third sector Team at BHCC to widen reach to vulnerable communities and population groups in the city 

·         To consider how cold weather and winter plans can help to reduce health inequalities, target high-risk groups and address the wider determinants of health.

·         To ensure that organisations and staff are prompted to signpost vulnerable clients onwards (e.g. for energy efficiency measures, benefits or related advice).

·         To work with partners and staff on risk reduction awareness, information and education including vaccinations.

·         To engage with local Community and Voluntary Sector (CVS) organisations for planning and implementation of all stages of the Plan.

·         Agreement that B&H communications and media messages will be jointly coordinated by BHCC and NHS Sussex communications teams.

·         Annual Flu and Covid19 booster campaign to support the vaccination uptake across all eligible groups and to the wider population

4.      Actions for the alert levels

 

The table on the next page sets out the expected minimum actions for each of the alert levels for a range of stakeholders and the public:

 

 

 

		Level 0		Level 1	Level 2		Level 3	Level 4
		Year-round planning All Year		Winter preparedness and action 1 November to 31 March	Severe winter weather forecast – Alert and readiness Mean temperatures of 2°C and/or widespread ice and heavy snow predicted with 60% confidence		Severe weather action Mean temperatures of 2°C and/or widespread ice and heavy snow	Major incident – Emergency response
	Commissioners of health and social care	1) Take strategic approach to reduction of EWDs and fuel poverty. 2) Ensure winter plans reduce health inequalities. 3) Work with partners and staff on risk reduction awareness (eg Flu and Covid19 vaccinations, signposting for winter warmth initiatives).		1)    Communicate alerts, messages and other relevant information and materials to staff/public/media. 2)    Ensure partners are aware of alert system and actions. 3)    Identify which organisations are most vulnerable to cold weather and agree winter surge plans.	1) Continue level 1 actions. 2) Ensure partners can access advice and make best use of available capacity. 3) Activate business continuity arrangements as required.		1) Continue level 2 actions. 2) Ensure key partners are taking appropriate action. 3) Work with partners to ensure access to critical services.	Level 4 alert issued at national level in light of cross-government assessment of the weather conditions, coordinated by the Civil Contingencies Secretariat (CCS) based in the Cabinet Office.   All level 3 responsibilities to be maintained unless advised to the contrary.
	Provider organisations	1) Ensure organisation can identify and support most vulnerable. 2) Plan for joined up support with partner organisations. 3) Work with partners and staff on risk reduction awareness (eg Flu and Covid19 vaccinations, signposting for winter warmth initiatives).		1)    Ensure cold weather alerts are going to right staff and actions agreed and implemented. 2)    Ensure staff in all settings are considering room temperature. 3)    Ensure data sharing and referral arrangements in place. 4)    Communicate alerts, messages and other relevant information and materials to staff and services users	1) Continue level 1 actions. 2) Ensure carers receiving support and advice. 3) Activate business continuity arrangements as required; plan for surge in demand.		1) Continue level 2. 2) Implement emergency and business continuity plans; expect surge in demand in near future. 3) Implement local plans to ensure vulnerable people contacted.
	Frontline staff – care facilities and community	1) Use patient contact to identify vulnerable people and advise of cold weather actions; be aware of referral mechanisms for winter warmth and data sharing procedures. 2) Ensure awareness of health effects of cold and how to spot symptoms. 3) Encourage colleagues/clients to have Flu and Covid19   vaccinations.		1)    Identify vulnerable clients on caseload; ensure care plans incorporate cold risk reduction. 2)    Check room temperatures and ensure referral as appropriate. 3)    Signpost clients to other services using ‘Keep Warm Keep Well’ booklet and other relevant information and materials . 4)    Communicate alerts, messages and other relevant information and materials to staff and services users	1) Continue level 1 actions. 2) Consider prioritising those most vulnerable and provide advice as appropriate. 3) Check room temperatures and ensure urgent referral as appropriate.		1) Continue level 2 actions. 2) Implement emergency and business continuity plans; expect surge in demand in near future. 3) Prioritise those most vulnerable.
GPs and their staff	1) Be aware of emergency planning measures relevant to general practice. 2) Ensure staff aware of local services to improve warmth in the home including the identification of vulnerable individuals. 3) Signpost appropriate patients to other services when they present for other reasons.		1) Consider using a cold weather scenario as a table top exercise to test business continuity arrangements. 2) Be aware of systems to refer patients to appropriate services from other agencies. 3) When making home visits, be aware of the room temperature. 4) Share comms and campaign materials  to staff and patients			1) Continue level 1 actions. 2) Take advantage of clinical contacts to reinforce public health messages about cold weather and cold homes on health. 3) When prioritising visits, consider vulnerability to cold as a factor in decision making.	1) Continue level 2 actions. 2) Expect surge in demand near future. 3) Ensure staff aware of cold weather risks and can advise appropriately.

 

8	Level 0	Level 1	Level 2	Level 3	Level 4
Community and voluntary sector	1) Engage with local statutory partners to agree how VCS can contribute to local community resilience arrangements. 2) Ensure VCS organisations can identify and support their   most vulnerable groups members and service users 3) Develop a community emergency plan to identify and support vulnerable neighbours. 4) Agree arrangements with other community groups to maximize service for and contact with vulnerable people. 5) Share general winter comms and campaign materials through community networks	1) Test community emergency plans to ensure that roles, responsibilities and actions are clear. 2) Set up rotas of volunteers to keep the community safe in cold weather and check on vulnerable people. 3) Actively engage with vulnerable people and support them to seek help. 4) Communicate alerts, messages and other relevant information and materials to VCS organisations and service users and to be shared onwards through community networks	1) Activate the community emergency plan. 2) Activate the business continuity plan. 3) Continue to actively engage vulnerable people known to be at risk and check on welfare regularly.	1) Continue level 2 actions. 2) Ensure volunteers are appropriately supported. 3) Contact vulnerable people to ensure they are safe and well and support them to seek help if necessary.	Level 4 alert issued at national level in light of cross-government assessment of the weather conditions, co- ordinated by the Civil Contingencies Secretariat (CCS) based in the Cabinet Office.   All level 3 responsibilities to be maintained unless advised to the contrary.
National level	1) CO will lead on co-ordinating cross- government work; individual government departments will work with partners on winter preparations. 2) DHSC,UKHSA[15] and NHS England will look to improve the CWP and the monitoring and analysis of winter-related illness and deaths. 3) UKHSA/OHID[16] and NHS England will issue general advice to the public and professionals and work closely with other government departments and other national organisations that produce winter warmth advice.	1) Cold Weather Alerts will be sent by the Met Office to the agreed list of organisations and Category 1 responders. 2) UKHSA and NHS England will make advice available to the public and professionals. 3) NHS England will continue to hold health services to account for action and UKHSA will routinely monitor levels of respiratory viruses throughout the winter period, and mortality surveillance.	1) Continue level 1 actions. 2) DHSC will ensure that other government departments, particularly DLUHC are aware of the change in alert level and brief ministers as appropriate. 3) Government departments should cascade the information through their own partner networks and frontline communication systems.	1) Continue level 2 actions. 2) NHS England will muster mutual aid when requested by local services. 3) Met Office will continue to monitor and forecast temperatures in each area, including the probability of other regions exceeding the level 3 threshold.
Individuals	1) Seek good advice about improving the energy efficiency of your home and staying warm in winter; have all gas, solid fuel and oil burning appliances serviced by an appropriately registered engineer. 2) Check your entitlements and benefits; seek income maximisation advice and other services. 3) Get Flu and Covid19  vaccinations.	1) If you are receiving social care or health services ask your GP, key worker or other contact about staying healthy in winter and services available to you. 2) Seek help from local community groups and networks to help you remain safe and well. 3) Check room temperatures – especially those rooms where disabled or vulnerable people spend most of their time 4) Look out for vulnerable neighbours and help them prepare for winter.	1) Continue to have regular contact with vulnerable people and neighbours you know to be at risk in cold weather. 2) Stay tuned into the weather forecast ensure you are stocked with food and medications in advance. 3) Take the weather into account when planning your activity over the following days.	1) Continue level 2 actions. 2) Dress warmly; take warm food drinks regularly; keep active. If you have to go out, take appropriate precautions. 3) Check on those you know are at risk.	Follow key public health and weather alert messages as broadcast on the media.

Figure 2  Summary cold weather actions for health and social care organisations and professionals, communities and individuals

5. Indoor room temperatures

 

Figure 3 Indoor room temperatures

6.      Governance and Assurance

 

6.1       The health, social, economic and environmental risks associated with a spell of severe cold weather have been assessed by the Sussex Local Resilience Forum (SRF) (Ref H18) and included on the Sussex Community Risk Register. Information regarding the risk of severe weather can be found on the Sussex Local Resilience Forum website https://www.sussex.police.uk/SysSiteAssets/media/downloads/sussex/about-us/sussex-resilience-forum/srf-community-information-on-risks-in-sussex.pdf

 

6.2      It is the responsibility of the NHS England South (South-East) and for Sussex DsPH to engage with providers and multi-agency partners via the Local Health Resilience Partnership, (LHRP), a body linked to the SRF to assess risks and to ensure plans are in place to protect the communities of Sussex from health-related vulnerabilities.

 

6.3       Partners have been consulted to produce this updated Plan, all of whom are aware of their responsibilities and have their own organisational plans, and assurance processes and governance in place.  

 

6.4    All council directorates have assurance processes in place and will address cold weather as part of their business continuity plans. Oversight of these arrangements will be provided by the Brighton and Hove Health Protection & Screening Forum, which reports to the Health & Wellbeing Board, in line with the National Cold Weather plan.

 

6.5      All partners must ensure that staff with an active part to play in the cold weather response need to be aware of the CWP and any training needed for its requirements and implementation.

 

7.      Cascading Cold Weather Level Alerts

 

7.1       The Level will be publicly displayed on the Metrological office website at Cold Weather Alerts - Met Office

 

Figure 4 Met office cascade system

 

 7.2     Local cascade arrangements within B&H

 

·         The BHCC Emergency Planning & Resilience Team forward alerts to all internal BHCC department nominated leads;

o   Health & Adult Social Care – work with vulnerable adults

o   Families, Children & Learning – work with vulnerable children and families

o   Housing Neighbourhoods and Communities – work with vulnerable communities and neighbourhoods

o   Economy, Environment and Culture – work with local businesses and transport and the urban environment

o   Strategy, Governance and Law – for Communications team

·         BHCC EPRR also send to;

o   External partners locally including the Community and Voluntary sector

o   ‘Community Resilience’ contacts that request the service.

·         BHCC Adult Social Care (ASC) have provided assurance that they will inform ALL B&H care & residential homes and home care providers

·         NHS Sussex Brighton and Hove (having delegated authority for Primary Care Commissioning), inform city GP Surgeries via a process agreed with the NHS Sussex Primary Care Team.

·         The NHS Sussex Resilience lead disseminates alerts to staff (on-call managers, agreed primary care staff and Communications), and to IC24 (Out Of Hour’s provider), and to Sussex Partnership Foundation Trust, (SPFT) and to the British Red Cross.

·         All category 1 providers (including SCFT / University Hospital Sussex Trust / SECAmb etc) also receive alerts direct from the Met Office.

 

It is therefore confirmed that systems are in place to ensure that all who need to receive cold weather alerts are doing so within the city.

 

8.      At-risk groups

 

Groups at greater risk of harm from cold weather (as defined by the national CWP) are detailed below.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Figure 5 those at greater risk of harm from the cold

Brighton & Hove has an old housing stock with 66% of houses built before 1945 (compared with 43% across England) and many private sector properties labelled ‘hard to treat’ (for example those with solid walls) in relation to energy efficiency measures. This puts a number of people at risk of fuel poverty and therefore impact of living in a cold home.

 

All sectors should ask or check if people can heat their homes. People being discharged from hospital or in-patient care may be at increased risk of the cold if their home was left empty and / or unheated. All discharge, rehabilitation and reablement plans consider home circumstances and include questions about ability to heat the home. Further links and contact details should be made explicit for support with cold homes and fuel poverty given the impact on health and recuperation especially for older people and those with respiratory or CVD conditions.   

 

9. Seasonal Vaccination Programmes

 

Flu is a respiratory illness and COVID-19 is primarily a respiratory illness. There are strong similarities between the two - those at higher risk of acquiring it, side effects and subsequent complications, and mortality.

 

9.1 Influenza vaccination programme 2022/23

 

This year the national Flu programme has extended uptake targets, expanded groups eligible for the vaccination and widened delivery routes..[17]

 

There is a joint Flu and Covid-19  NHS Sussex Programme Board with a range of workstreams focussing on key aspects such as; health & social care staff, primary care, outbreak arrangements, vaccine supply, data, communications, health promotion. Locally, the city’s multi-sector Flu Planning meeting co-ordinates implementation across organisations in support of the Flu programme.

 

Due to the Covid prevention measures of mask wearing, social distancing and lockdowns, the amount of Flu circulating in 2021-2022 was very low. It is thought that as society has opened-up again there is a high likelihood that the 2022-23 Flu season could be up to 50% larger than typically seen and this has been the experience of the southern hemisphere.  It could also coincide with Covid 19 outbreaks, placing additional pressure on the NHS. [18]

 

The uptake of the Flu vaccine has been consistently lower than the SE and England average for all eligible groups although big increases have been made with the over 65s (78.1%)[19]

 

This is supported by public facing marketing campaigns to encourage take up amongst eligible groups for the free Flu and Covid19 Booster vaccine, and a targeted campaign for front-line health and social care workers ‘boost you immunity’.  Resources will be available to from the Campaign Resource Centre.

Vaccinations are available to those not in the target groups through pharmacies at a low cost (£10-£18)

 

Free Flu vaccinations are available for:

 

·         all children aged 2 to 3 on 31 August 2022

·         those aged 6 months to under 50 years in clinical risk groups

·         Primary school children

·         Secondary school children in Years 7 to 9 (between 11 and 13 years of age on 31 August 2022) - after December 2022

·         Schools years 10 and 11 – after December and subject to secondary school vaccine availability

·         In pregnancy

·         those aged 65 and over

·         those aged 50 years to 64  – after October.

·         those in long-stay residential care homes

·         carers

·         close contacts of immunocompromised individuals

·         frontline health and social care staff including:

·         a registered residential care or nursing home

·         registered domiciliary care provider

·         a voluntary managed hospice provider

·         Direct Payment (personal budgets) and/or Personal Health Budgets, such as Personal Assistants.

·         Learning from the Covid19 vaccination programme as revealed a range of workforce who are day-to-day directly delivering health and social care to vulnerable residents and these groups will be considering as within this Flu programme. Examples include special school staff giving PEG feeds [20] to children; social care workers in supported living hostels. 

§  At the Brighton and Hove level additional groups are being considered as clinically vulnerable such as homeless and rough sleepers, regular services users of the Alcohol and Substance misuse services.

§  BHCC have an annual scheme with pharmacies for its staff to have the Flu vaccinations for those that are not eligible for the free NHS vaccinations.

 

Uptake ambitions – nationally the aim is to improve uptake in all groups to above the previous year. Efforts should be made to show improvement in coverage in those groups who were more than 5% lower than the national average.  General practices and school providers must demonstrate a 100% offer to all those who are eligible this season.

 

 

 

 

9.2 Covid-19 Autumn Booster and Evergreen Offer Vaccination programme

 

At the time of writing some of the further delivery details for the Covid-19 Autumn Booster vaccination programme are being finalised.[21] [22]

·         Covid19 Autumn boosters for;

o   those working in care home

o   those living in residential care homes for older adults

o   frontline health and social care workers

o   all those aged 16 to 49 years with underlying health conditions that put them at higher risk of severe COVID-19,

o   adult carers

o   adult household contacts of immunosuppressed individuals

o   from October to all adults aged 50 years or over

 

·         Continuing to publicise the ‘Evergreen offer’ of first, second and initial booster doses to those who are un/partly vaccinated. With support for those populations

·         and communities with lower uptake. 

 

10 Arrangements in local providers

 

These sections provide a short overview of the arrangements that are in place.  The assurance processes sit within each service and the following text has been provided by the services.

 

10.1  BHCC Health and Adult Social Care

 

Public Health - Reduction of excess winter deaths and fuel poverty are Public Health (PH) priorities as highlighted in the Public Health Outcomes Framework. 

 

Public Health and Housing co-chair a cross-sector, multi-agency Fuel Poverty and Affordable Warmth Steering Group, which meets to oversee and coordinate support, identify funding streams and collaborate on projects to support residents experiencing fuel poverty and/or cold homes.

 

The Steering Group membership is currently made up of representatives from the Council’s Public Health, Housing, Food Policy and Revenues & Benefits Teams, as well as multiple Community & Voluntary Sector (CVS) organisations: Brighton & Hove Energy Services Cooperative (BHESCo), Citizen’s Advice Brighton & Hove (CABH), Money Advice Plus (MAP), National Energy Action (NEA), East Sussex Fire & Rescue Service (ESFRS), British Red Cross (BRC) and Brighton Peace & Environment Centre (BPEC).

 

Public Health facilitate links between this group and the Welfare Support and Financial Assistance Group. The overarching aims of the Fuel Poverty & Affordable Warmth Steering Group are to:

·         Reduce preventable excess winter death rates

·         Reduce fuel poverty, cold homes and the impact on health & wellbeing

·         Reduce pressure on health and social care services

·         Improve the energy efficiency of homes.

·         Improve the energy literacy of residents and workers in the city

 

The Warmth For Wellbeing programme focusses 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 and reduce the health and wellbeing impacts through;

·         Information and advice

·         Warm Home Checks providing advice, advocacy, referrals and installation of small energy saving measures

·         Debt & benefits advice and casework

·         Small hardship grants

 

In May 2022, in response to increasing demand and the Cost Of Living crisis, Public Health allocated an additional grant fund to continue provision of money advice and small grants from June 2022 to March 2023. This is a one-off investment for 2022/23, delivered by Moneyworks partners Citizen’s Advice Brighton & Hove and Money Advice Plus.

Public health regularly send out information and resources through city wide networks and services about winter readiness and cold weather advice.

 

Adult Social Care - Both Domiciliary and bed-based services are delivered by the Directorate, which has well-rehearsed Business Continuity Plans and heightened infection prevention and control measures in response to the COVID-19 pandemic. Services and organisations across health and social care work closely together. Each service has a process in place which identifies level of need, the number of visits required and in what time scales. This assists in identifying and prioritising community visits at times of high demand / limited resources / extreme weather conditions.  All services delivered are considered in light of the COVID-19 guidance.

 

Flu vaccination is actively encouraged in all provider and commissioned services as staff are eligible under the National Flu Programme. All HASC front line social care delivery staff are actively encouraged to visit their general practice or local pharmacies for Flu vaccinations. The COVID-19 Autumn Booster campaign is running across care homes in the city and arrangements are in place for staff to access COVID-19 vaccinations.

 

 

The ASC team has contracts with much of the independent sector providing Care and Nursing Homes, Home Care, Supported Living and Community Support in the City. Contracts require that providers have business continuity plans which include winter readiness.

.

A range of resources are distributed through ASC networks for example Helping to prevent winter deaths and illnesses associated with cold homes; A quick guide for home care managers  Influenza-like illness (ILI): managing outbreaks in care homes,[23] ^[1]

promotion of the pneumococcal and shingles vaccinations and norovirus prevention.

 

Cold weather information is routinely be shared widely across the city through these general contacts and via a public health bulletin to the care sector .

 Access.Point@brighton-hove.gov.uk and / or Contracts Unit Admin Team ContractsUnit.AdminTeam@brighton-hove.gov.uk

Control.Carelink@brighton-hove.gov.uk  it is in use by the call centre 24/7 for HASC related out of hours services.

                                                                    

The UKHSA Winter-readiness (infection prevention) information for care homes in South East England Winter 2022/23 has been widely shared to care settings. It sets out key messages for care home managers on winter preparedness, including when and how to report outbreaks to your local Health Protection Team (HPT). It has two checklists on COVID-19 & flu, and norovirus readiness plus links for posters and further information on COVID-19, flu, norovirus, and shingles.

 

An annual plan is agreed with the NHS to support the patients journey on discharge from hospital:

·         a dedicated resource in Emergency departments to support rapid discharge from hospital

·         D2A – discharge to assess beds, and additional mental health support

·         Participation in HIT team in acute services in time of escalation to minimise use of care capacity and ensure correct discharge pathways are followed

·         Independence at home – reablement home care to support D2A process

 

 

10.2  BHCC Families, Children and Learning Directorate

 

 

It is important to involve services for children and families in winter preparations and health protection, particularly in order to reach the city’s schools. Schools closures have a clear impact on the city, and support to business continuity planning in educational settings is available.  Key city gritting routes do not always cover all individual routes to schools. Following the mandatory school closures experienced in 2020 and 2021 as part of the Covid pandemic response, schools, their pupils and their families are more set up for and experienced in home and remote learning techniques. This could help with school’s badly affected by poor weather and will be informed by the DfE’s guidance on  emergency planning and response, published in 2022.

 

A Families, Children and Learning (FCL) departmental representative attends the Health Protection & Screening Forum and this provides further opportunities to coordinate city winter planning. Services and information to support families in fuel poverty will be widely shared through FCL networks. Children’s centres and Council nurseries distribute weather related posters and leaflets, promote the Flu vaccine and can sign-post families for advice on fuel poverty.   Private, voluntary and private early years childcare settings can be sent information to pass on advice to families.  The Family Information Service can also pass on information using their Twitter account and Facebook page.  The Family Information Service and the Integrated Team for Families can provide advice for families to reduce fuel poverty. Information about the seasonal Flu vaccinations generally and the schools based vaccination programme will be shared through wider FCL networks. Children under 5, pregnant women are recognised at risk groups. 

 

The NHS Flu Vaccination programme has been extended to cover all school years from Reception to year 9 and extending to older years from end December, subject to vaccine supply.  There is a commitment to continue with the successful levels of vaccination uptake as seen in previous years. BHCC will be offering a reimbursed Flu vaccination to all school staff who are not eligible for the free NHS one.

 

10.3  BHCC Seafront Team

 

The City recognises that numbers of rough-sleepers across the city have risen, and this is a particular problem for the seafront area.

 

It has been acknowledged that advice to traders re flood defences etc can be obtained from the YouGov website at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/451622/LIT_4284.pdf

 

The Seafront Officewill 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.

 

A number of products such as flood sacks etc can be locally obtained from B&Q and Travis Perkins etc.

 

Events such as the B&H ‘Christmas Day Swim’ are kept under review. The team put out public safety signage and press releases about the dangers of swimming in the sea at this time of year in the lead up to Christmas., The swim is not an ‘event’ which is recognised by the council as it has no formal organiser and has no safety cover (Brighton Swimming Club do not wish to be responsible).  The Seafront Office are on duty on Christmas Day and will advise the public not to enter the water if they are considering it. However, the Seafront Officers are not there to provide lifeguard cover as this is not their role.

 

10.4  Cityclean

 

Cityclean (01273 294706/01273 292229) staff working for BHCC and trained as gritter drivers are on a rota for the winter season and operate under the direction of the BHCC ‘Winter Duty Officer’ who will advise on weather and road conditions, and on action required by the team.  Road gritting routes cover main roads, all bus routes and access roads to emergency services such as ambulance stations. In severe snowfall, additional Cityclean staff working for BHCC may work on pavement clearance for identified priority areas such as city centre and hospital entrances. There are 7 gritters (including a pavement gritter) and they will all be serviced before the start of the Winter Gritting period. 

 

10.5  The BHCC Highways Winter Service Plan 2022-23

 

This plan states the Councils gritting and monitoring arrangements specifically relating to public roads and pavements. It is available on the council’s public website (see below).

 

The Local Authority maintains an information page on the council’s public website, which provides advice on winter weather (see http://www.brighton-hove.gov.uk/content/parking-and-travel/roads-and-highways/winter-weather) and  driving and ‘what you can do’ as well as on ‘what the Council does’. The link to this page is: https://www.brighton-hove.gov.uk/content/parking-and-travel/roads-and-highways/winter-road-maintenance

 

The highways plan ensures that roads to NHS hospitals are gritted, as well as ambulance stations. Clearance of pavements which lead to those hospitals are also on the Priority list.

 

B&H Bus Company’s routes are on the City’s gritting routes.  Salt is good at combating ice but the addition of the buses and other heavy transport is needed to make it as effective as possible, Salt will only melt a very thin layer of snow or ice so anything more than snow flurries will settle on gritted roads.  Under such circumstances, the aim is to reclaim the network as soon as possible using a grit/salt mixture and snow ploughing. It is important to keep the buses running where possible to help break up snow but that is an operational decision for the bus company. Issues for Brexit; reduction in vehicle part access, fuels, etc will be covered by Business Continuity Plans

.

Pavement clearance will also be carried out during snow events.  Grit bins are provided across the coldest, steepest areas of the city for the public to use.

 

The service operates from 1 November until the end of March, 24 hours a day, 7 days a week.  The period may be extended on a day-to-day basis in cases of severe cold weather continuing into April or starting earlier in October.

 

10.6  BHCC Flood Management

 

The Council’s focus is on groundwater and surface water (the Environment Agency retains responsibility for main rivers and seas) which are the main flood risks to the City. The approach is to reduce (not eliminate) risk through strategic intervention. The following strategic flood management documents are being updated. Links to our current plans and strategies are found here:

 

• Strategic Flood Risk Assessment
• Surface Water Management Plan
• South East River Catchment Flood Risk Management Plan
• Local Flood Risk Management Strategy

 

10.7  BHCC Housing

 

The team has responsibility for the Council’s stock of social and seniors housing. The

Housing Sustainability & Energy Manager works closely with the Public

Health lead for fuel poverty & EWDs to plan annual winter warmth initiatives. Energy

saving advice is available for vulnerable council tenants from the Housing Inclusion

Team.

 

In an emergency the service is committed to stopping non-urgent work and to re-deploy housing staff to other services who need extra support.  The Estates Services provide salt and equipment to residents to help clear communal pathways to blocks.  The Council’s Housing Repairs and Maintenance service and heating contractor run out of hours services. They maintain winter contingency stock including heaters etc. Out of hours the duty housing officer is contactable via the Emergencies and Resilience Team or via Carelink.

 

BHCC commission the ‘Severe Weather Emergency Protocol’ (SWEP). This activates when the temperature feels like 0 degrees for 1 night, (SWEP will also open where possible on an Amber weather warning). The SWEP service offers overnight shelter to rough sleepers. Community and third sector organisations working with rough sleepers within the city are involved in ensuring that rough sleepers are informed when the service is open and how to access. The service is open to all rough sleepers regardless of local connection.

 

Over the Winter of 2022-23 the SWEP service will be available in self-contained environments. Every person using the service will have their own room to try and ensure the safety and wellbeing of rough sleepers whilst COVID-19 remains a real risk.

 

Warm Places

 

BHCC and its CVS partners have attempted to identify households and people in need of support this winter.

 A multi-agency group is collating and developing a directory of winter indoor activities and places, as part of a programme currently called ‘weathering winter in the city' in response to cost of living and fuel poverty crisis.

 

 

10.8  BHCC Emergency Planning and Resilience team (EP&R)

 

Transport hub arrangements and lists of community volunteers are annually reviewed.  The B&H Transport Hub results from an agreed arrangement between partners to support BHCC in running a hub facility during periods of severe weather. The Transport Hub is managed and staffed via the agreement, and by an operational document. The Hub (once setup) will:

Ø  Ensure an overview is maintained on weather conditions.

Ø  Liaise with the BHCC Highways department and media sources to understand the impacts of the severe weather on the cities road’s.

Ø  Understand the implications of the weather falling on roads on transport providers including buses and taxis.

Ø  Coordinate available 4 x 4 resources (including via the NHS and SRF MOU(s) with Sussex 4x4 Response), from partner organisations and local community volunteers Match local prioritised requests for 4x4’s against availability.

Ø  Work with community and voluntary sector groups who may be able to assist with the community response to severe weather events.

 

The BHCC ‘EP&R Team’ and the Public Health lead for Health Protection and  resilience  both engage with external partners including the Sussex Resilience Forum (SRF), and the Sussex Local Health Resilience Partnership (LHRP), and responding agencies to ensure that B&H is fully engaged in planning, testing and exercising  severe weather and winter-related plans at both the Sussex an local levels.

 

De-Briefing & Support Should there be a severe weather incident, a de-briefing should be held to ensure lessons are identified and learnt, and also partners should ensure that support is offered to staff in appropriate cases. This is usually led by the EP&R team.

 

10.9 NHS Sussex Integrated Care Board (ICB)

 

Local adverse weather and business continuity plans are in place across the healthcare system in Sussex and the ICB itself, to respond to severe weather and other hazards associated with winter.  The ICB’s assures, as part of the annual NHSE Core Standards Assurance Process, that these plans are in place, up to date and tested regularly.

 

Local surge management plans are in place to respond to escalations in pressure in the local health system. The level of pressure is gauged using the Operational Pressures Escalation Level Framework (OPEL) and the local response to the escalation levels identifies a set of actions to be taken by all partners within the Sussex health system to manage the increased levels of pressure.   .

 

Key performance objectives are monitored by a system-led process known as ‘SHREWD’ which provides real-time monitoring of hospital flow and capacity and is able to report information nationally.  

 

The ICB has set up the NHS Sussex Operations Centre which provides an information management facility for NHS Sussex, designed to identify, analyse, plan and mitigate health service risks and demands across Sussex over the winter period. 

The ICB also leads on the Covid-19 and Flu Vaccination Programmes for Sussex.

 

10.10  University Hospitals Sussex NHS Foundation Trust

                                   

Plans are reviewed annually at UHSx. The Trust participates in the NHS Operational Pressures Escalation Level (OPEL) procedures, which are centred around the Hospital Trusts geographic area and seeks to ensure that ‘capacity management’ issues are monitored effectively and where all resources in the local health and care system (including those of BHCC) are managed on a daily basis by a teleconference and reported/monitored using appropriate management tools. It now includes risk and pressures in the system relating to COVID19 as C-OPEL. It is led by the ICB’s Director of Resilience. It is recognised that the Trust is often at high levels of escalation, but the issues are actively managed with the support of other organisations.

 

The Trust is committed to raising staff Flu vaccination levels and vaccinate other eligible groups as identified in the annual Flu letter.  Business Continuity Plans are regularly updated. UHSx operates using COVID19 infection prevention and control guidance for the safety of staff, patients and partner organisations. 

 

10.11  Sussex Community NHS Foundation Trust

 

SCFT provides out-patient clinics on-site and teams of healthcare staff such as Health Visitors, who deliver frontline community health services to patients in B&H and across wider Sussex. The Immunization Team is part of this Trust and contributes to the annual Flu vaccination programme. The Trust maintains service level Business Continuity Plans and has access to 4x4 vehicles to deliver its role during severe weather. The Trust has a Cold Weather Plan, Winter Plan and Escalation Plan which are available to staff on the Trust intranet. Staff and patients are provided advice on all aspects of winter health that can be found on NHS How to  Stay Well This Winter and the Keep warm- keep well leaflets.

 

10.12  IC24 (NHS Out of Hours Provider)

 

IC24 provides out of hours and roving GP services to B&H and to E Sussex, as well as a GP in A&E at Royal Sussex County Hospital, a walk-in service and other facilities. The organisation may have challenges in providing some services during periods of adverse weather but may access 4x4 support via links with Adult Social Care and the ICB.

 

10.13  British Red Cross

 

BRC has agreed to link with BHCC and other local services and is available to support them during periods of severe winter weather. BRC have other winter provision available in B&H:

• A 24 Emergency Response Call Centre (Crisis Response Contact Centre) which will mobilise staff and volunteers as required, 24/7/365 to support people in crisis and depending on what the situation is, if BRC can help, they will respond.

• The basic “offer” to B&H is to provide practical and emotional support which will include working in rest centres etc.

•BRC can also provide blankets and hot drinks. If other support is required, such as the distribution of items to the vulnerable, please let the BRC know, and where possible, they will assist. 

 

To access this assistance, please contact the Crisis Response Contact Centre (CRCC) which is open 24 hours a day, on 0300 023 0700.

 

Red Cross – Jess Macefield-North   Senior Emergency Response Officer – BRC for Surrey & Sussex

0300 0230700   Jmacefieldnorth@redcross.org.uk

Please contact CRCC 0300 023 0700 If you have any queries in office hours, please feel free to ring my mobile on 07831 282581

 

10.14  Community and Voluntary sector

 

The CVS is key to building winter resilience in the city. As a trusted and first point of contact for many of the most vulnerable residents, charities and community groups play a vital role in a partnership approach to addressing the demands of cold weather.

 

The sector cascades Cold Weather Alerts provided by the Met Office and shares warnings, as well as other Public Health messages around cold weather harms and preventative actions. This happens through commissioned services, including infrastructure and community development groups as well as through community networks.

 

Advice services across the city support residents by providing support around fuel, finance, housing and advice on many other topics, food banks and community pantries offer free or low cost food. Befriending organisations help to alleviate loneliness and other community organisations work with specific groups who may be more vulnerable to cold, such as those with disabilities, older people, the homeless or vulnerably housed, those in poverty etc. Smaller groups also act at a neighbourhood level.

 

The local voluntary and community organisations are represented at a wide range of strategic bodies in the city, including; BHCC Flu Planning meetings and the Sussex Programme board, the Sussex Resilience Forum, the Health and Wellbeing Board, other council hosted bodies such as EquIP and welfare and financial assistance meetings, B&H Health and Care Partnership Exec Board and multiple workstream meetings. As well as enabling the sector to keep up to date with developments to share with their partners and service users, this is also an invaluable means by which their intelligence can be incorporated into the city's responses to cold weather.

 

 

11     Communication

 

11.1    Three areas of communication

 

The three areas of communication are: Awareness, Warning & informing and Advising the public.

 

11.2    Awareness

 

Pre 1st November each year. This will be done through the national and local campaigns, by informing and educating the public about the risks of cold weather, and how people in the identified vulnerable groups can prepare themselves.

BHCC has a seasonal weather opt-in cascade system for pre-emptively sharing general seasonal advice.

 

The UKHSA and NHS England marketing campaign, Help Us, Help You - Stay Well this Winter’, will run starting in September. This phased campaign aims to help those with long-term health conditions (particularly respiratory conditions), older people, school children, pregnant people and parents of under-5s stay well and keep their loved ones well this winter. This includes messages about Flu and Covid19 vaccinations, contacting NHS 111, seeking advice at the first signs of a winter illness, accessing evening and weekend GP appointments and the advantages of consulting with community pharmacists.

 

Further information is available from: https://campaignresources.phe.gov.uk/resources/campaigns/34-stay-well-this-winter/overview which also provides a link to sign up for email updates.          

 

‘Top Tips for Keeping Warm and Well’, in collaboration with Age UK. The leaflet is targeted at pensioners in receipt of pension credit in England, Scotland and Wales. It will sit alongside an updated ‘Keep Warm Keep Well’ booklet, found at:

 

https://www.gov.uk/government/publications/keep-warm-keep-well-leaflet-gives-advice-on-staying-healthy-in-cold-weather

 

NHS Sussex runs a winter communications campaign titled Help us help you this winter Stay well this winter . The campaign encourages people to use health services appropriately and highlight the other services available. There is a strong focus on self-care and prevention, which links into the NHS England campaign as described above. Brighton and Hove city council support this communication campaign and will be also sending out and sharing key message in readiness for winter.

 

Appendix 3 has the general public health messages and specific for each alert level

 

11.3    Warning

 

At each change of cold weather level. The Met Office will communicate to the public any change in levels and what the changes means, taking into specific account the local weather warnings. Local supportive messages will also be sent out to services and to the public.

 

11.4  Local Warning and Informing

 

Immediately when Level 2 and above is reached. BHCC Public Health staff and Emergency Planning & Resilience Team will liaise with NHS Sussex and BHCC Communications staff to agree appropriate local messagingand specifical targeted information for those at most risk.

 

11.5    Staff information

 

All partner agencies will ensure that suitable messages are also passed to staff, detailing warnings where appropriate, actions to be taken, and measures in line with their Business Continuity Plans, which must be kept up to date. This may include the need to re-deploy staff during severe weather, arrangements for home-working where appropriate, support to access Covid-19 and Flu vaccinations, and proactive information on how to stay safe and keep well during the winter months 

 

 

 

Appendix 1 Action Cards

 

Please find the full set of Action Cards here and these are updated nationally https://www.gov.uk/government/publications/cold-weather-plan-action-cards-for-cold-weather-alert-service

 

Appendix 2 NHS Sussex Adverse Weather Plan 2022-2023

 

Available on request generic email address sxicb.eprr@nhs.net

Appendix 3 Key Public Health messages

 

These are the core messages to be broadcast as official weather warnings alongside national and regional weather forecasts. They may be expanded or otherwise refined in discussion with broadcasters and weather presenters.

 

Key public health messages

Take up your Covid-19 vaccination when it is offered/available   Contact your GP or pharmacist if you think you, or someone you care for, might qualify for a free Flu jab.   Free Flu vaccinations are available for those who are at risk. For a full list see the annual Flu plan, available at: www.gov.uk/government/collections/annual-flu-programme   Keep your home warm, efficiently and safely: heating your home to at least 18°C in winter poses minimal risk to your health when you are wearing suitable clothing get your heating system and cooking appliances checked and keep your home well ventilated use your electric blanket as instructed and get it tested every 3 years never use a hot water bottle with an electric blanket do not use a gas cooker or oven to heat your home; it is inefficient and there is a risk of carbon monoxide poisoning and this can kill make sure you have a supply of heating oil or LPG or sold fuel if you are not on mains gas or electricity – to make sure you do not run out in winter   Keep in the warmth by: fitting draught proofing to seal any gaps around windows and doors making sure you have loft insulation. And if you have cavity walls, make sure they are insulated too insulate your hot water cylinder and pipes draw your curtains at dusk to help keep heat generated inside your rooms make sure your radiators are not obstructed by furniture or curtains   Look after yourself: food is a vital source of energy and helps to keep your body warm so have plenty of hot food and drinks aim to include 5 daily portions of fruit and vegetables. Tinned and frozen vegetables count toward your 5 a day stock up on tinned and frozen foods so you don’t have to go out too much when it’s cold or icy exercise is good for you all year round and it can keep you warm in winter if possible, try to move around at least once an hour. But remember to speak to your GP before starting any exercise plans wear lots of thin layers – clothes made from cotton, wool or fleecy fibres are particularly good and maintain body heat wear good-fitting slippers with a good grip indoors and shoes with a good grip outside to prevent trips, slips and falls make sure you have spare medication in case you are unable to go out check if you are eligible for inclusion on the priority services register operated by your water and power supplier   Look after others: check on older neighbours or relatives, especially those living alone or who have serious illnesses to make sure they are safe, warm and well   Get financial support: there are grants, benefits and sources of advice to make your home more energy efficient, improve your heating or help with bills. It’s worthwhile claiming all the benefits you are entitled to before winter sets in.

Specific messages related to the Levels suggested in national Plan

Level 1: Winter preparedness and action   A spell of chilly weather might warrant a message along the lines of:    “If this does turn out to be a spell of severe cold weather, we’ll try to give you as much warning as possible. But in the meantime, if you want advice about protecting your health from the cold go to the winter health pages at www.nhs.uk. If you are worried about your health or that of somebody you know, ring NHS 111.”

Level 2: Alert and readiness   The Met Office, in conjunction with UKHSA, is issuing the following cold weather warning for [regions identified]:   “Severe cold weather can be dangerous, especially for the very young or very old or those with chronic disease. Advice on how to reduce the risk either for yourself or somebody you know can be obtained from the winter health pages at www.nhs.uk or from your local chemist. If you are worried about your health or that of somebody you know, ring NHS 111.”

Level 3 and 4: Severe cold weather action/emergency   The Met Office, in conjunction with UKHSA is issuing the following severe cold weather advice for [regions identified]:   “Make sure that you stay warm. If going outside make sure you dress appropriately. If indoors, make sure that you keep your heating to the right temperature; heating your home to at least 18°C in winter poses minimal risk to your health when you are wearing suitable clothing. If there is anyone you know who might be at special risk, for example, an older person living on their own, make sure they know what to do to stay warm and are well stocked with food and medications. If you are worried about your health or that of somebody you know, ring NHS 111”