Gentoo Group launch Boiler on Prescription pilot
Published by LauraMcKinlay for Gentoo Group in Health and also in Care and Support, Education, Environment, Housing
Mr and Mrs Harris outside their home
North-east based social business Gentoo Group is working with the NHS on a pilot designed to help GPs ‘Prescribe a Boiler’ to their patients. Through the innovative project Gentoo has carried out energy efficiency improvements, in an effort to prove warm home equal healthy people, opening the door for future pilots.
Gentoo, in partnership with various North East Clinical Commissioning Groups (CCG), has initiated a ‘Boiler on Prescription’ pilot, creating a framework where a GP can prescribe a suite of home improvements, free of charge, to patients who have medical conditions exacerbated by cold, damp homes. It is hoped that by improving the home, the patient will be able to live in increased comfort, decreasing the need for medical interventions and therefore reducing repeat GP and hospital appointments. This is part of Gentoo’s approach to create sustainable Art of Living ventures that enhance health and wellbeing.
In January 2014, the first pilot, funded by Sunderland CCG, included six Sunderland households - not Gentoo customers - identified by their local GP as suffering from Chronic Obstructive Pulmonary Disease (COPD) a serious respiratory condition made worse by living in cold homes. Working with the patient, a specialised team from Gentoo carried out an energy efficiency assessment on the property to see what improvements could be made, including: replacing single glazed windows with double glazing; installing energy efficient boilers; loft and cavity insulation; external wall insulation; internal wall Insulation; and draught-proofing. Gentoo carried out the necessary improvements and continue to monitor the environmental improvements to the home, while the patients’ GP measures any possible improvements in health.
The Sunderland pilot identified before the project, in the six months prior to their homes being improved, the six patients involved had 63 interactions with the NHS, three of those were emergency admissions. The average spend on energy efficient improvements to homes in the trial is £5000; each single emergency admission to hospital costs £2500. It is also expected to generate a reduction in visits to GPs, walk in centers and A&E along with a reduction in prescription cost.
Director of Gentoo Green, Sally Hancox, said: “We are very excited to be working with our partners on this ground-breaking project. While conditions such as COPD can’t be cured, it is hoped improvements to people’s homes will not only improve quality of life and reduce the risk of fuel poverty, it may help manage the symptoms of COPD and result in less ongoing support from the NHS.
“Improving the Art of Living is at the heart of everything we do at Gentoo and wellbeing is core to this. We aim to help people feel comfortable in their homes. Improvements to a person’s health cannot be measured overnight, however we are committed to the long-term support of this project and are happy to report people are already sharing with us improvements to their general wellbeing. We hope the savings made to the NHS will enable us to increase the scale of this pioneering project and improve even more lives.”
One of the people to benefit from the Boiler on Prescription pilot was 77 year old Herbie Harris. The former electrician lives in Sunderland with his wife June, 75, and suffers from COPD as well as other serious medical conditions. Mr Harris said: “We’ve had new windows, two new doors and a new boiler. Previous to the pilot happening we were all double glazed but we put it in 30 years ago when we bought the house. We have noticed a big difference since the new glazing was put in. The house is now keeping its heat a whole lot better, we feel warmer and more comfortable in our own home. In general, we have a very comfortable home and hopefully it’ll reduce the bills and make a difference to my health.”
Mrs Harris said: “We’ve worked all our lives so this has been a very welcome surprise. My husband is always cold and used to sit with extra jumpers on but now he is taking his jumpers off. I am his nurse during the night and we used to keep the heating on low to keep the chill off the bedroom. Now we don’t know how to do that. We’re happier in ourselves and know we are not going to be half froze. It’s less worry.”
Dr Nonnie Crawford, Sunderland’s director of public health, said: “We decided to fund the ‘Boiler on Prescription’ pilot because we believe it is an alternative approach to an ongoing problem. With Gentoo, we are hoping to establish the impacts a warm home has on patients who have conditions we know are exacerbated by living in a cold environment.
“We want to enhance the quality of life for people with long-term conditions and prevent unnecessary and avoidable discomfort. Ensuring people have a positive experience of care, and caring for people in a safe environment, protecting them from avoidable harm is high on our priorities. If a patient can heat their home more effectively, does that allow them to manage their condition better? This trial will let us find that out.”
This is not the first project of this kind Gentoo has been involved in. In 2013 Gentoo published an Energy Saving Bundle report highlighting a number of learnings gained through delivering a 1200-home, community-based Green Deal pilot scheme – the Energy Saving Bundle (ESB). Although not initially the purpose of the home improvements, Gentoo discovered that while customers were happy with the savings to energy bills, the scheme delivered so much more on a personal level. It was the improvement in quality of life that was the major benefit. Residents felt healthier and happier and their general wellbeing was improved.
The Royal College of General Practitioners has agreed to become a medical advocate for the pilot and Public Health England has also offered support. The scheme has also been recently been acknowledged by the World Health Organisation. A number of other CCGs, both regionally and nationally, are currently in discussion with Gentoo about rolling out the trial in their locality.
The Rt Hon. the Lord Hunt of Kings Heath OBE, Philip Hunt, said of the pilot: “Gentoo’s ‘Boiler on Prescription’ trial looks to tackle health inequalities that many people with long term conditions face. All too often patients with medical conditions aggravated by cold homes can’t manage their situation effectively as they are unable to heat their home to an appropriate level, either due to the cost or the thermal inefficiency of the property.
“This trial is aiming to see what the impact will be on health by improving the thermal efficiency of the home and reducing the number of times patients need to seek medical intervention. What’s exciting is that this trial brings together Public Health, the Local Authority, CCG’s and social housing providers and looks to help people based on medical need across tenure.”
Vice Chair Royal College of General Practitioners Dr Tim Ballard FRCGP has also given his seal of approval for the project. He said: “The introduction of Clinical Commissioning gives us the opportunity to work in new ways and do things differently. The NHS has historically struggled to rise to the challenges of decreasing health inequalities and investing “upstream” to prevent illness and keep people out of hospital. The health sector also needs to respond to the challenges of delivering care more sustainably, clearly articulated at the launch of the NHS Sustainable Development Strategy 1.
“Boiler on Prescription’ is an innovative exemplar scheme demonstrating how all of these strands can be brought together. Investing in fuel-efficient boilers and home insulation for high risk populations leads to a better home environment, improved management of long term conditions and a decrease in hospital admissions. Fuel poverty is also addressed, empowering individuals to afford a better diet and quality of life. Finally there is the overall reduction in CO2 emissions. What is there not to like?”
Whilst the first pilot will continue to be monitored, a second pilot is due to commence in June 2014, funded and supported by NHS Durham Dales, Easington and Sedgefield CCG. Gentoo will be working with GPs to help children living with Lower Respiratory Tract Infection and asthma aggravated by cold, draughty homes.
Dr Lynn Wilson PhD FFPH Consultant in Public Health, Durham County Council said: “From a Public Health perspective we are interested in the impact warmer homes have on reducing health inequalities and are especially interested in the development of a measure of quality adjusted life years.”
Gentoo Group’s whole ethos is about believing nothing is impossible and finding new ways to challenge conventions, Gentoo aims to make society a better place to live and to make a real difference to the way people live their life. To find out more about Gentoo, visit gentoogroup.com for more information or follow @gentoogroup on Twitter.