Key findings

This report provides 17 case studies of approaches which target both fuel poverty and health. They are grouped into three themes: social prescribing; multi-agency collaboration, and effective use of data. The following key findings cut across all themes:

There is consistent evidence of cases having positive impacts on wellbeing, comfort, and wider determinants of health, but robust evidence on clinical outcomes is more limited.
Strong cross-sector collaboration (health, housing, energy advice and other third sector) is vital for all approaches.
Effective interventions rely on integration into existing systems (especially NHS pathways and local partnerships) rather than operating as standalone or external programmes. This is because the NHS can be a hard organisation to access from the outside, but also because it is a trusted organisation which is likely to encourage engagement.
In a similar vein, successful interventions are often those which align with existing healthcare interactions (e.g. GP visits, vaccination clinics, hospital admissions) rather than requiring separate engagements.
While most of the existing evidence base focuses on adults, the health case for targeting children is strong and this evidence gap itself is a reason for action rather than inaction.
Several of these projects are working with patient groups once they already have a condition, rather than being truly preventative. In the examples of the Alder Hey and Royal London Clean Air Clinics, by the time children reach services like these, housing-related harms have often already become severe enough to contribute to recurrent wheeze, difficult asthma, repeated respiratory infections, emergency attendances or ongoing specialist follow-up. These clinics are doing important and innovative work, but they are downstream of problems that should be preventable much earlier. There may be important opportunities earlier in childhood, particularly through health visitors, primary care, maternity services and early years pathways, to identify families living in cold, damp or mould-affected homes before respiratory morbidity becomes entrenched.
Holistic, person-centred approaches are consistently emphasised across cases.
Barriers to access and uptake persist, even where services are available. Several case studies noted low uptake rates and difficulties identifying eligible households.
The landscape is characterised by small-scale pilot projects, but it appears more challenging for projects to secure long term funding to support scaling. This finding is particularly important because several evaluations highlight that short project timelines limit the ability to observe changes in long-term health conditions.
Data availability and linkage is a central enabler of targeting, delivery and evaluation, but is constrained by access barriers, governance issues and system pressures within the NHS.
Evaluation capacity is generally limited which impacts the ability to demonstrate impact rigorously and support scaling and policy adoption.

The following key findings are theme specific:

Social prescribing

Evidence of health impact is stronger for larger and better-evaluated pilots.
Effective use of data is essential to identify eligible populations and support scaling.
Effective collaboration between health professionals and those specialising in fuel poverty/energy advice is vital for the success of any social prescribing project.
Sustainable funding is needed to allow for social prescribing projects to continue to run and innovate.

Multi-agency collaboration

When establishing projects, it is important to work with pre-existing organisations (private, public, and third sector) and community networks.
Partnership interventions often have a positive impact on the wider determinants of health, including reducing stress and isolation.
Consideration needs to be given to capacity and budget constraints of partners, including local authorities, GPs and other health services, and the third sector.

Effective use of data

There is clear potential for innovative analytics and dashboards to support population health management and intervention design.
Toolkits and shared methodologies can support replication across regions.
Where direct measures are unavailable, consideration should be given to what data proxies are appropriate for identifying fuel poverty risk.