Introduction

As a part of their 2025/26 and 2026/27 workplans, the Scottish Fuel Poverty Advisory Panel is focusing on fuel poverty and health. It has previously engaged with Energy Systems Catapult on their Warm Home Prescription (WHP) Trial, an intervention designed for people who struggle to afford energy and have severe health conditions made worse by the cold. It enables them to stay warm and well while reducing the energy consumption and carbon emissions of their home. Building on this engagement, the Panel was keen to explore further case studies of approaches which focus on both health and fuel poverty.

In order to be considered for inclusion case studies needed to target both health and fuel poverty directly. As such, an analysis of a fuel poverty intervention which has some health benefits but doesn’t specifically target recipients on the grounds of health would not be included. Case studies are from the last 10-15 years and are UK focused. Cases were identified via literature searching on the Scottish Government’s KandE database, Google and Google Scholar, as well through discussions with key stakeholders (Energy Catapult, Public Health Scotland, Health Innovation North West Coast). A particularly helpful source was a catalogue of health-related fuel poverty schemes prepared in 2015 by National Energy Action for the then Department of Energy and Climate Change[1]. While this is now somewhat dated and did not cover Scotland, it proved a useful starting point.

Given the nature of this exercise and the location of cases as largely within the NHS, local authorities, and the charity sector with minimal published outputs, it is important to recognise that this is not intended to be an exhaustive list of all relevant projects and it is highly likely that some projects will have been missed. Furthermore, caution should be employed when comparing case studies. This is because they target based on the different criteria, with some cases focused on specific health conditions (COPD, sickle cell disease), while other focus on general long term health conditions. Some cases are longer and more detailed than others, this is driven by the amount of publicly available detail and evidence for each case and is not intended to imply the relative importance of cases.

It should be noted that in 2021, NHS England was restructured as a single unified national body, replacing fragmented local commissioning with around 42 Integrated Care Systems. Furthermore, a number of case studies refer to Clinical Commissioning Groups (CCGs). In 2022 these were replaced by Integrated Care Boards (ICBs).

While many of the case studies included in this report utilise energy efficiency measures as a way to mitigate and prevent fuel poverty related health problems, it’s important to note that the interaction between warmth, ventilation, damp, and indoor air quality is complex. As such, retrofit does not always result in improved health. The Scottish Fuel Poverty Advisory Panel has also published research looking at the policy overlaps between fuel poverty and health policy in Scotland, and this report summarises the complexity around energy efficiency measures and health.

The 17 case studies presented in this report are grouped by theme: social prescribing, multi-agency collaboration, and effective use of data. Where case studies are categorised under one theme, this does not necessarily mean that they don’t span the other themes, demonstrating multiple strengths. For example, the Warm Home Prescription is categorised under social prescribing, but it is also an example of multi-agency collaboration and effective use of data.

In analysing case studies, the report aims to provide a summary of organisations involved, project duration and location, a high level overview of the project and who its beneficiaries are. Where evaluation and other evidence is available this is incorporated, but it should be noted that the strength of evidence varies. In several cases there is minimal evaluation available, with existing evidence often being fairly descriptive in character. This is because in most cases these are small pilot projects, without the means of carrying out robust evaluation. In other cases, projects are ongoing and evaluation is not yet complete. There are, nonetheless, useful learnings which can be drawn from these. Each section begins with a summary of key findings related to each theme.