Theme 1: Multi-agency collaboration

Key findings

There are numerous case studies which demonstrate the importance of multi-agency partnerships in delivering projects which target both fuel poverty and health.
When establishing projects, it is important to work with pre-existing organisations (private, public, and third sector) and community networks. This process should be built into project timelines.
Evaluation of these projects is, in many cases, limited. This is because many of these pilots are operating on a small scale. Nonetheless, in order to share learning from and potentially scale up projects, robust evaluation is vital.
Interventions (energy efficiency, new heating systems, warm banks) have substantial benefits for health and wellbeing but also have a positive impact on the wider determinants of health, including reduction in 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.

Case study 4: Warm Homes, Healthy Futures

Key details: network connecting health, housing and energy experts to deliver support locally to keep people warm, safe and healthy at home. Made up of 26 partner organisations working with over 500 health professionals across more than 100 communities in GB.

Organisation(s): National Energy Action (NEA), Energy Action Scotland, NHS bodies, public health teams, local authorities, housing and community organisations across more than 100 locations, Cadent, Northern Gas Networks, SGN, Wales & West Utilities. 26 delivery partners providing localised energy advice and support, and over 500 referral partners, including GPs, social prescribers, COPD nurses and care teams.

Location: Across GB

Duration: Ongoing, launched April 2024

Who it supports: The programme is targeted at individuals with physical or mental health conditions that are exacerbated by cold homes. Individuals are identified for support via health and social care professionals, including GPs, social prescribers, cancer care, pharmacists, mental health services, community health, and adult social care.

What is delivers: Warm Homes, Healthy Futures is a National Energy Action co-ordinated network connecting health, housing and energy experts to deliver support locally to keep people warm, safe and healthy at home. It establishes a pathway for health and social care professionals to connect the vulnerable people they support to vital energy and CO₂ safety advice, income maximisation, essential gas appliance servicing, as well as related crisis support. The project also raises awareness in communities and trains frontline professionals on the health risks of cold, damp homes and CO safety. The programme aims to be flexible in order to draw on local and regional intelligence to understand and shape delivery.

There are currently 26 partner organisations operating across local government and the voluntary, community and social enterprise sectors. These organisations are working with over 500 health professionals across more than 100 communities.

Evaluation and evidence: Full evaluation of the programme is not yet available. It is intended that it will take the following design:

Stream 1: what are the quantifiable impacts of the programme – social return on investment.
Stream 2: what is/was the lived experience of households we helped pre- and post- intervention?
Stream 3: what lessons can be learnt which spotlight principles and may benefit future programmes design?

There are some descriptive statistics available but no detail on the methodology behind them. Following the first year of the programme, NEA reports that:

Nearly 17,000 people were reached, and over 8,000 were given in-depth advice.
Over 3,300 benefit checks were carried out.
More than £350,000 in crisis funding accessed.
More than 600 frontline professionals trained.
Over 5,000 CO alarms distributed.
£25,000 in fuel debt relief.
Over 3,000 households offered gas appliance safety checks.
More than 5,000 people reached in person at community events.
Fuel vouchers, warmth packs and wider support given to hundreds of people[8].

As of March 2026, NEA reports that the programme has:

Reached over 39,000 people and provided in-depth advice for 17,000.
Unlocked £7.7 million in benefits and £1.8 million in additional financial outcomes.
Trained over 3,000 professionals across the health and social care sector.
Held 27,700 conversations on carbon monoxide safety and energy efficiency.
Improved health outcomes – with 29% of clients reporting better physical health and 33% reporting better mental health.
Reduced fuel poverty – fuel poverty[1] fell by 29% for those receiving support[9].

Clients who have received support through Warm Homes, Healthy Futures say that:

They are less likely to fall behind on energy bills and to need to ration food and fuel.
They have better knowledge of how to save energy while staying comfortable.
They feel more confident communicating with their suppliers and better able to heat their homes safely.

National Energy Action recently presented on the programme at their Insight to Impact Network. Beyond direct delivery, they highlighted that the programme has helped to shift the policy and practice conversation on cold homes as a health issue. Including by:

Raising the profile of health-connected fuel poverty at Westminster.
Positioning cold homes and health more strongly in national policy debates.
Extending influence through strategic partnerships.
Supporting growing policy engagement with government.
Strengthening the case for health-connected fuel poverty support as a system solution.

Case study 5: Warmer Homes, Advice and Money (WHAM)

Key details: multi-agency partnership in Bristol, North Somerset, Bath and Northeast Somerset launched in 2017. From September 2017 to January 2024 6,538 households were supported.

Organisation(s): Centre for Sustainable Energy, We Care Home Improvements, Talking Money, North Bristol Advice Centre, Citizens Advice (Bristol, North Somerset, and B&NES branches) Bristol Energy Network, AMS electricals, Clean Slate (Quid’s In), North Bristol NHS Trust, and Weston Area Health NHS Trust

Location(s): Bristol, North Somerset, Bath and Northeast Somerset

Duration: Ongoing, launched in 2017

Who it supports: those on low incomes and those struggling to afford to heat their homes. Also has a referral route via hospitals, with a particular focus on combatting damp and mould in people’s homes.

What is delivered: WHAM is a multi-agency partnership led by the Centre for Sustainable Energy which aims to tackle the interconnected causes of fuel poverty through providing advice on energy, money, benefits and carrying out home repairs. The project works closely with local authorities, public health organisations and the NHS to combat the rising occurrence of damp and mould in people’s homes. Hospital staff can make referrals directly to WHAM, with support being given even while the patient is still in hospital.

The project has caseworkers who rotate between each partner organisation, understanding the specialisms of each organisation, becoming the single point of contact for beneficiaries and co-ordinating the work undertaken by all partners.

Evaluation and evidence: Minimal evaluation or evidence of impact available. The service’s 2024 Impact Report notes that from September 2017 to January 2024, WHAM has supported 6,538 households to the value of £3.63 million in case outcomes[10].

Clients supported have emphasised the high quality of the support provided, and the compassion and kindness of caseworkers. One client said:

“Neal [WHAM caseworker] has been an absolute angel. Without his help I really don’t know what we would’ve done, I was at my wits end. Without him nothing would have been resolved. I can’t thank him enough.

The dehumidifier helped with the damp situation, and my partner’s breathing is better. Neal is a lovely positive caseworker, you helped get us through it all.

This service is really important in this crises, you need this to help people out there. You are a Martin Lewis[11].”

The project is recognised as good practice by NHS England and Public Health England in The 2^nd Atlas of variation in risk factors and healthcare for respiratory disease in England (September 2019).

Case study 6: Home Energy Scotland, vaccination clinic drop ins

Key details: energy advice provided at vaccine centres in NHS Lothian, NHS Borders and NHS Fife.

Organisations(s): Home Energy Scotland (HES), NHS Lothian, NHS Borders, NHS Fife

Location(s): Lothians, Borders, Fife

Duration: Since 2023 (at least) in Lothian and Borders, possibly earlier (2021-22) in NHS Fife

Who it supports: Support is targeted at those receiving winter and spring vaccinations. Eligibility for vaccinations varies by vaccine but generally relates to age (65 for flu, 75 for COVID-19) or having a weakened immune system.

What is delivered: HES has worked in partnership with NHS Lothian, NHS Borders, NHS Fife to provide advice at vaccine centres. The service supports people to stay warm for less in their homes and also gives advice on how you can reduce your energy use to lower your bills but still stay warm in your home. Support is also provided to households to see if they are eligible for any support to make energy efficiency improvements to their home, including insulation and central heating[12].

Evaluation and evidence: none.

Case study 7: Helping Sickle Cell Patients with the Cost of Heating via the Mayor of London’s Warmer Homes Programme and the Lambeth Sickle Cell Support Scheme

Key details: grants for energy efficiency measures available to people with sickle cell disease in London.

Organisation(s): Mayor of London, Lambeth Council, various NHS trusts in London

Location(s): London

Duration: Mayor of London Warmer Homes Programme, 2022 – present; Lambeth Sickle Cell Support Scheme, 2023 – present

Who it supports: People with sickle cell disease living in London generally (for the Mayor of London’s Warmer Homes Programme) and Lambeth specifically (for the Lambeth Sickle Cell Support Scheme).

What is delivered: The Mayor of London’s Warmer Homes Programme explicitly recognises haemoglobinopathies, including sickle cell disease, as eligibility criteria because cold exposure is a known trigger for pain crises.

The Programme provides grants of between £5,000 and £25,000 to eligible low income homeowners and private tenants, with funding amounts depending on existing energy efficiency rating, tenure and fuel type (i.e. gas, electricity, oil or LPG). Options available to those eligible include installation of heat pumps, insulation, and solar energy; heating system improvements or repairs, and draught proofing[13].

The Lambeth Sickle Cell Support Scheme provides residents with sickle cell diseases non-clinical support to help them avoid crisis and improve their health and wellbeing. The support provided is designed alongside residents and may include receiving energy efficiency measures, advice to maximise incomes or financial support to help with energy bills and other associated costs[14].

Evaluation and evidence: none

Case study 8: The Clean Air Clinic

Key details: paediatric clinic in Liverpool for patients whose recurrent illness is suspected to be linked to environmental exposures, running since 2021.

Organisation(s): Alder Hey Children’s Hospital Trust, plus collaboration with multiple health pathways (health visitors, GPs, Emergency Department, and paediatric clinics), local authorities, landlords and housing associations.

Location(s): Liverpool

Duration: Ongoing, founded in 2021

Who it supports: This is a service for patients whose recurrent illness is suspected to be linked to environmental exposures. Referrals typically involve children with recurrent wheeze, asthma or respiratory infections. While some cases are linked to outdoor air pollution or industrial emissions, most are related to poor housing conditions – particularly damp and mould. Patients are referred through multiple pathways, including via health visitors, GPs, Emergency Departments, and paediatric clinics[15].

What is delivered: Paediatric respiratory consultant, Professional Ian Sinha, formed the initiative after observing that a significant proportion of his work involved addressing environmental and housing issues. Each consultation involves a detailed clinical history, environmental history, integrated assessment and report. Video calls enable the team to visualise the home environment, focusing on problematic areas such as damp, mould, ventilation, and smoking/vaping, as well as travel and transport. Families are asked to provide photographic evidence which is included in the written report.

The clinical reports produced serve as evidence-based advocacy tolls that are shared with councils, landlords, and housing associations, either by the families themselves or by the clinic directly, to trigger environmental interventions. This collaborative approach with councils, housing associations, and communities is vital, and requires proactive engagement and the trusted relationships to support the navigation of complex bureaucracy. Further, this approach represents a culture shift which sees paediatric clinicians stepping outside of hospitals to tackle the root causes of illness in partnership with the systems that shape children’s environments[16].

Evaluation and evidence: see case study 9 below.

Case study 9: Children’s Environmental Assessment Service

Key details: paediatric respiratory clinic in East London which monitors pollution levels and their effects on patients, operating since 2023.

Organisation(s): Royal London Hospital

Location(s): East London

Duration: ongoing, opened in 2023

Who it supports: Children who have, or are at risk of developing, asthma.

What is delivered: The clinic was developed by Professor Jonathan Grigg, a researcher in air pollution and child health, and Dr Abigail Whitehouse, a paediatric respiratory consultant and senior clinical lecturer, to integrate environmental health research into clinical practice. The clinic monitors pollution levels and their effects on patients. It assesses both outdoor and indoor pollution exposure and aims to provide data-driven assessments of environmental exposure risks and potential mitigation strategies[17].

The one-hour appointment includes a full medical history and examination. Following this, there is a home visit to deliver and set up portable air quality monitors (which will be used over a three-day period), take relevant environmental photographs and conduct mould sensitisation tests. A separate appointment for mould blood tests is arranged, and children are brought back to clinic for follow up. The intention is that the accumulated information will create a picture of a child’s risk, and that the data can be used to inform bespoke recommendations on reducing exposure and supporting housing and lifestyle changes. By monitoring pollution levels both in the home and at school, the team produces an exposure report for each child. They then work with the child and their family to find ways of reducing their level of exposure.

Evaluation and evidence: The Royal College of Paediatrics and Child Health (RCPCH) have reported on both the Alder Hey and Royal London Clinics[18]. The report combines findings from interviews with clinic teams (n=7), a survey of paediatricians (n=24), and engagement with children, young people, and families.

The RCPCH report highlighted that the two clinics demonstrate how a dedicated, multidisciplinary approach can address the environmental determinants of health. The importance of personalised reports, collaborative advocacy, and extended, dedicated consultation is emphasised, with the result of these efforts including securing families improved housing and reduced exposure to harmful environmental conditions.

The report does, however, note sector-wide challenges. Despite socioeconomic deprivation, poor housing conditions, and high pollution exposure serving as significant barriers to good child health, these issues are often unaddressed in routine care. This is due to time constraints, limited training, and systemic resource pressures. Furthermore, these current models rely on charitable and academic funding and a small number of expert clinicians. As a result, without sustainable funding and dedicated training, replication across the NHS will be a challenge.

Nonetheless, the report concludes that the clinics offer valuable insights into cross-sector collaboration, holistic assessment, and patient empowerment. Children and young people and parents involved in the study discussed the importance of collaboration between multiple public services. Families are often scared to raise the issue of substandard housing due to fear of eviction and also found some housing services to be dismissive of complaints around conditions. The two clean air clinics’ combination of personalised, evidence-citing reports and more influential points of contact within housing and council organisations has led to faster and more productive interventions. It was also noted that the existence of the clinics serve to validate the concerns of families, while having clarity on the links between housing and health reduces the associated stigma.

All Clean Air Clinic clinicians agreed that education around environmental and social determinants of health were key outcomes of the clinics. This could include educating allied health professionals and working with partner organisations (such as existing collaborations with Global Action Plan) to create training materials. It could also specifically include upskilling paediatricians by embedding environmental health into the general paediatric curriculum and exams[19].

Case study 10: Home Energy Scotland Energycarer Service

Key details: specialist energy advice service for vulnerable households established in 2017 operating in Scotland.

Organisation(s): Home Energy Scotland (HES), and collaboration with local partners including the NHS, social services, local housing networks, and advice providers.

Location(s): Pilot projects took place in Annandale & Eskdale (South West Scotland) and Moray East (North West Scotland), since rolled out in the rest of Scotland.

Duration: Ongoing, pilot in 2017-19

Who it supports: Energycarers are specialist energy advisors who can provide intensive support to acutely vulnerable households with issues relating to physical or mental health, disability, family circumstances, low income and expensive heating. Often these are householders who are likely to require more than one face-to-face visit and are less able to make full use of the free phone service and website[20].

Referrals come internally from HES, but the service is also promoted among local partners including the NHS, social services, local housing networks, and advice providers.

What is delivered: Energycarers work to help householders achieve affordable warmth, so they can afford to keep their home at a comfortable and healthy temperature.

The service works in partnership with local organisations, so HES looks first to access support through local partner organisations before arranging a home visit. If no partner is in place and a visit would be helpful, an Energycarer meets the householder, sometimes with a relative or carer present, to look at how their home uses energy and see what could be improved.

The Energycarer supports the householder during the initial energy check and throughout the process of any changes made to their home heating or insulation. They work with the householder to make sure they can control the temperature in their home and find the best energy tariff.

Energycarers help householders to:

Find funding for energy efficiency improvements or home repairs through Warmer Homes Scotland and other funds.
Prepare their home for work to be carried out.
Approach their private landlord about energy issues.
Resolve fuel billing issues[21].

Evaluation and evidence: In 2019 the University of Edinburgh undertook an evaluation of the pilot project[22]. The evaluation involved: social survey (17 pre-intervention, 13 post-intervention); internal temperature monitoring with households receiving the service and a control group receiving a standard HES Community Liaison Officer service; interviews (n=3) with the HES Homecare team; a series of case studies, and a live learning document compiled by the HES Homecare team. However, it should be noted that the social survey and internal temperature monitoring did not reach the number of participants required for statistical analysis, which means that the findings from this aspect of the evaluation do not form a robust basis for policy development.

The pilot struggled to reach the numbers targeted, demonstrating the challenges for identifying and supporting vulnerable groups in rural areas with a high index of multiple deprivation.

A critical part of the Energycarer’s role was to establish partnerships with community and healthcare organisations in the region. The relationship between health and social care providers in Moray took time to develop, and the HES Homecare team reported that this delayed referrals. As such, the majority of referrals still came through Home Energy Scotland’s existing database of clients. The findings showed that it can be difficult to maintain partnerships with the variety of organisations that could potentially help in making referrals. At interview, the HES Homecare team reported that it could be challenging to maintain these partnerships whilst also managing customer journeys. As such, the pilot suggests that a more systematic strategy, including support for public health and social care services operating in liaison with neighbourhood and community organisations is very important.

Through HES Homecare, the residents received additional support through the processes of applying for funds and receiving interventions in the home. One of the HES Homecare team noted that “the freedom to spend time with the householder, to establish that relationship of trust and to support them every step of the way” was one of the main benefits of the scheme. This type of service was also highlighted as particularly important for a resident with chronic fatigue who made progress in receiving additional benefits with the help of regular reminders and Energycarer support. Having a consistent and personable level of support was identified by the HES Homecare team as a critical aspect of this service. However, while effective, the individual case approach applied through HES Homecare is resource intensive. As a result, the evaluation found that work needs to be done in order to develop a stronger area-based approach and to utilise existing local networks and services more efficiently for the coordination of an area-based strategy[23].

Case study 11: South Tyneside Welcoming Places Warm Banks Scheme

Key details: warm banks held across 70 venues in South Tyneside, launched in winter 2022.

Organisation(s): South Tyneside Council and 70 venues including community spaces, council buildings, family hubs, libraries, and local businesses. The Welcoming Place scheme built on preexisting organisations and locations; by expanding existing programmes to include a warm bank offer and developing other services and activities.

Location(s): South Tyneside

Duration: Ongoing, launched in winter 2022

Who it supports: Local residents who cannot afford to heat their homes. Although the project is described as a health intervention, no detail is provided on how targeting for the service was carried out.

What is delivered: South Tyneside’s Welcoming Places scheme was launched in winter 2022 in response the cost-of-living crisis. Warm banks, also known as warm spaces or warm hubs, are a relatively new type of health intervention to support those experiencing fuel poverty to stay warm for free if they cannot afford the heating in their homes. As well being a place for people to stay warm, Welcoming Places also set out to be spaces where people can socialise, access support and advice, and give back to their community[24].

Evaluation and evidence: A small qualitative analysis of the scheme was published by Teodorowski et al in 2024[25]. The evaluation of the project consisted of two stages. In stage 1, semi-structured interviews (n = 16) were conducted with residents who attended Welcoming Places and two focus groups with people running them (n = 9). In stage 2, the initial findings from stage 1 were discussed in a focus group with residents (n = 8).

The evaluation found that attendance numbers were higher during colder weather. Most participants felt they could use Welcoming Places as an alternative to putting heating on at home and to stay warm during the cold months. The ability to stay warm was of particular importance to the interviewed residents who had underlying health condition which required them to stay warm, they said:

“…with having leukaemia you feel the cold, the pressure of paying your bills, I mean I know we got help last year from the government but it was still pressure to pay the bills, you know. And it was just a couple of hours where you are not spending your money but you are keeping warm.”

Staying somewhere warm allowed participants to stay active; this included with activities organised by the Welcoming Places that encouraged attendees to stay physically active:

“[T]hey have Pilates here, but you couldn’t do that unless the place was warm, (…) we have a sewing group here, a knitting group, we do keep fit, which is fantastic for the old people.”

Another major benefit that many discussed was the positive impact on mental health and wellbeing. The Welcoming Places offered an opportunity for residents to socialise with others and avoid isolation at home. For some, the community offered by the Welcoming Places was crucial as they reflected on the social isolation that had developed since the COVID‐19 pandemic. One resident said:

“You know you can come in on your own, and somebody will straight away say hello and ‘how are you’ and, and you don’t feel alone. Which to me, makes me feel really comfortable.”

Overall, through this evaluation, it became clear that, in addition to providing a warm place to spend time and affordable food, the Welcoming Places had a significant impact on the mental health and well‐being of residents. Many residents spoke highly of the community and friendships that had been built while they attended their local Welcoming Place.

Case study 12: NHS Hastings and Rother Clinical Commissioning Group (CCG) Healthy Homes Programme

Key details: heating and insulation measures delivered to 146 households in Hastings and Rother over an 18 month period from October 2016.

Organisation(s): NHS Hastings and Rother Clinical CCG, Winter Home Check Service ran by East Sussex Council Public Health team, Hastings Borough Council

Location(s): Hastings and Rother

Duration: Project was established in October 2016 as an 18-month pilot

Who it supported: The programme was targeted at poor condition properties in the private sector (owner-occupiers and private tenants) where fuel poverty is an issue due to unsatisfactory heating, poor thermal insulation, and generally poor energy efficiency.

What it delivered: The pilot project funded installation of major heating and insulation measures, through the Winter Home Check Service. The programme aimed to reach at least 148 properties in wards with the highest number of fuel poor households in Hastings and Rother (i.e. Braybrooke, Castle, Gensing, Old Hastings, Central St Leonards, and Bexhill Central). Major measures funded by the programme included: cavity wall insulation, hard-to-treat cavity works, loft insulation, floor insulation, solid wall insulation, full central heating systems, central heating boiler replacement, and storage heaters[26].

Evaluation and evidence: The University of Brighton were commissioned to carry out a single-cohort mixed-methods evaluation, with before and after data collection points[27]. The results of the evaluation were published in 2019. Data collection for the evaluation was carried out via three main phases: baseline (pre-intervention) survey data collection (n=146); follow-up (post-intervention) survey data collection, and follow-up qualitative data collection (23 interviews with beneficiaries, 12 with stakeholders).

To assess health and wellbeing, a general health status question and the Warwick-Edinburgh Mental Wellbeing Scale were used. Baseline data were collected before any heating and/or insulation work had started and follow-up data were collected after all intervention work was completed. Self-rated health and wellbeing in beneficiaries increased significantly from 2.0 and 39.3 respectively, to 2.9 and 42.5 post-installation. Interestingly, health and wellbeing of those who had a minor measure installed, in addition to a major measure, benefitted more than those who only had a major measure installed.

23 beneficiaries were interviewed about their experiences of the programme and the impact that the new system has on their lives. Clear examples were provided of the positive impacts on physical health and wellbeing including people reporting fewer chest infections, reduced pain, feeling less anxious and depressed, and generally feeling happier and more relaxed. Interviews also highlighted broader areas of impact such as reduced social isolation, increased use of domestic space, and an increased sense of control.

12 interviews with key stakeholders of the programme were carried out to gather information on the delivery of the programme. A particular strength of the programme included the development of strong partnerships within the statutory and voluntary sector, which was viewed as essential for the scheme to be successful. It’s successful delivery was due to its integration within an already established service with existing partnerships and referral networks (the Winter Home Check Service). One stakeholder said:

“I think the main achievements are that we always said that we would want to deliver this at the greatest scale that we could, but in partnership and building on the existing relationships that exist between statutory and voluntary and community sector organisations, so it is added value, it is aligned, it is enhanced support for vulnerable people in our most deprived communities”.

Case study 13: Keep Warm, Keep Well

Key details: fuel poverty dashboard and energy advice service built into NHS structures to support vulnerable patients in Staffordshire since 2016.

Organisation(s): Beat the Cold, Staffordshire Community Energy (SCE), University Hospitals of North Midlands (UHNM)

Location(s): Staffordshire

Duration: Ongoing, launched in 2016

Who it supports: Vulnerable patients identified by healthcare professionals.

What is delivered: Keep Warm, Keep Well is a programme coordinated and part funded by Staffordshire Community Energy with support from University Hospitals of North Midlands and delivered by Beat the Cold. As well as demonstrating multi-agency collaboration, it is an interesting example of innovative funding, utilising a model where surplus income from SCE’s community-owed solar panels on University Hospitals of North Midlands buildings is ringfenced to fund local fuel poverty support, with additional funding provided through the Energy Redress Scheme. Any surplus income from the hospital PV installation is ringfenced in a dedicated community benefit fund, which cannot be used for any purpose other than addressing fuel poverty in Staffordshire[28].

The programme is designed to work within NHS systems, not alongside them, with fuel poverty being treated as a routine health issue, not an external referral. Patient cohorts are identified via One Health and Care shared care record (Graphnet), this is a fuel poverty dashboard embedded within NHS digital systems. Health and community professionals such as GPs, social prescribers and local charities can then refer patients to the service with this digital referral pathway becoming part of routine NHS activity.

Once referred, Beat the Cold provides tailored energy advice, practical support and advocacy with energy suppliers. Help can include fuel vouchers, energy debt management, water bill reductions, and small home improvements such as draught proofing or radiator foils.

Evaluation and evidence: An evaluation of the service was undertaken by the University of Staffordshire’s Centre for Health and Development (CHAD) and published in 2025[29]. Evaluation is based on the analysis of routinely collected data from 406 households, an in-depth survey from 108 participants, 24 participant interviews and 5 stakeholder interviews.

Based on the survey completed by 108 participants:

84% indicated that they received enough information from Beat the Cold on how to stay warm and well during the winter.
64% felt that Beat the Cold had a positive impact on reducing energy costs.
86% felt that Beat the Cold has helped their ability to stay warm in winter.
Participants who received financial support were 15 times more likely to report that they stayed warm and well during winter.
Provision of information appeared to be even more effective: individuals who felt they had received sufficient information reported they were 43 times more likely to improve their ability to stay warm.

Following support from Beat the Cold: 62% said their wellbeing and life satisfaction had improved; 48% said their physical health had improved, and a further 40% reported that their physical health had not deteriorated.

Through the self-report survey, the evaluation sought to assess the impact of the service on healthcare service provision. However, challenges with the data meant that it was not possible to analyse the findings in relation to healthcare impact with confidence. This was primarily due to limitations associated with the use of survey-based data when examining pre and post healthcare service use, including potential response bias, low response to health service use questions, and difficulties when triangulating the self-reported healthcare service use information.

Looking at the qualitative data, participants often emphasised that the ability to keep warm was not only a matter of comfort, but had a significant impact on health, particularly for those living with chronic or age-related conditions. In several cases, Beat the Cold’s support, whether through direct energy payments or practical advice contributed to easing physical symptoms and improving overall wellbeing. One participant with fibromyalgia described how the increased warmth in their home helped relieve pain:

“Physically it helps as well because with the fibro…I’m so sensitive to hot and cold, when I’m cold, my bones and the muscles ache. So it was helping being able to have that little bit of extra warmth…it helped with my physical pain barrier…it sort of has had a ripple effect. It helps with other things, not just the financial thing”.

Participants reported that Beat the Cold’s support had a substantial positive effect on their mental health. Many described feeling less anxious and stressed because of receiving financial assistance with energy costs, which helped ease the burden of bills and everyday expenses. The service from Beat the Cold is described as empathetic, tailored, and human-centered, often going beyond energy advice into broader emotional and social care. For individuals with mental health challenges or concentration difficulties, the ease of the service was particularly significant. One participant shared how much they appreciated that much of the effort was made on their behalf, reducing their own burden[30].

Case study 14: Seasonal Health Intervention Network (SHINE) Islington

Key details: a fuel poverty service for London residents with complex health, income, and housing pressures, launched in 2010 and expanded in 2026.

Organisation(s): Islington Council, North Central London ICB, GP surgeries and primary care networks (PCNs), social prescribing teams, local authority adult social care, as well as a range of partner agencies delivering energy advice, including Age UK Islington, Energy Saving Trust and Citizens Advice.

Location(s): Islington initially but now extended throughout London.

Duration: Ongoing, launched in 2010 and expanded in 2016.

Who it supports: The service targets London residents facing the greatest health, income, and housing pressures. Eligibility criteria is as follows: household income below £31,000; receiving means-tested benefits; a household member who has a disability OR has a long term health condition worsened by the cold OR is a child under 15 OR is an adult over 60 OR spends more than 10% of income on energy.

What is delivered: A fuel poverty and affordable warmth service which supports residents with complex health, mobility and safeguarding needs[31]. The service aims to provide holistic support for vulnerable adults, modelling the service on four key elements:

Holistic strategy addressing fuel poverty – targets energy issues plus cascading social and health harms to improve quality of life.
Long-term solutions beyond financial aid – combines energy efficiency, health referrals and wellbeing support to reduce short-term dependency.
Addresses broader consequences – mitigates poor nutrition and declining mental and physical wellbeing linked to fuel poverty.
Sustainable quality of life improvements – this is the ultimate aim of the service, a multi-dimensional approach to make outcomes lasting and reduce repeat crisis support[32].

The project has focused on embedding itself within health and social care systems, providing a one-stop referral system for the NHS and third sector to help them provide affordable warmth and seasonal health interventions to London residents. The service has supported uptake of NHS primary care referrals through refresher sessions, simplified prompts, and troubleshooting with practice managers.

The service provides the following services:

Energy-saving advice.
Help accessing grants for heating and insulation.
Support with energy bills and debt.
‘Energy doctor’ home visits to install energy-saving measures and offer tailored advice.
Referrals for Warm Homes grant.
Falls assessment.
Fire safety checks by the London Fire Brigade.
Air quality alerts for people with respiratory conditions via airTEXT.
Handyperson service for minor home repair.
Thermal imaging scans, used to detect key areas of heat loss in your home[33].

Evaluation and evidence: much of the publicly available evidence on SHINE is now relatively dated. There is some recent descriptive evidence, which summarises that across London in 25/26, the service created total estimated savings of £849,445; energy costs savings vis home visits of £421,249; over £47,361 worth of debt retrieved, and 470 fuel vouchers issued worth £18,800[34].

[1] It’s not clear how the Scottish definition of fuel poverty is factored into this calculation.