Health service leaders are pressing for extra government support, as the NHS faces up to the two-pronged impact of a looming energy crisis: rising demand from patients hit by the ‘heat or eat’ effects of fuel poverty, and rocketing costs from suppliers.

The likely impact of the government’s current stance on raising the energy price cap for consumers prompted Sam Allen, chief executive of the North East and North Cumbria Integrated Care Board, to write to regulator Ofgem last week. 

In her letter Allen expresses concern that energy supplies being cut would be “life-threatening” for many clinically vulnerable people, and put added pressure on a health sector that – in the words of NHS Confederation chief executive Matthew Taylor – is already “likely to experience the most difficult winter on record”. 

“[We] are starting to see examples where clinically vulnerable people have been disconnected from their home energy supply, which has then led to a hospital admission,” Allen says. “This is impacting on people who live independently at home, with the support from our community health services team, and are reliant on using electric devices for survival.

“Put simply, the impact of having their energy supply terminated will be life-threatening for some people, as well as placing additional demands on already stretched health and social care services.”

And last week saw similar initiatives to Allen’s launched across the health sector, all calling on the government to take urgent action.

University College London’s Institute of Health Equity published a report warning that 15m people – that’s 55 per cent of households – are expected to experience fuel poverty by the beginning of next year, leading to a “significant humanitarian crisis” because of the increased risk of respiratory and cardiovascular illnesses caused by living in cold homes. The institute called for extra funding for local government to address the crisis.

That report followed on from a letter to chancellor Nadhim Zahawi from the NHS Confederation in mid-August, warning that the country could soon face a “humanitarian crisis” of poor health, excess deaths and increasing social inequality unless the government took immediate action, and noting that the health service in England already spends £1.3bn each year treating preventable conditions caused by cold, damp homes.

Assessing the likely impact on the NHS, the confederation’s chief exec Matthew Taylor said in the letter, “NHS leaders have made this unprecedented intervention as they know that fuel poverty will inevitably lead to significant extra demand on what are already very fragile services. Health leaders are clear that unless urgent action is taken by the government, this will cause a public health emergency.”

To back up its argument, the confederation explained how fuel poverty risks creating a ‘vicious cycle of healthcare need’: a patient presents at their GP with a chest infection from a mouldy bedroom, the GP treats the infection but the patient goes back to sleeping in the same bedroom, and so the infection recurs. The NHS then treats the symptoms again but, without treating the source of the problem, the symptoms continue to recur.

Given its earlier positioning, the government perhaps shouldn’t be too surprised by the strength of the health sector’s reaction to the energy crisis and the knock-on effects of fuel poverty. Last year the government launched the Sustainable Warmth: Protecting Vulnerable Households in England report, which acknowledged that warmer homes can reduce the frequency and severity of health problems. And Public Health England’s regular Cold Weather Plans over the past decade offer ample evidence of the financial costs to the NHS of increased levels of illness due to cold weather – and also the relatively modest cost of repairing every household which currently has a ‘hazard’ rating for excess cold.

But regardless of the new Truss administration’s approach to raising (or freezing) the energy price cap for individual consumers, both the NHS and the social care sector face rapidly rising (and, as corporate customers, unlikely to be capped) energy costs that could see the level of service each sector is able to offer the vulnerable being severely constrained this winter. 

Research by the BMJ published last week showed some NHS trusts will now need an extra £2m each month, because their energy bills will be up to three times higher than last winter. A spokesperson for the NHS Confederation told the publication that these costs would “wipe out large parts of the NHS budget” and that – unless the government offers help – trusts will have no choice but to cut back on services. 

The BMJ found that Leeds Teaching Hospitals NHS Trust is preparing for increased gas and electricity costs of more than 100 per cent, while Nottingham University Hospitals NHS Trust has budgeted for an even larger rise – 214 per cent. 

Figures obtained separately by ITV show four out of Wales’ seven health boards are expecting rises of more than 200 per cent, and an FoI request by the Metro website has revealed that Manchester University NHS Foundation Trust is expecting a £4m hike in its energy bill over the next financial year.

And while NHS England has budgeted for a major increase in energy costs, its assessment back in May of the likely overspend – £485m – now looks hopelessly optimistic given the bleak forecast for the coming months, especially with no hope of prices being capped. 

Even worse, those awaiting the government’s new social care strategy, designed to ease the strain on the NHS, will draw little comfort from news last week that many care homes could be forced to close because of sky-high energy bills – said to be up in some cases by 600 per cent – unless the state intervenes.

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