Fuel poverty is strongly linked to a range of health conditions. Local authorities have been and remain at the forefront of initiatives to tackle fuel poverty in their localities, whether through awareness-raising, grants or their involvement in social housing improvement initiatives. At the same time, much greater emphasis on partnership working has developed. In recent times, local authorities have acquired responsibility for public health matters.
In 2016, the National Institute for Health and Care Excellence (NICE) released guidelines that recommended that a single point of contact should be established in each local authority area, with responsibility for coordinating a joint strategy that would address fuel poverty and the related health issues. A small number of local authorities have adopted the NICE standards, but, in the absence of any evaluation to date, little information exists on how successfully this approach is being implemented and what strategic, organisational and practical barriers are present.
Key research Question
The dissertation sought to understand the challenges associated with implementing the NICE guidelines and what options exist to make their delivery more attainable through an in-depth analysis of one local authority in the South East of England attempting to introduce a single combined pathway for referral.
Summary of activity
The research first involved a literature review on the role of public-sector-led partnerships in tackling fuel poverty in the UK. Data were then generated through a set of semi-structured interviews with frontline staff within both the local authority and other organisations in Portsmouth, plus additional interviews with workers involved in national fuel poverty initiatives and in other localities where NICE guidelines had been implemented. In addition, a questionnaire was sent to all attendees of multi-agency fuel poverty workshops held in Portsmouth since 2016.
The literature review found that while multi-agency work was common, few areas were explicitly working on the NICE agenda. Major challenges included a lack of leadership and difficulty in building joint work into the competing priorities of partner organisations.
The absence of evaluation in the NICE guidelines makes it hard to assess progress nationwide, but the evidence from ‘exemplar’ areas indicates that while there are challenges, the guidelines can be implemented with sufficient funding and leadership.
The case study of Portsmouth suggested that although progress was being made, combining housing and health, resident engagement, funding and silo working all remained major barriers. In addition, there were significant challenges in bringing local authority and health actors together to co-deliver on fuel poverty. Health and Wellbeing Boards and Clinical Commissioning Groups continue to remain largely separate from local fuel poverty agendas, and this lack of ownership means that the agenda remains predominantly led by local authority housing teams.
A lack of dedicated sustainable funding was likely to prove a major obstacle to successfully delivering single points of referral in many areas, as was the absence of a strong national lead on the issue of fuel poverty. Ongoing cuts to public sector budgets create a risk that agencies will concentrate on their core business and ignore collaboration.
In order to improve the chances of delivering on the NICE guidance and establishing single points of referral, the research proposed a series of measures for local authorities and partners.
An evidence-based case must be made to health services to secure their commitment. Health and social care teams must dedicate staff to a single referral service.
To address the funding constraints, resources should be focused on priority groups of vulnerable residents.
Establishing the continuing support of senior leaders is essential.
Ongoing training workshops with workers from a wide variety of teams across the public and voluntary sectors are key to promoting knowledge of fuel poverty.
How Local Authorities Are Responding to the NICE (2016) Quality Standards Regarding a Single-point-of-contact Approach to Tackling Fuel Poverty – A Case Study of Portsmouth City Council