Prepayment meters (PPMs) have traditionally been installed in low-income households and those that have previously incurred arrears or defaulted on their energy bills. However, PPM users have often faced higher charges for energy, as well as a reduced ability to switch supplier and access incentivised payment methods such as direct debit. In 2016, the Competitions and Markets Authority imposed a settlement on energy companies to introduce a fairer approach.  

The introduction of the Heat Network (Metering and Billing) Regulations 2014 meant that owners of properties operating district heating schemes were subject to new obligations. It has been assumed that such schemes deliver benefits to residents through reduced energy consumption and lower bills, thus helping to alleviate fuel poverty, but the actual dynamics of tenants’ awareness, knowledge and engagement with the practical and financial aspects of these systems are not fully understood.

Domestic energy consumption continues to generate a significant proportion of the UK’s carbon emissions. Since the start of the century, considerable investment has been made in increasing household energy efficiency and promoting energy conservation. Despite this, emissions from gas heating sources remain unchanged, and energy consumption is rising in some areas.

Although solid wall insulation (SWI) is known to have a positive impact on domestic energy efficiency, its installation is technically demanding and, in practice, disruptive to residents. The introduction of the national ‘Green Deal’ and Energy Company Obligation schemes from 2012 brought significant emphasis on the installation of energy efficiency measures in domestic properties, particularly where the household was at risk of fuel poverty or the building was eligible for improvement.

The Winter Fuel Payment is a universal payment made to all UK households where the primary occupant is over 60 years of age. Introduced in 1997, it is intended to offset the cost of domestic heating for older people and thereby reduce the risk of fuel poverty and attendant impacts on health in this section of the population. However, as a non-means-tested benefit, it is available to more affluent households who have no need of the supplement.

Living in a poorly heated, damp home is known to place householders at risk of developing ill health. Those with pre-existing conditions, particularly respiratory illnesses, can experience aggravations of their symptoms and an increased likelihood of mortality. However, there is a paucity of information on the energy performance of the homes of such people and the exact relationship between their heating arrangements, health status and other variables. 

Cold homes are believed to be a significant factor in excess winter deaths recorded in the UK, and low internal and/or external temperatures are associated with ill health, but it has often been a challenge to demonstrate a causal link because of the complex variables involved and the prohibitive expense of dedicated research. It is often assumed that low-income households are at a high risk in this respect, being less able to afford to heat their homes or pay for improvements and more likely to live in properties in poor repair.

‘Affordable warmth’ is a term widely used in the energy sector, yet, given the wide variety of property types and sizes, incomes and locations, measuring what is affordable for a given household is a complex process.

Chronic obstructive pulmonary disease (COPD) is a long-term degenerative condition that reduces the airflow into and out of the lungs. It remains a major challenge for health services; the level of mortality is far greater than that observed among asthma sufferers. Mortality among COPD patients is twice as high in summer as in winter, and the progression of the disease is much more rapid, suggesting the influence of seasonal effects.

Many low-income households are also in fuel poverty and fuel debt. They can often face the conundrum of needing to reduce the amount they spend on domestic energy while at the same time being unable to afford the cost of installations that would potentially achieve the necessary savings. However, if funding to carry out such work can be justified, this challenge may be overcome.