Boiler on Prescription
In late 2011, while making coffee in our staff kitchen, I happened to ask my Director, Sally Hancox, “Do you think we’ve stopped folk turning up as much at their Doctors, now they have had the home retrofitted with energy efficient measures?” We have gathered a tremendous amount of anecdotal evidence from our retrofit programme to suggest people with conditions made worse by the cold were now managing their conditions better. However, as presented, it was worthless to the NHS… Sally’s response “No idea, go and find out”.
Now my first question was, who do you ask to see if 2000 people had stopped turning up at the Doctors? The answer is your local Clinical Commissioning Group (CCG). Once we explained what we were investigating they quickly started generating some very worrying figures.
I should start by telling you that Gentoo is social business with a vision to improve people's lives through a range of housing and social investment initiatives and we manage 30,000 homes in Sunderland. In the year previous 2010/11, 1 in 3 of our residents had accessed A&E in the area we were improving, against 1 in 7 in a control group from non-Gentoo residents in another part of the city. Meaning a person was twice as likely to seek emergency help if they were a Gentoo resident. Even accepting that we will have a higher proportion of elderly residents, that can’t be right. We were also told that Hendon one of our most deprived neighbourhoods had an average life expectancy of 67 compared to an average of 80 in Fulwell, just a mile and a half down the road.
Understanding these statistics it became very clear to me that it was no longer enough to wish we could do something about this. As an ‘Art of Living’ business we have the opportunity and the responsibility to be able to try something new. How do we help make people feel better?
Looking at the anecdotal evidence and speaking with the CCG we started to explore the idea of what if a Doctor could prescribe environmental improvements to homes. What would need to happen? Could it happen? Who would we ask? Who would pay? Did it have potential to make an impact? What would success look like? How does it allow Gentoo to achieve its Art of Living vision?
It transpires that the CCG can commission any service they believe will improve the health of the people they are responsible for in their locality. There clearly has to be a rationale behind their decision and the ability to demonstrate success. That was all the encouragement we needed to pursue the concept of “Boiler on Prescription”.
Now not being short on naivety and having enthusiasm by the bucket load, we started to work with the NHS on creating a scheme. Two traits that would serve us very well. As what I had genuinely failed to appreciate is just how big and complex the NHS is. Asking them to work on a small and innovative project is difficult due to the governance required in order they can protect patient confidentiality. However it’s not impossible and together we’ll persevere. The below is proof.
So here we are. Six homes improved, six individuals who before the work was undertaken had accessed the NHS 63 times in the previous six months. Six households who’s Art of Living is being improved by a joint approach to housing and health. We are genuinely excited about the results we are expecting over the months ahead.
The next time I speak to Sally in the kitchen I think I’ll ask about the football….