Is the cold weather costing the NHS £1.36 billion a year?

Published: 23rd Nov 2012

"Cold homes cost the NHS in England £1.36bn every year in hospital and primary care admissions due to their "devastating impact" on older people's health. [...] Each year in England and Wales there are about 27,000 extra deaths each winter, mostly among older people."

BBC Online, November 22, 2012

NB: This article was updated on November 27, 2012

Age UK's annual Cost of the Cold report, released on Thursday, shed light on the devastating - and often fatal - impact winter can have on elderly people. The BBC reported 27,000 excess deaths from cold weather for each winter. The figure has varied considerably through the years; and most recently the ONS reported 25,500 winter excess deaths for England and Wales for the winter of 2010/11. 

We've mapped the most up-to-date data by region. The data also includes an excess winter mortality index, which is calculated as excess winter deaths divided by the average non-winter deaths, and expressed as a percentage.

The main causes of death for the elderly who die in winter are, according to Age UK, strokes, heart diseases and lung problems, worsened by the cold. The organisation also expressed concern at the fact that countries with much colder winters, such as Finland, present lower winter excess deaths, suggesting the situation in England and Wales could be improved.

Poorly-insulated homes and people having to cut back on heating to save money, due to the increase in energy bills are blamed for the annual crisis. 

The general trend for excess winter mortality has continued to generally improve in the last 60 years as the graph below shows us.

The charity acknowledges that with death rates falling since the 1950s, progress has been made thanks to new measures to insulate homes.

Curiously, though poorly insulated homes are identified as one of the main culprits, the report goes on to say that their estimate of costs to the NHS "does not take into account recent improvements in home insulation, which might be expected to lead to a slightly lower estimate."

Which brings us to how these costs were calculated. 

Costs to the NHS

This is what Age UK wrote in their report:

"Age UK updated their figure (£859 million) using 2011 household numbers estimates for England (Office for National Statistics) and the GDP deflator (from HM Treasury's website) to inflate the estimates to 2011/12 prices. Age UK's new figure does not take into account recent improvements in home insulation, which might be expected to lead to a slightly lower estimate."

When we initially asked Age UK for more details on how they calculated the estimate, we were advised to contact the Department of Health (DH).

The DH pointed us to the 2011 Cold Weather Plan for England, which they say contains a current estimate for 2011 on annual cost to the NHS of treating winter-related disease due to cold private housing. The plan cites a considerably different figure - £850 million - which is roughly two-thirds of the cost cited by Age UK. The source for this estimate is the 2009 Annual Report of the Chief Medical Officer (CMO).

How did Age UK come up with that number? 

The oft-quoted figure of £1.36 billion - purportedly the cost to the NHS of cold weather related illnesses - was calculated by the chief economist of Age UK, José Iparraguirre, "using the method described in South East Regional Public Health Group Factsheet (2009) Health and Winter Warmth.

This pamphlet isn't currently online, and when we established contact with Mr Iparraguirre, he was able to send us an attachment. According to the factsheet, published in December 2009, excess cold hazards cost £859,105,100 a year to the NHS in England. However, the estimate was based on prices from 2005/6 and household numbers from 2001 which was said to be around 16.1 million, though the 2011 Census put this figure at 20.5 million.

Age UK therefore re-estimated the cost to the NHS using the latest (Census 2011) estimates for household numbers and HM Treasury's GDP deflator to inflate the cost estimates to 2011/12 prices. The result was £1,362,139,906.

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Flickr image courtesy of Daniel Paquet

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