With fuel poverty having a devastating impact on people’s physical and mental health, a Birmingham initiative is supporting those who are unable to keep warm and well at home.

If you can’t afford to heat your home, it won’t just affect your ability to keep warm. It can severely impact your physical and mental wellbeing, too. With fuel poverty affecting an estimated 6 million people nationwide, Cadent – the country’s largest gas distribution network – recently released new statistics from its Energy Diaries insights series. It revealed that almost one in three Brits feel their physical health has been negatively impacted by decisions to save money on heating their homes.

How fuel poverty impacts health

“There’s a strong link between fuel poverty, cold homes and health,” says Phil Burrows, Head of Vulnerability and Social Purpose. “A cold home is a damp home, which exacerbates conditions such as asthma and bronchitis. Evidence suggests that it can also lead to heart problems and respiratory illnesses. Plus, if you’re living in a cold and damp environment, it can have a detrimental effect on mental health.”

Surprisingly, fuel poverty could also have an impact on hospital beds in the UK. If a patient is hospitalised due to an illness caused by living in a cold house, for example, doctors will be reluctant to discharge them back home where their condition could worsen. It’s the same for patients without a working fridge, as they won’t be able to store their medicine at the correct temperature.

There’s a strong link between fuel
poverty, cold homes and health.

Offering vulnerable Birmingham residents support

Last September, Cadent and the Cadent Foundation joined forces with Birmingham Community Healthcare NHS Foundation Trust Charity to create a brand-new service called Well & Warm. The £2.4 million initiative aims to provide in-home energy efficiency interventions over the next two years for Birmingham residents living in fuel and general poverty. Birmingham was chosen as a pilot because the West Midlands has the highest fuel poverty rate in the country.

At the heart of the initiative is the Direct Access to Wellbeing Services Team (DAWS), which operates in the community and hospitals across Birmingham. Health practitioners — including doctors, nurses, midwives and health visitors — can now refer those in fuel poverty to DAWS for help and advice. 

Holistic approach to fuel poverty

“DAWS provides energy support to those living in vulnerable situations, helping them to get the best out of their home heating solutions,” explains Burrows. “The team signposts to general medical guidance while working alongside Cadent experts to ensure gas appliances in eligible patients’ homes are checked and serviced to confirm they are safe and working efficiently. Additionally, the initiative ensures patients receive financial guidance, as well as health and carbon monoxide advice, ultimately enabling residents to live safe, warm and independent lives at home.”

Burrows adds: “This is a flagship initiative and joined-up, holistic approach to fuel poverty, which we’re committed to rolling out in other areas. We’ve been told by those who have benefitted from it that being able to afford to put the heating on — or having their boiler fixed so that they can be discharged from hospital — is nothing short of life-changing.

How Mandeep got support from DAWS — and her heating back on

Dr Suzanne Cleary

Chief Officer for Strategy and Partnerships & Deputy CEO, Birmingham Community Healthcare NHS Foundation Trust

A mum of six from Birmingham couldn’t afford to have her boiler fixed, which was a catastrophe for her and her family — until the Direct Access to Wellbeing Services (DAWS) team got involved and solved the issue.

When her boiler broke down, Mandeep — a mother of six from Birmingham — couldn’t afford to have it fixed. In desperation, she had to boil kettles for hot water and use electric heaters and electric blankets to keep her family warm. This went on for several months which was a real struggle with six children.

“It’s been incredibly difficult for us to not be able to bathe or keep warm,” says Mandeep. “Even to wash, we would have to fill up buckets of water.” When Mandeep investigated to see if she could get a free boiler, she was told she wasn’t eligible.

Helping people stay well and warm at home

Thankfully, Mandeep’s health visitor recommended that she get in touch with the new DAWS team, which got her heating and hot water back on within three days. Stories like this are heartbreaking in the 21st century but not uncommon — something Birmingham Community Healthcare NHS Foundation Trust has recognised.

Suzanne Cleary, Chief Officer for Strategy and Partnerships and Deputy CEO, says: “Every day, we see firsthand the hard choices people must make with regards to heating their homes and the detrimental impact this can have on their physical and mental health. The DAWS initiative means that we are able to help local people to stay well and warm at home.”

For Mandeep, DAWS was a lifeline. “I wouldn’t want anyone to go through what my family has been through,” she says. “If it wasn’t for the support I received from this team, I wouldn’t be here today.”

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While the weather has taken a turn for the better, the NHS is still feeling the impact of another tough winter where high levels of flu and norovirus piled pressure onto already stretched services.¹

The NHS went into this winter facing record demand across GP surgeries and A&Es. This is fuelled by an ageing and increasingly unwell population, which often has more complex or multiple health conditions for clinicians to manage.

Corridor care has become normalised

Despite their best efforts, NHS staff have had to resort to caring for patients in corridors or overflow wards² — practices that were unthinkable a decade ago. This has sadly become normalised following the combination of rising demand, years of underinvestment and a spike in winter viruses. Corridor care not only compromises patient privacy, dignity and safety but can also leave NHS staff subject to the moral injury of being unable to provide the care they would like to. 

One of the key challenges is the lack of social and community care, which leads to delays in discharging medically fit patients out of hospital. This causes bottlenecks throughout the urgent and emergency care system, which can leave ambulances queuing outside hospitals and patients waiting hours to be transferred to wards from A&Es.

We must make sure that the
NHS does not face another
winter like the last few.

Preventing further tough winters

We must make sure that the NHS does not face another winter like the last few, which have been some of the worst in its history.³ Tackling corridor care will take a concerted effort across the health and social care systems so that patient flow in and out of hospitals can be improved. Work already underway includes setting up same-day emergency care services, urgent community response programmes and wraparound care innovations.

We look forward to working with the Government and NHS England on implementing the urgent and emergency care improvement plan. The NHS will not be able to improve urgent and emergency care performance until the challenges across social care are also addressed. The upcoming Casey Commission into social care is a welcome development, with wholesale reform the only means to achieve the improved adult social care system that the NHS — and the public — needs.

[1] NHS England. 2025. Over 40,000 bed days lost to norovirus last month. 
[2] Royal College of Nursing. 2025. Corridor care: ‘Devastating testimony’ shows patients are coming to harm.
[3] NHS England. A&E Attendances and Emergency Admissions 2024-25.

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