GPs cut COPD appointments 60% through 'boilers on prescription' scheme

A pilot scheme in Sunderland allowing GPs to prescribe boilers to COPD patients helped reduce their need for GP appointments by 60% over the following 18 months, a report suggests.

Patients Margaret and John Boulton with their boiler prescription: 'This has really changed our lives.'
Patients Margaret and John Boulton with their boiler prescription: 'This has really changed our lives.'

The boilers on prescription pilot scheme – a non-medical intervention commissioned by Sunderland CCG – saw GPs prescribing boilers, double glazing and other home improvements to some of their patients with COPD.

The pilot – run with housing firm Gentoo Group – allowed six properties to be kitted out with upgrades worth an average of £5,000 each throughout January 2014.

Only patients with respiratory conditions that were likely to be exacerbated by the cold and whose house had been given an Energy Performance Certificate (EPC) rating of D or below were eligible for the scheme.

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The EPC is an energy efficiency rating that ranks a property from A – most efficient – to G – least efficient, and is given by a domestic energy assessor.

Selected patients were offered a range of improvements for their homes including energy-efficient boilers, double glazing and insulation to maximise their thermal efficiency.

A report on the trial by Gentoo then compared the outcomes of these six patients and to a control of six other COPD patients who had not received any home improvements.

It found that six months following installation, patients on the scheme experienced a 28% reduction in GP appointments and a 33% reduction in outpatient appointments. Additional benefits included a 42% increase in living room temperature and savings of up to £30 a month in gas bills for affected patients.

After 18 months, the trial showed further benefits, demonstrating a 60% reduction in the number of GP appointments needed by patients taking part in the trial.

GP appointments

A&E attendances also dropped by 25% over this time period, outpatient appointments by 22% and emergency admissions fell by two appointments, equivalent to a 25% drop.

In the wake of the study, a number of other boiler on prescription schemes have been launched over the country, for example in London, Edinburgh, Cornwall and Derbyshire.

The government also announced in March last year £3m funding for a national boilers on prescription programme.

RCGP vice chairman Dr Tim Ballard welcomed the findings. ‘The link between energy efficiency measures that improve the quality of homes or buildings and the health impacts such measures generate is a new field of investigation,’ he said.

‘But a growing body of evidence supports the claims that energy efficiency measures have positive impacts on the health of some of the most vulnerable of our patients.

‘We welcome these findings especially in relation to patient wellbeing and the potential impact on GP workload.’

Margaret Boulton, whose husband John has COPD, was one of the patients helped by the scheme.

She said: ‘If anything good was to come from my husband suffering from COPD, then it’s this scheme. We now have a home with a new efficient gas central heating system. We’re able to heat the whole house for the first time in god knows how long, it’s unbelievable.

‘John still has bad turns when he spends time outdoors in the cold, damp air. But in the house it’s a totally different story now. By this time last year he had been into hospital five or six times – he was really poorly and we had a terrible Christmas. So far this year – touch wood – he’s not been in hospital once and his health is generally so much better. He’s much happier in himself because he’s not suffering.’

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