The Price of Poverty - The dire impact of the cost of living crisis in older adults

Dr Chris Hay is the BGS Trainee Policy and Communications rep and a ST6 at Glasgow Royal Infirmary.

The UK is experiencing a cost of living crisis and older people are particularly vulnerable to the impact this has on their health. Age UK estimated that 1.1 million older households were in fuel poverty at the end of 2021. A year later and this figure has almost trebled. An estimated 8,500 people died last year in England and Wales as a result of living in cold homes.

Fuel poverty not only affects a patient’s health directly but their access to healthcare as well. The BGS Trainees’ Council have discussed this at length and we realised that we all have stories about how the cost of living crisis is adversely affecting our patients. Some pointed to the stark choices our patients have to make: ‘I wanted to bring a patient up to clinic due to some adverse blood test results but she said she couldn’t afford the bus fare and the only money she had left for the month was for food.’ Some clinics have noticed the impact through patients requesting ‘telephone appointments’ and ‘home visits’ due to the costs involved and delaying appointments until their benefits come in. 

One patient who suffers with a chronic health condition has had to ask their neighbours to shop for them at budget supermarkets due to the rising cost of food. Despite this, they are still only able to afford one meal a day. This often only consists of beans and toast resulting in adverse health consequences.  Another patient has had to stop meals on wheels because they ‘can’t afford it’ and are only ‘heating one room’. These are just a few snapshots from our experiences – we are sure that BGS members up and down the country will have similar stories.  For months, major news outlets and charities have been publishing people’s stories about the cost of living crisis, including Independent Age, who have launched a £1 million emergency fund. It is the poorest communities that unfortunately are suffering the most.

The UK Government has introduced an ‘Energy Price Guarantee’ that brings a yearly ‘typical household energy and gas bill’ to £1950 in Northern Ireland and £2500 for the rest of the UK. There are a range of benefits available to older people with some additional funds available this year due to the cost of living crisis. These can be claimed on top of other benefits. Links for these are below and details available on Such a response by the Government and energy companies is welcome but sadly it will not be sufficient for many older adults living across the UK.

One project that is trying to help this difficult situation is ‘Warm Home Prescription.’ This is a partnership between Energy Systems Catapult and some NHS regions to help the most vulnerable whose health conditions are exacerbated by cold weather. Consequences of cold homes cost the NHS £1billion in England alone. The project allows NHS teams to identify vulnerable patients who are then offered credit to keep their home between 18 and 21 degrees. Regions taking part include Aberdeen and North East England and the response from patients has been positive. There was a pilot trial in Gloucestershire commissioned by the NHS last winter. Should we in the future be prescribing heating, the same way we prescribe other preventative medicines?

There are numerous other organisations involved in trying to help with the crisis. Food banks remain busier than ever and many charities have put out urgent appeals for help. Age UK, energy advice charities and government agencies are advising people on how best to keep warm and also offering grants for insulation. There are others such as ‘Don’t pay UK’ and ‘Fuel Poverty Action’ that are actively protesting about the rising costs. Meanwhile there are campaigns to demand higher taxes on UK energy companies, which continue to earn significant profits, estimated to be around £170 billion in 2022.

To healthcare professionals this can all seem overwhelming. We are in the midst of a serious cost of living crisis coupled with so many other challenges across the NHS. In order to best support our patients and colleagues this winter, it will be essential to educate ourselves about what is out there by way of advice and support. We will all be very busy this winter and need to be aware of the conditions that our most vulnerable patients face. We should keep the conversation open about the implications of the cost of living crisis and be the strongest possible advocates for our patients. We must work together in order to bring some hope in the coldest winter months.

While sources of support will vary depending on your locality, we have provided some links that will hopefully help you to get started in understanding the support available to your patients. In many areas, your local authority will be the first port of call with many providing a hub of information about locally available support.

Have you found a good source of help for your older patients? Is there anything else we should be doing as a society on this issue? Make sure your colleagues know so they can share the information with their patients as well.

We would welcome any comments, stories and suggestions. Please email us at the BGS Trainees’ Council.

Christopher [dot] hay2 [at] nhs [dot] scot

List of contributors:
Dr Alex Elliot-Green, Dr Julianaa Raghu, Dr Victoria O’Brien, Dr Clayton Micallef, Dr Amy Heskett, Dr Fariha Naeem, Dr Katherine Chin.


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