Actions to take


1. Review the recommended general actions. This includes information about raising awareness and partnership working.

2. Make use of health data and registers which are already held within local authorities and organisations with a role in service provision. Data sharing requires relevant approval, but subject to that being received, organisations involved in emergency planning could make use of local authority data on people receiving care and other types of support in order to ensure that their needs are appropriately considered.1

  • See the Further Resources section for an example of where this has been done. The Devon, Cornwall and Isles of Scilly Local Resilience Forum’s ‘Vulnerable People Tactical Framework’2 has involved identifying appropriate organisations working with vulnerable individuals and developing an ‘Information Sharing Protocol’ through which information about vulnerable people and sites such as hospitals and nursing homes can be shared during an emergency situation.


3. Consult guidance about how to incorporate climate change impacts into risk registers and other key strategies including local Joint Strategic Needs Assessments (JSNAs). Some of the equivalent context for Wales and Scotland with respect to flooding and health is included in our Why climate justice matters presentation, where relevant.

  • See the Further Resources section for links to guidance and examples. Guidance relating to risk registers has been produced by Lancashire County Counciland there are examples of risk registers from local authorities from Blaby District Counciland Greater Manchester5.
  • Assess the climate resilience of your local JSNA using the checklist at the back of the Environment Agency/SDU ‘Under the Weather toolkit’.Kent County Council has also produced guidance on JSNAs and sustainability.7


4. Make use of specific guidance for raising awareness among people in poor health and encouraging the development of wider personal plans either alone or with appropriate health-care professionals or voluntary groups

  • See the Further Resources section for links to:
    • Guidance on health and heatwaves, including heatwave alerts.8,9
    • National Flood Emergency Framework guidance on flood-related communications.10 Guidance covers the information requirements of different groups and different communication methods such as social media. 
    • Guidance for the wider public and front-line responders on flooding issues, answers to frequently asked questions, floods and mental health and cleaning up safely after an event.11
    • Information about the services of the Flood National Flood Forum12
    • Information about how to join Priority Service Registers run by UK energy companies.13


5. Consider how staff training events can be used to build up knowledge of the issues. This can include some of the resources noted elsewhere and dedicated information sources for Category 1 and 2 responders, such as through the Flood Guidance Statement.14


6. Consult guidance about health issues to consider after a flooding event has occurred.15


7. Develop a step-by-step programme of activities.

  • See the Further Resources section provides links to examples of what others have done. For example, Hertfordshire County Council produced guidance and identified and assessed twelve possible actions as part of their 2009 assessment of climate change impacts on health and adult care services. Bedford Borough Council has listed a set of specific recommendations targeted at organisations involved in health and social care,16 some of which are related to the recommendations provided by the NHS Sustainable Development Unit.


8. Work in partnership with others to protect the vulnerable people in poor health. Partnership working is a crucial part of any response to the challenges of climate change and extreme weather. Workshops are one way through which improved dialogue can be achieved, but in order to make meetings as effective as possible it is important to involve all relevant organisations. Wider discussions may also identify new opportunities to join up with existing initiatives or communication channels with target groups, such as through measures put in place to tackle the problem of fuel poverty and to ensure that such measures do not create problems with adapting to summer heatwaves.

  • See the Further Resources section for a link to an example of who to involve. The National Flood Framework lists organisations and agencies to work with in relation to a number of vulnerable groups.17 A list of organisations that should be considered is provided in the ‘Under the Weather’ toolkit.18   Local Resilience Forums also provide a good basis for collaboration and dialogue and provide a foundation for understanding pressures and opportunities across a range of organisations with shared goals and related responsibilities. 
  • Also see the Further Resources section for more information on partnership working.


9. Support and encourage local organisations to work with the voluntary and community sector to raise awareness of climate risks and promote personal adaptation strategies. Where possible, this should build on existing programmes and voluntary sector initiatives and pay particular attention to reaching marginalised communities.

  • See the Further Resources section to watch an interview about the responses that Equinox has implemented to help illicit drug users in hot weather.19
  • See the Further Resources section for a link the Snow Angels initiative.This aimed to reduce the physical and social isolation of sensitive individuals during cold weather but ideas could be extended to consider needs during other extreme weather events.
  • See the Further Resources for links to community resilience building tools, such as the Community Disaster Resilience Scorecard Toolkit20 (produced by the Australian Government but with content which can be applied in the UK) and resources produced by the Cabinet Office.


10. Use existing processes and good practice guidelines to help draw up adaptation plans for health and social care organisations

  • See the Further Resources section for a link to the Sustainable Development Unit’s information about the characteristics of a good adaptation plan in health and social care.21 Five steps are recommended in the Sustainable Development Unit’s report as follows:

Step 1: Find out who to involve from the organisations listed in Appendix 1.

Step 2: Find out what information is needed from the suggestions listed in Appendix 2.

Step 3: Assess the relative local importance of different potential impacts, investigate how they will affect the day-to-day running of essential services and systems and draw up possible responses to problems which may arise.

Step 4: Decide on a set of priorities for action. 

Step 5: Construct plans and initiate a regular monitoring and review process.


11. Ensure that preparedness for extreme events includes relevant infrastructure, such as buildings which are important for delivering health and social care so that patients and staff are protected from the impacts of events like heatwaves and flooding.22 Such buildings include hospitals, clinics and health centres, doctors’ surgeries, care centres, residential care and nursing homes, day centres and general care facilities.

  • See the Further Resources section for a link to the Health Technical Memorandum 07-07: Sustainable health and social care buildings23 and Health Building Note 00-07 Planning for a resilient healthcare estate24
  • See the Further Resources section to watch a video examining how existing National Health Service hospital buildings might be refurbished in order to become more resilient to the impacts of high temperatures.25
  • See the Further Resources section for other resources to support building resilience to flooding.


12. Explore ways in which changes can be made in how and where people work, the codes of practice used and the sorts of systems used to deliver services. Relatively simple back up measures may be helpful, such as the use of telephone follow ups in place of appointments if patient access is an issue during extreme events.26 Telehealth and telecare may also offer some opportunities through which the health and well-being of very ill patients or those who have limited mobility can be monitored.27 There is now an increasing availability of electronic devices which can support healthcare providers, for example through providing warning systems to carers or through triggering automated responses, e.g. the activation of fans at certain temperature thresholds. However, it is important to note that telecare systems like these have implications for socially just adaptation, given that they are only available to those who can afford them unless other means are found to financially support people on low incomes. There is also a need to consider how such systems will operate during the potential power cuts and related problems associated with extreme events (see Figure 2, in Section 1).

  • See Further Resources for a link to a report examining the benefits of telecare options.28
  • See the Further Resources section for links to examples of the services which can be offered, for example by Bournemouth29 or Taunton Deane Borough Council.30


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  1. Houston, D., Werritty, A., Bassett, D., Geddes, A., Hoolachan, A. & McMillan, M. (2011) Pluvial (rain-related) flooding in urban areas : the invisible hazard, Joseph Rowntree Foundation, York.
  2. Devon, Cornwall and Isles of Scilly LRF (2012) Vulnerable People Tactical Framework
  3. Lancashire County Council guidance relating to risk registers
  4. Blaby District Council Adaptation Risk Register
  5. Greater Manchester Community Risk Register
  6. Environment Agency and SDU (2014) Under the Weather toolkit
  7. Kent County Council (2013) Joint Strategic Needs Assessment: A Guide to Integrating Sustainability
  8. NHS (2010) Heatwave: Looking after yourself and others during hot weather
  9. Heatwave Plan for England
  10. Defra (2013) The National Flood Emergency Framework for England
  11. Public Health England (2014) Flooding: Health Guidance and Advice
  12. National Flood Forum (2011) Ready for Flooding: Before, During and After
  13. Citizen's Advice Bureau, Self-help guide on the Priority Services Register for older and disabled people
  14. Flood Forecasting Centre, Flood Guidance Statement
  15. Public Health England and the Environment Agency, Flooding: Advice for the Public
  16. Bedford Borough Council recommendations for health and social care organisations (list near bottom of long webpage)
  17. Defra (2013) The National Flood Emergency Framework for England
  18. Environment Agency and SDU (2014) Under the Weather toolkit
  19. YouTube video: Equinox's response to climate change
  20. Torrens Resilience Institute (2012) Community Disaster Resilience Scorecard Toolkit
  21. NHS Sustainable development Unit (2012) Adaptation to Climate Change for Health and Social care organisations “Co-ordinated, Resilient, Prepared”.
  22. NHS Sustainable development Unit (2012) Adaptation to Climate Change for Health and Social care organisations “Co-ordinated, Resilient, Prepared”.
  23. Department of Health (2013) Environment and Sustainability Health Technical Memorandum 07-07: Sustainable health and social care buildings Planning, design, construction and refurbishment
  24. Department of Health (2014) Health Building Note 00-07: Planning for a resilient healthcare estate
  25. Video clip: refurbishing hospital buildings to reduce overheating. This work is part of an EPSRC-funded research project Design and Delivery of Robust Hospital Environments in a Changing Climate which was carried out by the Universities of  Cambridge, Loughborough and Leeds with the Open University.
  26. NHS Sustainable development Unit (2012) Adaptation to Climate Change for Health and Social care organisations “Co-ordinated, Resilient, Prepared”.
  27. London Climate Change Partnership (2011) London’s changing climate. In sickness and in health.
  28. Yeandle S. (2009) The Bow Group, Telecare a crucial opportunity to help save our health and social care system
  29. Bournemouth Borough Council telecare services available to older people
  30. Tauton Deane Borough Council telecare services