Extreme Heat Alert QIP

The benefits of this project

Opportunity for improvement

• Severe hot weather is dangerous and is becoming more common in England. Mortality and morbidity from hot weather are preventable, but this requires preparation.
• Anyone can be affected by hot weather; however, some groups of individuals are at a higher risk (with risk a result of a combination of factors related to their health, behaviours and environment). High-risk groups include the following:
  - Older people aged over 65 years
  - Babies and young children under the age of 5 years
  - People with underlying health conditions, particularly cardiovascular conditions, respiratory conditions, dementia, diabetes, kidney disease, Parkinson’s disease or mobility problems
  - Pregnant women
  - People with serious mental health problems
  - People who are already ill and dehydrated (for example from diarrhoea and vomiting)
  - People with alcohol or drug dependence
  - People who are physically active and spend a lot of time outside such as runners, cyclists and walkers
  - People who work in jobs that require manual labour or extensive time outside
  - People experiencing homelessness, including rough sleepers and those who are unable to make adaptations to their living accommodation such as sofa surfers or those living in hostels
  - People who live alone and may be unable to care for themselves
  - People on certain medications (see below)
• Some medications increase the risk of poor health outcomes during hot weather- these include:
  - Diuretics (especially loop diuretics)
  - Medications that interfere with cardiovascular responses, including antihypertensives and antianginal drugs
  - Medications that interfere with sweating, including anticholinergics and beta blockers
  - Medications that cause diarrhoea or vomiting, including colchicine, antibiotics and opiates
  - Medications that can impair renal function, including some antimicrobials, immunosuppressants, NSAIDs, anti-ulcer agents and chemotherapies
  - Medications with levels affected by dehydrations, including lithium, digoxin and antiepileptics
  - Medications that alter state of alertness, including hypnotics, anxiolytics and analgesics
  - Medications that can interfere with central nervous system thermoregulation, including neuroleptics and serotinergic agonists
  - Medications can increase basal metabolic rate, including levothyroxine
• During extreme heat episodes, there is a risk of individuals developing specific heat-related illnesses such as heat exhaustion and heatstroke. However, the main causes of morbidity and mortality are respiratory and cardiovascular diseases (both exacerbation of existing conditions and triggering of new serious health issues such as strokes). Air pollution (which can worsen in hot weather), combined with extreme heat, can also trigger exacerbations of cardiovascular and respiratory disease.
• Heat-Health Alerts are issued in England when the weather conditions have the potential to impact the health and wellbeing of the population. The colour is based on the impact that the conditions could have on health and likelihood of those impacts occurring. Yellow alerts are sent out when weather poses health risks to vulnerable people, amber when weather is also likely to affect the health service, and red alerts indicate a significant health risk to the general population. These assessments are made with the Met Office when adverse weather conditions are forecast, and are issued as early as possible to allow users to make their local assessments and take action to reduce harm to health. A summary of suggested actions for managers are found here.
• This project outlines how to put these recommendations into practice (see disclaimers), supporting healthcare organisations to assist their patients, staff and practice buildings prepare for and cope with extreme heat.
• You might like to create SMART goals for your project e.g., to set up a training session for staff on the dangers of heat to your patients before June 1^st every year, and assigning the annual running of your at risk patient audit to a staff role so a text message can be sent out to patients found in the audit. 

How to carry out this project

How to scale this project up or down

Please note - Use of this project requires NetworkPLUS membership. If you would like to share this project with others, please invite them to purchase their own membership —access must not be shared with non-members.

You could share your project with your PCN, Federation, ICB (England) or Cluster, Health Board (Scotland or Wales) or GP federation, Health Trust (Northern Ireland), so the learning can be shared and the project easily implemented by other practices too.

You could choose to offer staff training to a group of practices rather than just your own.     

Top Tip

You could involve your PPG in some education sessions about heatwaves which would include sharing patient resources such as www.vcsep.org.uk (with free resources and guidelines to help navigate the risks associated with extreme heat),  https://www.redcross.org.uk/get-help/prepare-for-emergencies/heatwaves-uk (with education about the risks of heatwaves and advice about how to stay safe) and  https://www.ageuk.org.uk/information-advice/health-wellbeing/mind-body/staying-cool-in-a-heatwave/ (with advice about how to stay cool). 

Involve your PPG

Have you completed this QIP?

Tell us a little about your project and enter your data in order to generate a certificate showing the probable cost savings and other benefits. This project may help with CQC evidence submission (see disclaimers).