The Cold Weather Plan is a public health plan. It aims to prepare for, alert people to and prevent the major avoidable effects of winter on people’s health, which claim around 25,100 lives each year.
This text is excerpted from the Department of Health Cold Weather Plan for England: Protecting Health and Reducing Harm from Severe Cold. A full copy of the Plan and associated documents can be accessed from the DH website:
The Cold Weather Plan for England [external link]
Cold Weather Plan overview
Cold Weather Alert System
Role of the Health Protection Agency
Level 0: Winter Preparedness: Long Term Planning
Level 1: Winter Preparedness
Level 2: Alert and readiness
Level 3: Severe Weather Action
Level 4: National Emergency
The Cold Weather Plan is a public health plan. It aims to prepare for, alert people to and prevent the major avoidable effects on health during periods of severe cold in England.
It recommends a series of steps to reduce the risks to health from prolonged exposure to severe cold weather for:
The Cold Weather Plan was first published in November 2011. This year’s plan builds on the experience of developing and improving the ability of the NHS and its partners to deal with significant periods of cold and wintery weather.
The Plan is underpinned by the Cold Weather Alert system which has been updated and now comprises five main levels. Level 0 - long term winter planning and, between 1 November – 31 March, Levels 1-4, comprising winter and cold weather preparedness to a major national emergency. Each alert level should trigger a series of indicative actions.
Cold weather alerts are issued by the Met Office on the basis of either two measures: low temperatures or widespread ice/heavy snow. Often low temperature criteria are met at the same time as the ice and snow. However, sometimes one may occur without the other. The thresholds for what constitutes severe winter weather have been developed in consultation between the Met Office, Department of Health, Cabinet Office and other experts
|Level 0||Long-term planning
|Level 1||Winter preparedness programme
1 November – 31 March
|Level 2||Severe winter weather is forecast - Alert and readiness
Mean temperature of 2°C and/or widespread ice and heavy snow are predicted within 48 hours, with 60% confidence
|Level 3||Response to severe winter weather - Severe weather action
Severe winter weather is now occurring: mean temperature 2°C or less and/or widespread ice and heavy snow
|Level 4||Major Incident - Emergency response
Central Government will declare a Level 4 alert in the event of severe or prolonged cold weather affecting sectors other than health.
Public Health England (PHE), in collaboration with other agencies provides both information on mortality and morbidity due to cold weather at each of the four severe cold weather alert level.
PHE will routinely monitor outputs from real-time syndromic surveillance systems including calls to NHS Direct, GP out of hours/ unscheduled care consultations and emergency department attendances and GP in hours consultations for the impact of cold weather related morbidity using a range of syndromic health indicators. Information on selected cold related indicators will be included in routine weekly surveillance reports. These will provide a source of intelligence on how severe the effects are and how well services are responding.
PHE will produce weekly excess all-cause mortality estimates based on ONS data during the winter period and publish outputs weekly in the mortality section of the influenza report.
Summaries from winter 2011-2012 from both surveillance teams can be accessed in the HPA’s Evaluation Report of the Cold Weather Plan:
Cold Weather Plan for England: evaluation 2012 (PDF, 3.2 MB)
Excerpts and selected examples on actions from the Cold Weather Plan 2012 are given below. A full list, including action tables for organisations and individuals can be found in the full Cold Weather Plan 2012 [external link].
This emphasises that to build resilience for the coming winter requires long lead-in planning times. This level of alert is aiming to emphasise the need to prepare for, adapt and mitigate for climate change and develop long-term sustainable approaches which seek to ensure behaviour change across the general population, community and healthcare professionals. Level 0 denotes that these are actions which should be taken across the year and certainly before Level 1 starts for winter preparedness at the start of winter.
Health and social care and local authority providers should ensure that they are engaged with local EPRR and other strategic arrangements as these develop – especially for winter planning. Professionals should work within their organisations and with partner organisations to ensure that systems are developed to support the identification and sharing of information between agencies of people who may be vulnerable to cold weather and other seasonal variations
Community and voluntary organisations should engage with local statutory partners to agree how they can contribute to the local community resilience arrangements.
Individuals should access appropriate energy advice about improving the energy efficiency of your home and staying warm in winter and protect water pipes from freezing if possible.
They should also seek advice from their Local Authority environmental health department if as a tenant their heating is defective or they cannot affordably heat their home.
A Level 1 is in force throughout the winter from 1 November to 31 March and indicates that preparations should be in place to protect health and ensure service continuity in the event of severe cold and winter weather
Health and social care services should provide a flu vaccination programme to all front line staff and encourage staff to be vaccinated.
Community and voluntary organisations should set up rotas of willing volunteers to keep the community safe during inclement weather and to check on vulnerable people and neighbours
Individuals should take steps to prepare for winter, such as: getting a flu jab if they are in a risk group; insulating their homes and protecting water pipes from freezing; looking out for vulnerable neighbours; and checking their entitlements and benefits.
Level 2 is declared when the Met Office forecasts a 60% risk of severe winter weather in one or more defined geographical area in the days that follow. This usually occurs two to three days ahead of the event. A Level 2 Alert would be issued when a mean temperature of 2°C is predicted for at least 48 hours, with 60% confidence, and/or widespread ice and heavy snow is forecast, with the same confidence.
Health and social care services should consider how forecast weather conditions may impact on day to day work – and make appropriate arrangements. They should also remind clients of the actions they can take to protect themselves from the effects of severe cold.
Community and voluntary agencies should actively engage vulnerable people known to be at risk and check on welfare regularly.
Individuals should maintain regular contact with vulnerable people and neighbours who they know to be at risk in cold weather– ensuring they have access to warm food and drinks and are managing to heat their home adequately
A Level 3 alert is issued when the weather described in Level 2 above actually happens. It indicates that severe winter weather is now occurring, and is expected to impact on people’s health and on health services.
Health, Social care and Local Authority Providers should implement plans to deal with surge in demand and activate their business continuity arrangements
Community and voluntary organisations should ensure volunteers are appropriately supported and implement the ‘business’ continuity plan
Individuals should keep active and ensure that if they have to go outside, they make sure they dress warmly and wear non-slip shoes. Also tell someone where they are going and let them know when they intend to get back. If individuals have a mobile phone keep it charged and on their person at all times.
This is reached when a period of cold weather is so severe and/or prolonged that its effects extend outside health and social care, such as transport or power or water shortages, and/or where the integrity of health and social care systems is threatened. At this level, illness and death may occur among the fit and healthy, and not just in high-risk groups and will require a multi-sector response at national and regional levels. The decision to go to a Level 4 is made at national level and will be taken in light of a cross-Government assessment of the weather conditions, coordinated by the Civil Contingencies Secretariat (Cabinet Office). A Level 4 alert is a judgement made in light of this cross-Government assessment and, depending on the severity of the conditions and impact, could be declared over any time period.
Continue actions as per Level 3 unless advised to the contrary