Assess the nature of the problem in your area

Identify locations with high proportions of people in your area whose activities are potentially affected by ill-health using the Climate Just map tool.

Identify the magnitude and likelihood of hazards associated with the changing climate, including flooding and heatwaves.

• Consider how patterns of people in ill-health and more broadly sensitive to the impacts of climate change and extreme weather events compare with patterns of potential exposure to flooding and heatwaves.
• Draw on existing risk assessments, adaptation tools such as the UKCP09 projections, UKCP18 which will update the UKCP09 projections and other local information (for example following the UKCIP Local Climate Impacts Profile (LCLIP) process).  See the Further Resources section for an example LCLIP for Greater Manchester.
• Examine the impacts of extreme weather events including their location, timing, costs and the effectiveness of responses by recording local experiences to support continuous learning.

Review the case studies in the Further Resources section to see what others have done.

Use additional resources to identify particular sensitive and susceptible individuals, groups and locations. See the How can we do it section for more ideas about where to get information.

• Use the Strategic Health Asset Planning and Evaluation (SHAPE) tool to access a range of health indicators at fine geographical scales (areas representing populations of 1000-3000). The SHAPE tool also includes overlays of areas potentially affected by flooding. See the Further Resources section for more information about the SHAPE tool.
• Identify the location of sensitive groups in institutions, such as those in care homes and hospitals.
• Identify where sensitive individuals live. The map portal provides information about where there are particularly high proportions of sensitive people, but it is also important to remember that all communities will have some sensitive people within them. 

Ensure that a full range of issues are incorporated into organisational risk registers.

Raise awareness of climate change to build adaptive capacity among sensitive individuals and groups.

• Raise awareness among the wider public of the potential impacts on health from extreme weather events using existing guidance and public-orientated information bulletins. This should also include information about what preventative actions can be taken and the support available to assist people in making short and longer-term preparations. Support can include what needs to be done to sign up for telephone, text or email flood warning messages and how to join Priority Service Registers run by UK Energy companies to protect people reliant on medical equipment.¹ Consider appropriate outreach activities for marginalised groups and those who are particularly susceptible to the impacts of high temperatures and the health impacts of flooding. In locations with a highly transient population, information may need to be more frequently issued or made available in different ways and there may be other particular needs for people who have only recently arrived to a local area.² See the Further Resources section for more information about raising awareness.
• Raise awareness among social and health care staff. There are also recommendations that climate change adaptation needs to be built into training programmes for those working in health and social care. It is important to ensure that all staff members, especially those in day-to-day contact with people with vulnerabilities, are aware of the issues and of appropriate adaptation measures so that they are considered as part of everyday working activities.³See the Further Resources section for links to advice for different staff groups:
  • Advice for health and social care practitioners: supporting vulnerable people before and during a heatwave^.4
  • Advice for care home managers and staff: supporting vulnerable people before and during a heatwave.⁵
  • Advice available to Category 1 and 2 responders as part of the Flood Guidance Statements issued by the Flood Forecasting Centre at times of heightened likelihood of flooding.⁶

Develop local plans that reduce the impact of heat-waves and floods on sensitive individuals and which protect the systems through which care is delivered to them.⁷ It is recommended that plans build from national guidelines but are strongly tailored to specific local circumstances. Wider risk management activities are already well established for those with responsibilities for health and social care provision. Therefore plans should aim to make climate change adaptation part of general risk management and not just reserved for emergency situations.⁸ If this is achieved it helps to ensure that information is readily available when it is required, often when normal communication channels are particularly stretched. It also helps to establish measures which can help reduce exposure and build adaptive capacity but which require a longer time-frame to be effective.

• Consider your specific legislative context. The following text relates primarily to England, but 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. 
• Joint Strategic Needs Assessments are a primary mechanism for highlighting local ambition on reducing climate-related burdens on health and can make the links on this agenda to inform local activities.⁹ The SDU and Environment Agency’s ‘Under the Weather’ toolkit¹⁰ is designed to help health and wellbeing boards and commissioners to increase resilience in a changing climate by integrating climate-related risks into JSNAs.
  • See the Further Resources section for a link to an example Joint Strategic Needs Assessment produced by the London Borough of Hackney.¹¹
     
• Sustainable Development Management Plans The Sustainable Development Unit (SDU) recommends that health and social care organisations develop SDMPs and that these include a specific section on climate adaptation and that this provides information on local risks and the processes for their management.¹² This information can be used by coordinating bodies such as Health and Well-Being Boards and show how obligations are being delivered. These sections might also identify how measures are accounting for specific local circumstances and the potential for uneven impacts as a result of patterns of social vulnerability and socially vulnerable groups.
• Specific adaptation plans. The research carried out as part of the Built Infrastructure for Older People’s Care in Conditions of Climate Change (BIOPICCC) project has fed into the development of the Sustainable Development Unit’s recommendations for developing an adaptation plan for building climate resilience.
• See Section 5 'How can we do it?' for more information.
• Encourage people with specific needs to make their own flood and heatwave plans either alone or with health care professionals. This can cover having a safe place for contact lists, information about prescriptions and care needs, a check list of personal items, instructions for safe operation of equipment, items to help with maintaining hygiene and other general guidance, e.g. as outlined by the National Flood Forum. Preparatory work can include signing up for flood messaging, heat wave alerts and registering on the Priority Service Registers run by UK energy companies. Awareness raising work might also help to identify and deal with any misconceptions about flooding.
• Reduce exposure of the vulnerable individuals by considering ways that buildings and local environments can be better adapted over the longer term.
• Enhance green space and green infrastructure in the design of health and social care facilities as well as more widely in urban areas in order to offset the impacts of flooding and reduce temperatures. See the Further Resources section about why this is important and appropriate measures which can be taken.

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