England's care sector needs more support to prepare for changing climate, authors say
The increasing number and intensity of heatwaves in recent years has significantly impacted the health of care and nursing home residents in England, according to a new study.
The frequency and intensity of projected heatwaves caused by climate change is increasingly recognised as a risk to health and social care delivery. The health dangers associated with hot weather are of particular concern among older age groups.
Care homes in the UK are generally designed to retain heat during winter to protect against cold risks but these measures may increase the risk of summertime overheating if appropriate cooling strategies are not available.
The study, led by researchers from the London School of Hygiene & Tropical Medicine, compared mortality records from England between 2022-24 from the Office for National Statistics, with daily average temperatures.
Data showed that between 2022-24, the risk of death for nursing home residents, where a high level of round-the-clock medical care is needed, doubled (200% increase) on days where external temperatures hit 25°C compared to days of 16°C.
For residents living in residential care homes, where the level of care can be lower and residents are often more mobile, the risk of death still increased by 50% over the same time period.
Nursing home deaths increased by 34.1% and residential care home deaths by 13% during the July 2022 heatwave when temperatures exceeded 40°C for the first time in the UK.
Heat risk was progressively higher in care homes rated successfully poorer by the Care Quality Commission, the independent regulator of care homes in the country.
The full paper is published in the British Geriatrics Society's Age and Ageing journal.
Dr Shakoor Hajat, Professor of Global Environmental Health at LSHTM and lead author of the study, said: "With temperatures in the UK continuing to rise and the population ageing, we urgently need to understand the health impacts of heat in care homes.
"Our results show that heat risk in England's care homes has increased in recent years, suggesting the sector needs more support to adapt to our rapidly changing climate. Our results indicate those care homes that would benefit most from focused heat adaptation measures.
"Even at moderately high temperatures experienced in England most summers, the risk of poorer health for residents within nursing or residential care homes is elevated. It's likely this risk will increase as heatwaves and high summer temperatures become more frequent.
"Typically when we think about cooling buildings, our first thought is to consider air-conditioning. Most buildings in the UK traditionally have no air-conditioning installed because it hasn't been regularly needed. Air-conditioning units can also be expensive to install and run, contribute to emissions and can cool a room too quickly, so are not always the right solution.
"Passive cooling solutions such as increasing shading around buildings, ensuring there is secure nighttime ventilation and using building materials known to reflect sunlight are all easier and more sustainable alternatives. Air-to-air heat pumps are also an efficient way to heat and cool the air inside a building.
"When an extreme heat event is forecast, the UK Health Security Agency (UKHSA) provides guidance to all social care providers in England on how to help minimise the impact for staff and patients. While overheating is not likely to be a problem across all care facilities, we should be making every effort to prepare for a hotter future, to protect the health of our loved ones and those who care for them."
The authors say that ideally, temperature exposure would have been characterised using indoor measurements rather than outdoor values used in the study. However, only external temperature readings are currently widely accessible. The next step will be to understand which interventions may be the most helpful in reducing the impacts of heat stress.
Publication
Hajat S et al. Heat-related deaths in social care in England: can the Care Quality Commission ratings system be used to identify care homes that would benefit most from heat adaptation measures? Age and Ageing. 2026. DOI: 10.1093/ageing/afag100
