There are different ways to assess the economics and health of a nation. One way is to examine health spending. A new analysis of 4.37 million patient records in England finds resources asymmetrically impacted by winter cold and summer heat, with about 64% linked to common cold days while very hot days drive sharp same-day demand surges.
These findings come from a University of Oxford-led study, published in The Lancet Planetary Health (“Quantifying the health-care burden of temperature in the National Health Service in England: an economic analysis of resource use and costs”). The study is the first to link daily temperature data to health-care use and costs across primary and secondary care in England.
By using linked patient records from 4,366,981 people registered at 244 English GP practices between April 2007 and June 2019, researchers were able to estimate that exposure to average daily temperatures outside a mild reference range (18°C to 21°C) accounted for around 3.0% of recorded health-care costs in their dataset.
Furthermore, by using illustrative budget figures, this amounts to £3 billion in costs for National Health Service (NHS) England and is of the same order of magnitude as spending on a vital service like dentistry.
When NHS leaders plan for winter pressures and wider service resilience, the study provides new evidence on how temperature-related demand and costs sit across the health system in England.
The first scenario is not likely to be helped by the process of climate change. The UK frequently experiences cold conditions, with days averaging 0°C to 9°C accounting for around 64.4% of the estimated burden, reflecting cumulative increases in NHS use across the winter period.
The study also raises a practical concern in extreme cold: when average temperatures fell below 0°C, health-care use declined in the data. This suggests barriers to seeking care in hazardous cold conditions such as snow and black ice.
However, the study also highlights that hot weather, which is becoming more frequent under climate change, also conveys concerning health risks. Although very hot days were rare in the study period, which limits precision, the data reports sharp, same-day surges in parts of the system – including accident and emergency attendances and prescribing – when temperatures are unusually high.
This means that while cold weather is linked to a larger cumulative burden on the NHS, heat is linked to sudden spikes that can challenge day-to-day service delivery. Older adults were consistently the most affected group across the findings.
Commenting on the findings, Dr Patrick Fahr, Senior Health Economist at the Nuffield Department of Primary Health Care Sciences, University of Oxford, says: “Temperature affects the NHS every day, but until now nobody knew how costly this was. Three percent is both a small and a large figure, because these costs are concentrated on cold and hot days only when demand is spiking. Historically, the winter season has been and remains associated with additional health risks, which occur routinely each year, however heatwaves are emerging as a new challenge.”
Fahr adds: “In the data, heat tends to be associated with short, same day increases in demand and pressure on services, requiring a rapid response. Overall, the practical implication is that planning for temperature-related variation in service use is a year-round issue. Vulnerable people, such as older adults, can be particularly at risk.”
