National Hoarding Week

Did you know that this week is national hoarding awareness week and events such as this one by Horizon Amicus are being run.

We are delighted to post Ellis Turner’s blog today:

When I first started as a practitioner mine and others response to a complaint about a “filthy and verminous” property was to simply assess for pest infestations and human waste outside the toilet pan and of course notify social services. Most of us have all had experience of blitz cleans and met some very intelligent and interesting people.

On reflection I and other professionals have tackled the symptoms and have not always been able to tackle the cause of hoarding behaviour. Collectively we have invested time, energy and resources into housing, tenancy and often severe legal interventions with a wide range and at times extreme and occasionally sad outcomes.

Last year I was pleased to be part of a cross disciplinary working group that set out to develop tools and awareness of the significant impact and gap in service provision of supporting those experiencing hoarding behaviour.

Islington now has hoarding panel to co-ordinate action on the most extreme case (similar to the MARAC Multi-Agency-Risk-Assessment-Conference) model and has developed a protocol and fact sheet which forms part of our joint strategic needs assessment.

For some other useful resources, click on the links below:

What is clear to me is that only through co-ordinated action, support and advocacy from all health, social care, public health practitioners and third sector can we start to help support those experiencing hoarding behaviour. The mental capacity act code of practice on capacity assessments is a good place to start and ensuring the capacity assessment is specific to “capacity to clean and tidy one’s home”

Other countries like the US are a bit ahead of us on understanding hoarding and have recognised this as diagnosable condition, which then in turn opens the door to treatments and advocacy for those experiencing hoarding behaviour. The one big change I have made though is to stop saying hoarding disorder and to start talking about hoarding behaviour.

Special thanks to Shadia-Ousta Doerfel at Islington Council and Megan Khans at Hoarding UK

(Ellis ends)


At EHRNet we would be very pleased to hear of other useful open access resources, and will set up an open access resources page similar to our others.


Cold homes: New Toolkit and the challenges for HMOs

We are delighted to post information on this new publication, the Centre for Sustainable Energy’s (CSE) Affordable Warmth and Health Impact Evaluation Toolkit (April 2016).

This toolkit is available to help local organisations assess what difference their fuel poverty schemes make to the health and wellbeing of target users. It’s been developed by Centre for Sustainable Energy’s research team in partnership with the Department for Energy and Climate Change (DECC), and with oversight by experts in the fields of health and evaluation from a number of organisations, including Department for Health, Public Health England and a range of front line delivery organisations.

Senior Researcher Nicky Hodges led the work at CSE. She said:

“This is a useful tool to show whether improvements in people’s health are linked to the interventions they’ve been offered. Schemes at the local level are very diverse so we’ve built flexibility into the tool to deal with this. We hope that this tool with help organisations demonstrate the contribution their scheme makes to people’s health and wellbeing.”

William Boohan, at DECC, commented that:

“This toolkit was born out of conversations with local groups who told us that, though they knew evaluation to be a useful tool to validate what they were doing, they didn’t always have the resources or expertise to carry one out. We hope this toolkit will help redress that situation.”

The toolkit includes case study examples of affordable warmth schemes that have incorporated health impact evaluation. It provides guidance on planning and resourcing an evaluation, making sure you collect appropriate data, suggestions on working with the health sector, thinking through ethical considerations and reporting with impact. It is a free resource. By supporting evaluation of the health impacts of schemes, the toolkit is anticipated to help unlock funding held at the local level.

DECC and CSE would be happy to hear of your experiences using this toolkit and to take on board ideas for how it could be improved.

And in addition! More good news is the ongoing research into energy efficiency and fuel poverty in houses in multiple occupation.  We have just been alerted to this open access paper from People, Place and Policy: Energy vulnerability in multiple occupancy housing: a problem that policy forgot – a title that says it all really. It is an essential read for anyone working in HMOs and for us we are particularly excited that it includes reference to some of work (see references from Barratt and Stewart). Of the Stewart (1999) paper I would like to mention that this was my first peer reviewed publication but although dated in places, is still being read. It shows the importance of our work to a far wider audience and what may be routine for us is of immense interest to others.


The voices of EHPs: in print & podcast

Yesterday was a landmark for aspiring EH researchers like me with the publication of the summary of Professor Steve Tombs’ research on EHPs and the broadcasting of parts of this research on BBC Radio 5 Live followed by a wider debate on food safety and the limits of risk regulation.

Publication is free from here:

BBC Radio 5 Live Investigates podcast here (available for 29 days):

Both illustrate why research matters and provided important critiques of what’s happening to local government EHPs, why it’s happening and what front line EHPs think about it. In particular I take my hat off to those EHPs who contributed to the radio programme with their fears and concerns for the public’s health. I think it says a lot about what’s happening in local government that many were afraid to go on the record for fear of losing their jobs.

My hope is that this research and coverage will be harder to ignore and could give EHPs more confidence to speak out and thereby lead to a more informed and critical debate about what’s happening in local government environmental health services. My fear is that we won’t make time to engage for many reasons, not least our desire to get on with (and keep) our jobs and not to upset our seniors and those who claim to represent us.

Our cause is becoming clearer by the day, recruiting for environmental health rebels here…

With best wishes,


Radio 5 live: giving EHPs a voice on Sunday 1st May at 1100

I wrote recently below about Professor Steve Tombs’ new book and the coming release of ‘Better Regulation: Better for whom?’ – the pamphlet summarising  his research on EHPs and its policy implications by the Centre for Crime and Justice Studies and The Open University’s Harm and Evidence Research Group.

I attended the second talk in Liverpool yesterday evening and the pamphlet hasn’t yet been released because Radio 5 Live recorded the first London event for its ‘5 Live Investigates’ programme – hosted by Adrian Goldberg – which airs on Sunday 1st May 2016 at 1100.

There are no further details yet on the Radio 5 Live website, but the current link to the programme is:

Further, it should be available for all as a podcast after broadcast and I will provide further details and the link to the pamphlet here soon. In the meantime a summary of Tombs’ main argument is available here:

I hope this broadcast helps to stimulate a long overdue and critical national debate about what’s happening out there to environmental health services, why it’s happening, why it’s endangering the public’s health and what we could do about it.

Many thanks and best wishes,


Celebrate Public Health Week with SAGE

SAGE Publishing is celebrating National Public Health week with free article release from the Society for Public Health Education (SOPHE) for a limited time. These articles are from Health Education & Behavior, Health Promotion Practice, and Pedagogy in Health Promotion – some of which are of interest to environmental health.

To access, click here.

Better Regulation: Better for whom? Free launch in London & Liverpool soon…

My review of criminologist Professor Steve Tombs new book – Social protection after the crisis: regulation without enforcement – has just been published in the April edition of Environmental Health News. I have asked for permission to reproduce it here for those who are not CIEH members, but very briefly Tombs looks behind the ‘cuts’ headlines by using research to explore what’s been happening to us for decades, why it’s happening and what we could do about it.

Rejecting simplistic explanations like deregulation, Tombs instead argues we are in a period of ‘re-regulation’ characterised by the gradual marketisation of state agents, including EHPs, and increasing inter-dependencies with the private sector via initiatives like Better Regulation and the outsourcing of public services. 

Chapter 6 in particular charts the decline in law enforcement activity across environmental health regulators and is amplified by the results from research into Merseyside EHPs. These include an investigation of their attitudes towards Better Regulation, an exploration of the impacts of cuts on their capacity to protect public health and important critiques of the Primary Authority scheme and outsourcing.

I will write more about the book soon, but at its core it reminded me why I became an EHP – i.e. to maintain and improve public health, not to promote economic growth!!

The coming launch of ‘Better Regulation: Better for whom?‘ – a pamphlet summarising the book – by the Centre for Crime and Justice Studies and The Open University’s Harm and Evidence Research is therefore very timely, not least with the Cabinet Office’s recent announcement of its Cutting Red Tape review of local authorities (see: and the CIEH’s call for case studies to be included in their submission.  

The pamphlet will be launched at two free events in London and Liverpool on the 26th and 27th April respectively. For more details and to book your place please visit:

London –  

Liverpool –  

Current Government policy and past reviews (e.g. Hampton, Rogers) suggest that we need all the help we can get, I hope that EHPs at all levels will make the time to engage with Tombs’ work. Please watch this space….              

With best wishes, Rob