Impediments to policy implementation: The offer of free installation of central heating to an elderly community has limited uptake

Objectives: Increasing the warmth of homes in the UK to combat excess winter mortality has become an important part of public policy. This study examined the success of a local initiative to provide free installation of central heating for a group of elderly people. Study design: Cohort study. Methods: The uptake of the offer of central heating was monitored through its different stages. Where possible, comments were invited from the elderly tenants to whom the offer was made; a sub-sample was interviewed about their views. Results: Of 1181 tenants approached, only around one-quarter finally received central heating within the year. Reasons for the tow uptake included inaccuracies in estimating those eligible as well as tenants' worries over upheaval and mess, health concerns and fear of increased heating costs. Conclusion: Successful policy implementation requires not only command of appropriate financial resources and the backing of local 'implementers', but also the local resources with which the policy wilt engage, especially local knowledge, and the 'targets' of the policy initiative, in this case the elderly tenants. (c) 2005 The Royal Institute of Public Health. Published by Elsevier Ltd. All rights reserved.