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Heat, cold and health: UKHSA guidance for organisations

UK Health Security Agency guidance on protecting public health during hot and cold weather: the Adverse Weather and Health Plan and its evidence base, heat-health alert action cards for health and social care, advice for schools and early years, mass gatherings and events, and cold-weather support for vulnerable people. For care, education, event and local-authority professionals. Curated by Kopik from public sources: UK Health Security Agency, GOV.UK (OGL v3).

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This assistant answers questions about protecting health during hot and cold weather in England, based on UK Health Security Agency (UKHSA) guidance. It is meant for care managers, teachers, event organisers, local authority teams and anyone who wants to know what the official advice says. Answers come from the Adverse Weather and Health Plan 2026 to 2027, its supporting evidence and the UKHSA guidance pages published on GOV.UK.

What the Adverse Weather and Health Plan covers

The Adverse Weather and Health Plan (AWHP) is a technical document that gives national, regional and local planners a structured framework for protecting health from adverse weather. Its guidance covers heat, cold, flood and drought, together with public health messaging.

Health is a devolved responsibility in the UK, and the plan states that it only applies to the health and care system in England. The plan is backed by a supporting evidence document that summarises the science behind it, and by guidance and action cards for specific audiences.

UKHSA publishes a timeline for each plan year, including preparedness webinars before the heat and cold seasons, mortality monitoring reports published as Official Statistics and an annual report on the plan.

How Weather-Health Alerts work

UKHSA issues Heat-Health Alerts and Cold-Health Alerts based on Met Office forecasts. Each alert is given a colour (yellow, amber or red) according to the impact the weather could have on health and the likelihood of that impact, shown in a risk matrix.

Heat-Health Alerts run during the summer season, from 1 June to 30 September, and the Cold-Health Alert season begins on 1 November. Alerts are sent to registered users and published on the Weather-Health Alerts web platform, and are cascaded to government departments, NHS England, local authorities and the public.

A yellow alert usually means those who are particularly vulnerable could be affected. Amber means impacts are likely across the whole health service, with potential for the whole population to be at risk. Red indicates significant risk to life even for the healthy population.

In some circumstances an amber Heat-Health Alert may be issued alongside an amber Met Office National Severe Weather Warning Service (NSWWS) Extreme Heat warning, while a red alert would be issued together with a red NSWWS Extreme Heat warning and a national response coordinated across government.

Why heat and cold matter for health

According to the supporting evidence, an estimated 2,985 heat-associated deaths were observed in summer 2022, across 5 heat episodes, the highest number in any given year. Temperatures above 25°C are associated with an increased risk of heat-related deaths.

Cold remains the bigger burden: even with climate change, cold-related deaths are expected to continue to represent the biggest weather-related cause of mortality. Cold exposure can raise the risk of blood clots, heart attacks and strokes, chest infections and falls.

The evidence document also cites projections that, in plausible worst-case scenarios and without adaptation, annual heat-associated deaths could rise to over 21,000 in the 2070s, while deaths from extreme cold are predicted to peak around 2030.

Hot weather at events and mass gatherings

Event organisers are advised to identify hot weather as a risk in their event risk assessments and to make sure all staff know the guidance and local plans before 1 June each year. Large crowds can increase exposure to heat and sunlight, and people may drink less to avoid toilet queues or losing their viewing position.

Suggested measures include free drinking water on hot days, temporary shade, water stations and health facilities placed in the shade, fewer queues, and moving strenuous activities to cooler times of day. Attendees should be allowed to bring sunscreen into events.

Other ideas from the guidance include water sprays or mist areas, a map of nearby public air-conditioned spaces, and messaging on screens, announcements and printed media. The checklist is meant to be used alongside more detailed advice such as the Health and Safety Executive's Events Safety Guide and the Purple Guide.

Frequently asked questions

Does the Adverse Weather and Health Plan apply to Scotland, Wales or Northern Ireland?

No. The plan states that health is a devolved responsibility in the UK and that the document only applies to the health and care system in England. It does mention working with the devolved nations on extreme weather that affects several UK nations.

Who decides when a Heat-Health Alert is issued?

UKHSA issues the alerts, with the assessments made together with the Met Office when adverse weather is forecast. The colour reflects both the possible impact on health and how likely that impact is.

Can a heat alert be issued outside the summer season?

The action card for providers says the Heat-Health Alert system operates from 1 June to 30 September, but that alerts may still be issued outside of this period. Organisations are encouraged to stay prepared accordingly.

How can I keep my home cool during a heatwave?

The Beat the heat checklist suggests shading or covering windows, opening them when the air outside is cooler (for example at night), and turning off lights and electrical equipment that are not in use. Electric fans can help if the air temperature is below 35°C, but they should not be aimed directly at your body.

What indoor temperature does UKHSA suggest in cold weather?

The Keeping warm and well guidance suggests trying to heat the rooms you spend a lot of time in, such as the living room or bedroom, to at least 18°C. It also advises keeping bedroom windows closed at night and wearing several thinner layers of clothing.

Why do people at events get dehydrated more easily in the heat?

The events guidance notes that alcohol and some prescription and recreational drugs can worsen the effect of heat, and that physical activity such as dancing increases dehydration and body temperature. Organisers are encouraged to promote alcohol-free options or alternating alcoholic drinks with water, and to offer cool, water-rich foods such as salads or ice lollies.

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