Heatwave preparedness for UK general practices: A guide for staff 

Heatwaves in the UK are increasing in frequency, intensity, and duration as a result of climate change. 

A cross-government collaboration, which includes the NHS and the Department of Health and Social Care, produces an annual Adverse Weather and Health Plan that incorporates heatwave preparedness measures. Services are expected to be prepared for periods of hot weather from 1 June to mid-September each year. However, this year’s record-breaking temperatures over the May Bank Holiday suggest that primary care services may need to be ready even earlier than the current heatwave plan anticipates. 

This blog summarises the evidence, suggests actions to take in general practice that can help save lives, reduce service demand, and protect staff and infrastructure during periods of extreme heat. Useful links to key policies and additional resources can be found at the end of this page. 

How do heatwaves lead to increased mortality and morbidity? 

Vulnerable patient groups are more susceptible to the adverse effects of heat. This includes: those with certain illnesses e.g. cardiovascular disease (CVD), diabetes mellitus, older adults, young children, pregnant women, individuals taking medications that affect hydration or thermoregulation (e.g. antipsychotics and diuretics), those who work outdoors, and people experiencing homelessness, Adverse heat events can negatively affect all body systems. 

Heat can have direct effects on health, increasing the risk of dehydration, falls, impaired temperature regulation, increased drug toxicity, and impaired judgement. 

This year’s early heatwave has also been associated with one of the highest recorded rates of youth drownings, with both inland freshwater bodies and coastal waters being the sites of these tragic incidents. 

The negative effects of heat can range from heat cramps, sunburn, and heat rash to heat exhaustion and heatstroke. Heatstroke can be fatal and requires rapid recognition and treatment. 

GP surgeries are increasingly having to consider staff working conditions, as high indoor temperatures can reduce productivity, increase the likelihood of errors, and lead to heat stress. 

The UKHSA Heat-Health Watch reports that excess deaths increase by 15–20% during heatwaves, with many occurring within the first 24–48 hours. Mortality reports provide summaries of heat-related deaths. Mortality rates have been shown to increase even when temperatures rise to just above 22°C. 

Get started with heatwave preparedness 

• Carry out a QIP on extreme heat alerts – see the Greener Practice Platform for a ready-to-use plan 
• Adopt an extreme heat policy. Please note: you'll need to be a member of Greener Practice to access the above resources 
• Assign a Heatwave Lead: Designate a staff member to coordinate preparations and monitor alerts. 
• Conduct a Drill: Run a mock heatwave scenario to test your plan. 
• Collaborate Locally: Work with pharmacies, care homes, social services and local authorities to share resources. 
• Review Annually: Update your heatwave plan every May before summer. 
• Sign up for adverse weather event alerts including warnings of heatwaves

Heatwave Alerts: What GPs Need to Know

UKHSA Heat-Health Watch operates from 1 June to 15 September, with 4 alert levels: 

Keeping your practice cool 

• Use thermometers to check room temperatures frequently - for comfort, temperatures should be below 26 degrees Celsius but consider closing or relocating if temperatures reach 30 degrees Celsius inside. 
• Use fans if temperatures are less than 35 degrees. Do not direct them directly at people as this increases dehydration risks.  
• Set air conditioning to 22-24 degrees Celsius.  
• Close windows once the outdoor temperatures are hotter than inside to keep it cooler inside.  
• Put down shades/close curtains before direct sun heat increases 
• Service refrigerators and ensure there is adequate ambient storage for medicines to be kept below 25 degrees Celsius. Check medicines storage temperatures twice a day. 
• Stock up on adequate water supplies, consider getting some ORS, cool packs. 

Patient Preparation

• Communicate on website, waiting room screens and using posters  
• Identify vulnerable/ high risk patients  
• Prepare texts/emails that can be sent to the above patients before and during heatwaves advising on self care/suggested medication management changes: 

- Increase fluid intake to 2L/day unless contraindicated.

- Avoid outdoor activity between 11 AM–3 PM.

- Check on [patient’s name] daily during amber/red alerts.

• hot weather communication toolkit from UKHSA 
• Share links to the RNLI resources on staying safe in the water and drowning risk reduction
• Fast-track high-risk patients for same-day and earlier in the day appointments.
• Offer telephone/online consultations to reduce travel.  
• Ask patients not to arrive early so they avoid sitting in hot waiting rooms 
• Beat the Heat poster 
• Red Cross advice and resources 

Staff preparation 

• Discuss heatwave plans in advance and provide training on the recognition and management of heat stress.  
• Encourage self-management measures, such as wearing lightweight, breathable clothing (including relaxing uniform requirements where appropriate), taking frequent short breaks to cool down and maintain hydration, and rotating staff to work in cooler areas where possible.  
• Consider earlier start times to avoid the hottest parts of the day.  
• Identify staff who may be at greater risk from extreme heat and ensure they receive appropriate support.  
• Information on available wellbeing resources, including employee assistance programmes and mental health support services, should also be provided. 
• Disseminate the 'Society of Acute Medicines’ heatwave management action plan to clinical staff. 

Official Guidance  

• NHS Heat Exhaustion and Heatstroke 
• An excellent summary from the Society of Acute Medicine 
• Adverse weather and health plan  
• Heat Health Alert  
• Mortality reports 
• Guidance on protecting workers during heatwaves 
• NHS Medicine Storage Guidance
• England: Follow the Heatwave Plan for England. 
• Scotland: Refer to the Adverse Weather and Health Plan. 
• Wales: Guidance from Public Health Wales. 
• Northern Ireland: PHA Heatwave Advice.