Working with a range of partners, guest blogger Jamie Sinclair’s important work looks at ways to engage people on low incomes with advice services, in a health related setting. We’re pleased to highlight Jamie’s work given that engagement is a challenge many of our clients face.
Policy in Practice’s Benefit and Budgeting calculator can be used to inform people of how the benefit system can support them financially, and identify personalised steps they may be able to take to become more independent. We recently hosted a webinar on supporting people with disablities into work, view here.
This blog highlights some lessons from the successful Deep End Advice Worker project in Glasgow.
Building on the well-established model of co-locating social and economic support services in general practice (GP) settings, we sought to develop and test approaches to delivering financial, debt, social security and housing advice from two Deep End GP practices in the east end of Glasgow. Through providing expert advice, in a trusted and neutral setting, we aimed to improve social and economic outcomes for people experiencing poverty.
The initial phase of the project engaged with 165 people and secured £850,000 worth of financial gain through income maximisation work. Quite simply, it put nearly a million pounds’ worth of social security payments into the pockets of people who should already have been receiving them. It also identified and arranged manageable repayment plans for £150,000 worth of personal debt. Nearly half of the people who engaged with the service were referred onto additional forms of community support, such as mental health, fuel poverty and carer’s support.
Nearly four-out-five people we worked with had a household income of under £15,000 per annum. Considering the vice like grip financial hardship and uncertainty can have upon individuals, families and entire communities, it is clear the project and work of this nature offers the opportunity to lessen the impact of poverty.
General practices: trusted and neutral community hubs
Co-locating advice services in community locations is not a new phenomenon. There are dozens of examples of this type of work throughout the country, with libraries, housing associations and community centres all common locations where advice services co-locate. Working from general practices therefore should be viewed as one of many locations in which advice can be delivered.
However, our experience makes explicit the importance of the universal nature and trusted status of general practices in increasing the reach of advice services. Put simply, anyone can attend their local practice. People also tend to have longstanding and positive relationships with their GPs. These elements, that is of trust and familiarity, offer the opportunity to improve the accessibility of support services, particularly for those who may not otherwise use mainstream services. In the Deep End Advice Worker project, 85% of the people referred to the service, had never used the advice agency previously, despite their 15-year presence in the area.
Feedback from people engaging with the project made clear that their longstanding relationships with GPs; familiarity of the building the general practices were based in; and previous positive experiences interacting with the practice underpinned their willingness to engage with the services on offer. From a GP perspective, the provision of advice within the practices underpinned improved patient relationships and anecdotally, reduced the time they spent on non-clinical issues.
The project did not merely involve an advice worker parachuting into the practices to deliver a standalone service. Instead, we consciously attempted to embed the advice worker into the everyday work of the general practices. By this, partner organisations sought to normalise the availability of expert social and economic advice, and the advice worker’s presence in the practices, to the extent that referrals to the service were viewed in the same vein as referrals to other NHS health services.
Access to medical records
An important component of the project was the advice worker’s ability to access medical records, with the informed consent of patients. This provided them with a multi-dimensional view of patients’ circumstances, allowing them to triangulate three sources of information – patient’s input, GP perspective and medical histories. In turn, this approach allowed for the development of robust supporting statements, with GP input, for people applying for health-related social security payments.
Engaging with communities
The outcomes achieved by the project raises several questions regarding approaches to engaging with communities, particularly those impacted by welfare reform and poverty. Our experience suggests working with, and from, general practices can improve the accessibility of advice services. It also challenges the policy concept of ‘hard to reach communities’ and instead suggests the right places are yet to be fully identified and ‘reached’.
Partners involved in the project are now contemplating how to deliver a service which provides specialist social and economic advice and also identifies opportunities for people to engage with additional forms of support. For example, volunteering, education, skills development and employment support programmes.
Implications for policy and practice
The Deep End Advice Worker project, which is now working from nine general practices, is one of many ways to support people experiencing poverty and reduce the resource pressures faced by the services that support them. Further thought should be given to how work of this nature can be spread to other geographic areas, with specific consideration of communities disproportionately affected by poverty, such as carers, lone people, certain ethnic minority communities.
However, although maximising income and reducing costs can help people achieve a greater degree of independence and in some cases, lessen the grip of poverty, stronger legislation and policies which protect and support people living in poverty are needed.
Potential interventions could include progressive income and wealth taxation, ‘fair work’ and wage levels, an ‘anti-poverty childcare system’, measures to reduce the poverty premium, a social security system which prevents poverty, implementation of a ‘living rent’ and other actions on housing quality and affordability, alongside poverty-proofing of national and local government policies.
These broader societal and legislative changes are fundamental to ensuring poverty is reduced throughout Scotland and the UK. Ultimately, without addressing the fundamental causes of poverty, projects like the Deep End Advice Worker will continue to be needed to lessen the impact of poverty at an individual and community level.
The Deep End Advice Worker project evaluation can be found here. For further information please contact Jamie Sinclair, Building Connections programme manager, Glasgow Centre for Population Health, on 0141 330 2747 or email Jsinclair@glasgowkelvin.ac.uk.