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Lower stress, better sleeping More effective use of medication Smoking cessation

Welfare advice services offer multiple health benefits, including lower stress, better sleep, smoking cessation, improved diet, and housing stability. Collaboration between advice and health sectors can reduce health inequalities. Evaluation studies show significant outcomes and financial gains for individuals accessing these services in Northeast Glasgow. Practice and advice staff report positive impacts on workload and mental health. Future directions include maximizing practice sizes and engagement with child poverty and chronic disease management.

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Lower stress, better sleeping More effective use of medication Smoking cessation

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  1. Health gains from welfare advice • Lower stress, better sleeping • More effective use of medication • Smoking cessation • Improved diet & physical activity • Better relationships • Housing stability • Reduce GP time spent dealing with benefits • Fewer repeat appointments & prescriptions • Advice & health sectors working closely and strategically can help reduce health inequalities

  2. GP & Primary Care workforce Specialist Link Workers Community Link Workers (Socioeconomic focus) (Health & wellbeing focus) Link Worker roles - specialist & community Midwives & Health Visitors Community Organisations Welfare Rights Advisors Scottish Social Security Outreach Team

  3. Background Methods Money advice outcomes Views on project Discussion GCPH evaluation study

  4. 25% claim out-of-work benefits 26% report limiting disability Healthcare staff refer to welfare advice services in 7 health centres 2015-17: advice worker in 2 GP practices Significant number - disability-related benefits; no past advice service contact 2017: embed 3 advice workers in 9 GP practices. Half day advice session, per practice, per week Practices serve 40,000 people - caseloads range from 3,000 to 6,500 Northeast Glasgow profile

  5. Methods Data collected between April 2017 & March 2018

  6. Advice referrals by staff group 665 referrals = 100%

  7. Advice referrals across 9 GP practices GP practice

  8. Money advice referrals, uptake & outcomes (68.9%)

  9. Who is accessing advice? • Majority: below poverty measure for single person (BHC) • 65% (n=422) - annual household income > £10,000 • 19% (n=123) - annual household income > £6,000 • Single women, older, unfit for work, living in social housing • 1 in 5 had children • Two thirds had no contact with advice services in the past year*

  10. Financial gains & managed debts (£)

  11. Individual gains & debts (£ annual)

  12. Accessing other support • 124 out of 451 accessed other services (27.5%) • 166 reasons

  13. Views on project benefits Practice staff • People value appointments • Not paying travel costs • Positive impacts on mental health & financial gains • Some staff reported easing workload Advice staff • Practice as a trusted hub • Reduced stigma • Promoted uptake • Encouraged more openness about money worries

  14. Advice staff access to medical records • Advice staff had access to medical records, after consent – to prepare welfare applications, reports & letters for benefits reviews/appeals. • Three categories of access to medical records identified: • Full access to individuals’ records but ‘read-only’ • Intermediate access to basic information & summaries • Basic access via staff (face to face; staff printing summaries) • Differing views on what access meant between advice & practice staff & practices

  15. Reported benefits and concerns Benefits • Clarify diagnosis, medication, treatment when preparing advice cases • Increase better understanding of wider social situations • Offer more effective advice e.g. avoid stressful benefit appeals • Reduce need to ask GP for further clarification Concerns • Re-emerging anxieties led to some practices reducing access • Need for clearer position across all practices - governance, confidentiality, non-NHS employees, new data protection

  16. Views on future direction • All practice staff make referrals & directly book advice appointments • Provide practices with regular feedback on advice outcomes • Allocate advice sessions to recognise practice sizes (3,000 - 6,500) • Take advantage of the practice as a “trusted hub” • Maximise opportunities - GPs engaging with child poverty - Practice nurses undertaking chronic disease management

  17. Some discussion points

  18. Comparing advice referrals over 12 months

  19. Implications for all Link Workers • Need to tackle important money worries & high household debt levels to address other health & wellbeing priorities • Strong links between debts & mental health, addictions & suicide - disproportionally impacting Deep End GP practices • Social housing: £120,000 gains, rent & council tax arrears were important debts (Universal Credit) • 1 in 4 accessed other support: housing, homeless, mental health & fuel poverty • How can all Link Workers ensure timely access to support e.g. housing, welfare advice, mental health?

  20. Thank you James Egan Glasgow Centre for Population Health james.egan@glasgow.ac.uk www.gcph.co.uk

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