The Welfare Advice Service Faciliator (WASF) aims to establish welfare advice and health partnerships within healthcare settings.
The service is hosted by the Improvement Service, which works in collaboration with NHS Scotland and the Scottish Public Health Network to support and implement the partnerships in primary, secondary and other health and social care settings. Funded by the Scottish Government, the initiative assists the embedding of appropriate advice services within existing care pathways.
Welfare reform and austerity are putting health services under undue pressure. Increasingly, health care professionals are dealing with socio-economic problems and the immediate effects of poverty, meaning that they have less time to focus on their patients’ clinical needs. There now exists an extensive body of evidence that proves the integration of advice and health services has extensive benefits for health services, patients and advice services. Independent research and evaluation shows that welfare advice and health partnerships have a positive effect on patient health, reduce the pressure on health services and enable advice agencies to engage with client groups who would otherwise not engage with their services.
The WASF initiative offers advice and support to advice agencies, Health and Social Care Partnerships, and health services interested in developing welfare advice and health partnerships. Please contact Roddy Samson for further information and assistance.
This briefing on specialist link workers (SLW) has been prepared by the Scottish Public Health Network, NHS Health Scotland and the Improvement Service. It has been produced for Health and Social Care Partnerships (HSCPs), GPs, NHS Boards and other key stakeholders involved in developing Primary Care Improvement Plans.
Primary Care Improvement Plans offer HSCPs the opportunity to provide SLW in general practice who can focus on meeting the social welfare and financial needs of patients and, when necessary, connect patients to sources of support in their community. This is a quality assured and regulated service developed over the last 25 years which is currently in place in approximately 50 general practices in Scotland.
Accessing money advice services in GP practices has only been tested on a small scale in Glasgow. Yet, the city has 80 of the 100 “Deep End” GP practices serving the most deprived populations in Scotland. Initial learning from two local practices supported this study which looked at integrating advice services in nine Deep End practices across north east Glasgow over a 12-month period.
This new study from Glasgow Centre for Population Health found that GPs took the lead in referrals, which totalled 654 people. The majority were living below a standard poverty measure and often had no past contact with advice services. There were £1.5 million in gains with successful claims for disability-related benefits making up half of the gains. Support to manage household debts totalled £470,000 with rent and council tax arrears significant debts. The main reasons people accepted support from other services was homelessness and housing, followed by mental health. The return on investment was £25 for every £1 invested, which was a conservative estimate.
Douglas O’Malley, Health Improvement Lead with Glasgow Health and Social Care Partnership, summarises the findings of the research in his blog.
A Social Return on Investment analysis carried out by the Improvement Service, in partnership with NHS Lothian, Dundee City Council and Granton Information Centre, found that every £1 invested in the co-location of advice workers in medical practices would generate around £39 in social and economic benefits.
The benefits listed below – among others - were identified, measured and valued by talking directly to the people most affected:
Glasgow Centre for Population Health (GCPH) produced a report on the processes underpinning the Deep End Advice Worker project, including an assessment of its impact. The project developed and tested approaches to delivering advice services (e.g. financial and debt advice, housing advice and social security support) in two general practices in north east Glasgow. The main focus of the Deep End Advice Worker project was to improve social and economic outcomes for people. It also sought to reduce the time medical staff spent on non-clinical issues.
The report explicitly examines the importance of practitioner knowledge and professional relationships in collaborative service delivery projects. Recommendations are made regarding approaches to delivering future work of this nature.
A report by Citizens Advice and the Royal College of General Practitioners evaluating the impact of integrated advice services in general practice. The report focusses on services provided by Citizens Advice Bureau in Liverpool and Derbyshire evaluating the impact on patients, practice staff and advice service providers. Key findings include:
An evaluation report by NHS Sefton on the impact on integrated advice services in general practice. The Citizens Advice Bureau Health Outreach Service provides advice surgeries in nine practices in the Sefton area. Data was gathered from 148 patients from six practices on use of health services six months before and six months after first appointment with the CAB service. These showed statistically significant reductions in the number of GP appointments and prescriptions for hypnotics/anxiolytics.
This study by the National Institute of for Health Research measures the impact that advice services have on improving recipients’ health and reducing health inequalities.
The project used realist evaluation to find out how, why, for whom, and in what circumstances Citizens Advice Gateshead (CAG) advice services were effective in improving health. The data shows a very significant increase in wellbeing and significant decrease in stress as a result of contact with CAG. Interviews with staff and clients show how CAG contributed to this positive outcome.
This report shows how the right welfare advice in the right place produces real benefits for patient health especially where advice services work directly with the NHS and care providers and presents clear evidence that early and effective advice provision reduces demand on the NHS. The report is an evidence review undertaken through a joint project between the Low Commission and the Advice Services Alliance. It outlines key findings from 140 research studies in the field and gives an overview of 58 integrated health and welfare advice services; the key finding is that welfare advice provided in health context results in better individual health and well-being and lower demand for health services. The report compiles the mounting evidence of both the adverse health impact of social welfare law problems and the beneficial health impact of receiving good advice and makes recommendations to relevant health bodies and stakeholders.
A background paper outlining the development of Health Justice Partnerships in various countries. The paper summarises various approaches and reasons for developing HJPs in Australia, North America and the UK and reviews the impact these have on health services, patients and advice agencies.
A poster and companion postcard infographic resource summarising the findings of the Social Return on Investment evaluation conducted by the Improvement Service.
A fact sheet outlining the key elements required to develop Welfare Advice and Health Partnerships in General Practice.
A roundtable discussion on the embedding of welfare advisers in health and social care services, as an effective response to the impact of welfare reform.
The discussion involved Kate Burton, Public Health Practitioner at Scottish Public Health Network; Roddy Samson, Welfare Advice Service Facilitator at the Improvement Service; and Karen Carrick, Project Manager at the Improvement Service. They discuss what a welfare adviser is, and detail the embedded model - its effectiveness, challenges and plans for it going forward.
A short film aimed at healthcare professionals outlining the link between poor health and money worries. The film explains how HCPs can address issues about patients’ money worries and support them to engage with appropriate advice services by introducing the principle of CARE – Consider, Ask, Refer, Engage.
The documents in this section are information for those who are integrating welfare advice services into NHS settings, particularly general practice, but can be adapted for other settings.
These documents should be developed in partnership with the appropriate NHS Board Caldecott Guardian and the GP and Advice Service leads for information governance.