2015 Improving Peoples’ Health Through Advice Allyson Whisker, Citizens Advice

GP Non- health Demand: A Very General Practise  GPs spend 18.7% of their time on non-health matters  Four in five GPs (80%) report that dealing with non-health queries leaves them with decreased time available to treat other patients’ health issues  15% of GPs refer patients to an advice expert based in the surgery  Three quarters (73%) of GPs report that the proportion of time which they have spent dealing with non-health issues as part of consultations has increased over the past year Director of Policy, National Voices “The doctor of the future will give no medicine”

GP Non- health Demand: A Very General Practise Most non-health demand results from personal relationship problems, housing, welfare benefits, unemployment / work-related issues (unrelated to health), debt / financial difficulties and social isolation Most GPs (84%) rely on advice provision in the community to support patients With GPs in England spending almost one fifth of their consultation time on patients’ non- health issues, this translates to an implied cost of nearly £400 million to the health service. Legal Action Group and the Law Society “…a majority of doctors believe that the number of their patients who would have benefited from legal or specialist advice has increased in the past year”

1,000+ ad-hoc locations Consumer advice service (phone, /letter) in England, Wales and Scotland Our website ‘Adviceguide’ providing extensive self-help information on a wide range of topics. Evidence - national level research Sample size = 2,728 Survey of clients across service reveals high level of self- reported impact on mental well-being and physical health earch_report_2014.pdf “Less stressed, depressed or anxious”

1,000+ ad-hoc locations Consumer advice service (phone, /letter) in England, Wales and Scotland Our website ‘Adviceguide’ providing extensive self-help information on a wide range of topics. Evidence – health and poverty pilot Sample size = 143 Detailed survey of change in clients’ mental well-being suggests significant positive change 4-6 wks after advice

+ ad-hoc locations Consumer advice service (phone, /letter) in England, Wales and Scotland Our website ‘Adviceguide’ providing extensive self-help information on a wide range of topics. Evidence – Centre for Mental Health study with SMHCAB Quicker hospital discharge Prevention of homelessness Preventing relapse MH_services.pdf Three key savings pathways Successful Advice Improved Financial or Housing Stability Better Mental Health Reduced Use of Services

319 member bureaux (f2f, phone, /letter) 2,500+ regular community locations 1,000+ ad-hoc locations Consumer advice service (phone, /letter) in England, Wales and Scotland Our website ‘Adviceguide’ providing extensive self-help information on a wide range of topics. Our services in health locations nationally Type of health outreachNumber GP Surgery614 Hospital (66) or Hospice (4)70 Mental Health Day Centres/Drop-ins User Groups29 Psychiatric Hospital10 Total723 % of all regular outreaches38%

Advice on Prescription: Derby CAB 94 GP surgeries across Derbyshire 6000 clients: 30,000 problems £900,000 financial gains £1 of funding returns £12 of additional income and £8 debt managed 20 year long service Local Public Health Funding

“The main determinants of health are socio-economic. If we want to promote good health, prevent ill health and reduce inequalities in health, we must act on the social determinants that are likely to impair people's health (Marmot 2010). Citizens Advice Bureau (CAB) provide advice, help and support to people on a wide range of issues that comprise many of the social determinants of health.” [Derbyshire County Council making the case for GPs advice service]

Liverpool Advice on Prescription Partnership Social Prescribing Model Health Professionals and vulnerable patients Launched in GP practices 3057 enquiries Managed £1.8 million of debt £3.5 million maximised for patients

Emerging Local Opportunities Devolved budgets and responsibility Local Flexibility Services designed around patients and health professionals Partnerships

Allyson Whisker Service Design and Development Specialist, Citizens Advice

citizensadvice.org.uk Published June 2015 Citizens Advice is an operating name of The National Association of Citizens Advice Bureaux. Registered charity number Free, confidential advice. Whoever you are. We help people overcome their problems and campaign on big issues when their voices need to be heard. We value diversity, champion equality, and challenge discrimination and harassment. We’re here for everyone.