Advice and Health Project James Sandbach, Low Commission Lindsey Poole, Advice Services Alliance

Why advice and health People with poor health often have other problems with (at least partial) legal solution People with legal problems often have poor health, particularly mental health Direct relationship between poverty and health Direct relationship between poverty and the causes of poor health

Link is startling 50% people in debt have a mental health issue (c.f. 15% of the general population) Mental ill health accounts for 23% of overall ‘disease burden’

Why advice and health too Stress on frontline services/GP’s time Not medicalising social problems Options for some patients limited Access to advice services patchy Targeting advice services at those with most need Going to where likely to find people with problems

Background to project Barings Roundtable Event, July 2014 agreed to set up a project to look at how advice can engage with health services Many successful projects but not mainstreamed and reported ‘hard to sell’ Building the evidence base – some good evidence (Marmot etc), but not influencing decisions Future Advice Funders Forum Interest

Challenges I How to engage with two (currently) separate sectors at three different levels:

Challenges II Policy churn in both sectors – LASPO, Care Act, NHS reform, public health, mental health etc. Austerity and cuts- everyone looking for savings

Challenges III Cultural and language differences between health and advice Lack of accepted ‘evidence base’ Complexity of structures in all areas of health and social care

Structure of Project Evidence base for relationship between advice and health outcomes Rapid Assessment of Evidence Mapping current work between health and advice services Polling GPs around SWL needs Engage Stakeholders in Oversight/Governance Dissemination strategy to influence key stakeholders

Findings I: LAG Poll of GP’s

Findings I: LAG Poll of GP’s

Findings II: Clear evidence base Marmot Review: Social determinant links Welfare advice can reduce anxiety, improve general health, relationship & housing stability Welfare advice can reduce GP time by 15% Strong debt/mental health link Welfare advice in secondary care settings can help facilitate discharge planning

Findings III: Mapping services Captured 58 examples of advice in health context, over half in primary care settings, but wide variation in models & funding: Eg:- Bromley by Bow – Social prescription Wirral Primary Care Advice & Advocacy Sheffield Mental Health CAB Steps to Wellbeing – Dorset Healthcare MacMillan/Claterbridge Cancer NHS Trust Croydon Community Navigators

Dissemination Launch at House of Lords in June Sent out through ASA members and ASTF partnerships Copy of report to every Chair of HWB, Director of Public Health, Clinical lead in CCG’s linking to ASTF partnership Seminar for high level stake holders

Launch Event

Event at DeptHealth

Thinking about the future Older People 4.8m Over 80’s by 2030 5.4m with one or more co- morbidities. Treatment & care of long term conditions = 70% of all health & social care spend Younger people Over 10% of young people have common mental health issues NEETs, socially isolated, or in debt and other social welfare problems x 5 likelihood of mental health problems.