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

2. 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

4. 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’

5. 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

7. 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

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

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

11. 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

12. 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

13. Findings I: LAG Poll of GP’s

15. Findings I: LAG Poll of GP’s

16. 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

17. 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

18. 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

19. Launch Event

20. Event at DeptHealth

21. 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.