Legal Services Consumer Panel
The information prescription
9 July 2015
Years ago, I met with a group of carers of people recently diagnosed with dementia. When I asked how supportive their GPs were, half said their GPs were useless and half said their GPs had changed their lives. The difference turned out to be giving them one telephone number - of a support group.
GPs and other health professionals have increasingly come to realise that an 'information prescription' is sometimes at least as valuable as one for medicine. And some health services have gone further still.
I recently went to the launch of a report called The Role of Advice Services in Health Outcomes. Research commissioned jointly by the Low Commission and the Advice Services Alliance, it maps initiatives all over the UK that provide welfare advice to patients and their carers in health settings.
The report gives many examples of health and welfare collaborations. Camden Citizens Advice Bureau (CAB) runs a welfare advice service in Great Ormond Street Hospital for parents and carers of sick children. It targets poor families whose needs are not being met. Heathlands CAB partners with a local hospital trust to run advice sessions in a psychiatric ward. Clatterbridge Cancer Centre runs a Macmillan Benefits Advice Service as part of its rehabilitation and support programme, offering advice at key points on the 'patient journey' from diagnosis to the aftermath of treatment. In South Tyneside, as part of treatment, three GP surgeries refer adults to agencies that can advise on debt, benefits, housing, fuel poverty – all factors that both cause and arise from poor mental or physical health.
The report also reviews findings from 140 research studies. The clear message is that welfare advice provided in health care settings can impact on health and well-being – including lowering stress, improving sleep, stabilising relationships and housing. Conversely, it found mounting evidence that not addressing social welfare law problems can make people ill. So advice can indeed be good for your health!
But advice can also be good for the NHS. The report found that providing social welfare advice at the point of care can reduce health inequalities by reaching the most vulnerable people in settings they trust and where their needs are understood. It also found some evidence that providing advice at the point of care could actually lower demand for health services.
The report acknowledges that until good outcome and evaluation measures are developed, it is difficult to provide robust business cases for more of these types of collaboration. Still, I think it is fair to say that at a time when the NHS is overwhelmed, there is growing evidence to suggest that timely and targeted social welfare advice could have a significant role to play in reducing demand.
More generally, from a Consumer Panel member's point of view, the report offers rich examples of providing advice where people can best receive it and be supported to use it to improve their lives. I hope that The Role of Advice Services in Health Outcomes will get others thinking laterally about ways of bringing legal services to people, especially people in circumstances that make them vulnerable and unlikely to seek legal help elsewhere.
I wonder if any of you reading this are providing legal services in equally imaginative ways?