Agenda item

To share with the Board the findings and recommendations of the recently completed health needs assessment of benefits and debt advice for Northumberland and to seek their views on the recommendations and next steps.

Members received the findings and recommendations of the recently completed health needs assessment of benefits and debt advice for Northumberland and to seek their views on the recommendations and next steps.  The report was presented by Dr Kathryn Bush.

Dr. Bush raised the following key issues:-

·            The assessment was carried out in late 2021 and considered the type of needs, unmet needs and implications.

·            Normative Need (published evidence and expert opinion)

·            The Marmot Reviews highlighted the links between income and health.  People living in the most deprived areas lived shorter lives and a longer proportion of their lives in poor health compared to those in less deprived areas.

·            Welfare benefits and debt advice could improve health through increased income to buy food, providing heating and indirectly to lower stress, improve mental health, and generally engage more with health services.

·            There was a two way relationship between debt and health.

·            The Department for Work and Pensions estimated at approximately £7.1 billion, was unclaimed each year (pension credit, housing benefit, income support/employment and support allowance.)  Unclaimed benefits in Northumberland could be £31.8 million per year.

·            Increase in inflation and overall cost of living – those with the lowest incomes are most severely affected by rising costs.

·            Comparative Need (how we compare with other places)

·            Northumberland presented unique problems due to its geography and widespread rural population. 

·            Healthy life expectancy was lower than national average and decreasing.

·            Suicide rates higher than national and North East average.

·            North East of England had lowest median weekly earnings in the country

·            Northumberland had higher number of children living in poverty in working families than in non-working families.

·            Felt Need (What people say they need)

·            2015 Residents’ Survey Findings

·            Adequate income top factor contributing to health and wellbeing

·            14% faced difficulties paying fuel and energy bills

·            9% had difficulties buying food and 2% were reliant on high interest money lenders

·            19% did not use the internet.

·            2022 Survey Results

·            Citizens Advice Bureau – most commonly named source for benefits and debt advice

·            Some people needed advice but did not access it

·            8% did not know where to get it

·            6% were concerned about confidentiality

·            Others had difficulty accessing advice or were too embarrassed.

·            Expressed Need (which services people were currently using)

·            Many organisations provided basic budgeting and financial advice but referred on for benefits advice or debt management.

·            Citizen’s Advice Northumberland was signposted by other agencies

·            Northumberland Communities together provided advice and discretionary grants to residents.

·            Northumberland County Council’s Welfare Rights Team provided training and support to care managers and social workers.

·            Citizens Advice Northumberland gave advice to 22,582 clients in 2019-20 and covered benefits and debt advice

·            Potential Unmet Needs Identified

·            Between February 2019 and January 2020 51% calls to Citizens Advice were unanswered.  The pandemic resulted in an overall increase in numbers requiring and accessing advice services. 

·            Families who had previously been ‘just about managing’ were now facing financial problems.

·            Challenge of meeting needs of rural populations and residents with low income highlighted.

·            Report Implications

·            Advice services in Northumberland not currently meeting the increasing needs of population.

·            Increase core service funding

·            Invest in wider capacity building over the next three years.

·            Increase planned investment from £420,000 per annum to £520,000 per annum.

The following comments were made:

·            The Northumbria Healthcare NHS Foundation Trust offered debt advice to all staff and so it was important to recognise the support offered by organisations to their staff.

·            It should also be acknowledged that there was a lot of social prescribing activity within Primary Care related to debt management and help in accessing debt services.

·            There may be a role for Northumberland Communities Together in improving access to the internet for the 19% (2015) of residents reported to have no access.  There was often a view that everyone could access digital technology, but this was not the case.  It was important to find ways to help people to access the internet without having to pay.

·            The issue was wider than just people’s finances and often also related to housing problems.

·            The principle of ‘Making Every Contact Count’ was valuable and it was hoped that it would be possible to improve the ability of workers to recognise where help was needed and signpost a patient to appropriate services. 

·            Comparison figures were obtained by looking at neighbouring Local Authority areas and areas where the cost of living was similar to Northumberland.  It was clear that workers in the North East were earning less.  Lower income was also a contributing factor in health outcomes.

·            Many people needing help to fill in forms or seek advice found it difficult to access advice services by telephone or face to face.  The survey had revealed that sometimes the opening times of town centre hubs did not fit in with public transport.  Citizens Advice had made the decision in 2017 to increase its service by telephone and digital means.

·            Job roles should be created which would address rurality problems and allowed proper targeting to ensure that the right people got the right message.  There needed to be a consistent approach to ensure that these staff were properly trained and ensure that they were regularly updated.

·            Provision of welfare and benefit advice within NHS partner organisations was an issue that could be picked up through the ICS Strategy to ensure a consistent approach. 

RESOLVED that

(1)    Members’ comments on the evidence in the report and Advice Services Health Needs Assessment Summary be noted.

(2)    The importance of the role that advice services have in reducing inequalities be acknowledged.

(3)    The role of advice services with Northumberland’s system-wide Inequalities Action Plan be noted; and

(4)    The contribution of partners to support access to welfare and benefits advice for their staff, patients, and residents, be agreed.