1
Just what the doctor orderedResearch into
health-based welfare rights advice for Age
Concern England

• Neil Batemanwww.neilbateman.co.uk

2
The project

• Research commissioned by Age Concern England to
  identify scale, funding, monitoring, range and
  impact of independent benefits advice delivered
  in healthcare settings in England
• Also to look at lessons what works/doesnt work
  whats needed.

3
Research methods

• Project team Neil Bateman and Geoff Fimister
  reporting to Sally West at ACE
• Survey, data collection from national bodies,
  mapping of provision
• Literature survey on impact of WR advice on
  health
• Telephone interviews with 5 very different
  projects and up to three stakeholders per project
• Additional two projects (Liverpool HABIT and
  Southwark WRS) visited and written up as case
  studies

4
Findings

• 170 services, variety of providers and advice
  methods (mostly CAB or LA WR services). Incl at
  least 10.5 (889) of GPs practices. 167 fte paid
  advisers. 523 are CAB services
• 33 decline in these CAB services from 2005
• Distribution of services very variable
• 74 hospitals, 93 MH settings, 27 other NHS
• 6,179 hrs (167 fte advisers)

5
Findings (2)

• 5.77m spent on services,
• 43 - 58 m extra in benefits, for estimated
  28,216 people in 2006 (1,549 per service user).
  70 aged over 65?
• 260,523 per fte adviser return of 10.13 per
  1 spent on service
• Everyone reports a positive impact on health/well
  being, especially a drop in stress
• More research needed to quantify impact, but like
  many clinical interventions, it may be hard to
  quantify the health impact

6
Key messages

• PCTs often marginal. Can run without them, but
  need PCT backing for service to be sustainable
  and integrated
• Most services financially weak (eg big decline in
  CAB services)
• Performance measurement too variable. Monitoring
  is variable
• Use pre-booked appointments, but be flexible
• The right type of adviser is important
• Lack of a national strategy, confusion about role
  of DWP welfare reform
• Relationships with NHS counterparts are vital
• Services highly valued by stakeholders
• Paradox of sustainability overload

7
How not to set up an advice service in the NHS

• Insufficient evidence of need impact
• Initiative parachuting
• Lack of a champion
• Insufficient time spent building relationships
• Unclear referral process/criteria
• Ignoring the PCT and/or NHS trust
• Inconsistent use of advisers
• Rigid service model
• Extravagant needs for premises
• Poor grasp of health care professionals needs
• Poor rationale for the method used
• No long-term funding possible.