Health-justice partnerships helping people to access legal advice

Victoria Central Hospital: Home to Flouish Wellbeing Hub

Co-locating legal and health support services is producing results, new research has indicated, with some clients saying they would not have accessed support without a healthcare professional directing them to it.

They are reaching, broadly speaking, older white women from the lowest socio-economic grade who have a long-term health condition.

On Friday, the Ministry of Justice (MoJ) published two reports on so-called health-justice partnerships (HJPs) – one a progress report from an evaluation of 13 located in primary healthcare settings like GPs’ surgeries, and the other early findings from the Flourish Wellbeing Hub, an HJA set up with MoJ support at a secondary healthcare setting, Victoria Central Hospital in Wallasey on the Wirral.

HJPs were identified as part of the MoJ’s 2019 legal support action plan and an initial feasibility study for the evaluation, published earlier this year, said that clients who obtained legal advice at their GPs’ surgeries reported “a range of positive outcomes, including on their mental and physical health” as well as their finances.

The evaluation of HJPs – 11 involving Citizens Advice, one a law centre and another a housing association – is due to end next summer but the progress report found positive signs: “Some clients suggested they would not have accessed the necessary and beneficial support if they had not been referred or signposted by a healthcare professional.”

A physical presence of legal advisors in healthcare settings was described by all particularly valuable – although being able to deliver advice remotely when required “helps maximise the reach of services”.

In one HJP, a coffee kiosk next to the advisors’ office encouraged patients to seek legal advice before or after a medical appointment.

An advisor explained: “Particularly for elderly people, [they] would come in there, have a coffee and by conversation they would know that I’m sitting around the corner. And they can pop in if they’ve got a letter they don’t understand or whatever.”

Direct booking systems, allowing a medical professional or receptionist to arrange appointments for patients, were key to successful referrals, while some HJPs reported hosting regular multi-disciplinary meetings (subject to data protection agreements) to discuss patients’ needs in a holistic way and organise their care plans.

“Representatives from a range of organisations are often in attendance, including social workers, occupational therapists, link workers and Citizen Advice advisors.

“These meetings offer an opportunity to share information about patients and make ‘warm’ referrals to multiple organisations at the same time.

“In this way, many healthcare professionals and advisors described feeling that they support efficient referrals. They also explained that these meetings provide forums for ongoing discussions about the impact of referrals and patient outcomes.”

The report said: “Many clients spoke positively about the ease of access to advisors that are co-located in healthcare settings. Notably, in many cases, clients suggested that it was the referral from primary care that really enabled their access to legal support.

“This is because for many people, a GP is the first person they consider contacting when they need support, and because GPs are considered trusted sources of support.”

Co-location also supported the continuity of care for patients, some of those interviewed said.

“They suggested that the referral from a healthcare professional, alongside the co-location of the advisor, encourages clients to treat advisor appointments as medical appointments.

“In this way, some patients are more open to receiving help from advisors (and financial support) because the appointment is viewed as a means to support their overall health.”

Clients of the HJPs tended to be aged 45 or older (65%), female (64%), white (92%), tended to be from E socio-economic grade (55%) and have a long-term health condition (71%). (E is state pensioners, casual and lowest grade workers, unemployed with state benefits only.) Nearly one in three had mental health issues too.

“HJPs reported providing advice and support for a wide variety of issues. However, the main types of advice offered by HJPs tended to be the same across the board: issues to do with benefits, housing and rent, and debt and finances.”

The Flourish Wellbeing Hub provides a range of support for people experiencing social and economic issues that impact on health, and very often have a legal component relating to welfare rights.

The five charities currently involved are Citizens Advice Wirral, Age UK Wirral, Wirral Mind, Involve Northwest and Change Grow Live. Services go well beyond legal advice into ‘social prescribing’ more broadly – supporting people with issues and problems that are making them unwell.

“Flourish aims to provide a seamless transition between services, allowing people to tell their story once before receiving appropriate support,” the MoJ report said.

“Early findings show that services are now reaching individuals early, providing support to people before their issues have the potential to escalate. Acting as a trusted provider and developing a strong presence in the local community is felt to be key to the success of Flourish.”

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