Providing legal assistance services in healthcare settings can both improve access to advice and support health services to manage non-clinical demand, new research has argued.
It said integrating health and social welfare legal services should be considered “an essential element in the development of social prescribing”, that is, enabling GPs to refer patients to non-medical support services.
The first survey of its kind has found that almost 400 social welfare legal services exist across England and Wales in healthcare settings such as GP practices, but nearly half have funding for just a matter of months.
The research, funded by the Legal Education Foundation, was carried out by Professor Dame Hazel Genn and her University College, London (UCL) colleague Sarah Beardon as part of a scoping effort to see whether cuts in legal aid for the poorest people should prompt a national health justice strategy.
It found the network of healthcare-based advice centres had grown up organically over many years – their development “bottom-up, leading to diverse and innovative examples” – but there was a “strong case” for integrating social welfare legal and health services more formally.
UCL itself has run a legal advice clinic in the London Borough of Newham – one of the most deprived in the country – providing legal services to health clinics and GP practices and staffed by UCL law students, supervised by qualified lawyers.
The research found 380 advice services, most of them helping clients with welfare benefits issues such as filling in application forms and representing people at tribunals, with many also offering housing and debt advice, had low levels of long-term financing.
Some 40% of services had funding for less than a year, given by charities, local authorities, or NHS sources.
Professionals working in the sector said the services helped reduce pressure on health services – with consequent savings in public money – but resource constraints and the difficulty of showing hard outcomes presented challenges.
The authors said that official backing from NHS partnerships and having legal services based in healthcare settings helped make them “become part of accepted ways of working”.
They added: “When effective partnerships were established, they were found to be highly valued by healthcare professionals.”
Such collaborations had “potential to improve the health and wellbeing of individuals, as well as to support healthcare services in delivering holistic care that addresses the underlying determinants of health and reduces pressure on frontline services”, they said.
“As services that facilitate access to the most basic needs and rights which are fundamental to health and wellbeing (such as sufficient income and appropriate housing), social welfare legal services should form core components of any holistic social prescribing scheme.
“Greater recognition of the contribution of social welfare law to social determinants of health and health inequalities is needed.”