Practical advice service helping to tackle causes of poor health

A ground-breaking service that provides financial support and advice through Liverpool GP practices is demonstrating a significant impact.

An evaluation of the Advice on Prescription service, which was introduced by NHS Liverpool Clinical Commissioning Group (CCG) and is run by Citizens’ Advice Liverpool (CAB), has shown how it is helping some of the city’s most vulnerable households to increase their income and reduce debt.

NHS Liverpool CCG announced a new five-year contract for Advice on Prescription in 2016, representing a £2.5 million investment as part of its mental health strategy.

Operating from 50 locations across the city, all Liverpool GPs can refer patients for assistance from CAB advisors on a range of issues including: housing, homelessness, job loss, complex debt issues and benefits advice.

Figures compiled by the CCG and the CAB show that between 2016 and 2018 the service resulted in:

• A total of £6.7 million in income maximisation – helping people make sure they are receiving all the financial support available to them and reducing debt and other outgoings where possible.
• An average increase in household income for referred patients of £762.
• Helping people to manage debt totalling £2.7 million – with more than £157,200 of this written off.

The service was developed after GPs reported a rise in patients presenting with problems that had a practical rather than medical cause, reflecting the strong link between social and economic hardship and poor health.

A significant number of Liverpool residents live in areas of high deprivation – the city was ranked as the fourth most deprived authority on the Index of Multiple Deprivation 2015.

The evaluation found that nearly 57% of people referred to the service had a monthly household income below £800, and 62% of referrals came from the most deprived areas of the city.

Advice on Prescription reports high levels of satisfaction with both those using the service and GPs who refer people into it: 77% of patients reported an increase in their capacity to manage their own physical and/or mental health, and 23% reported an increase in their capacity to maintain somewhere to live and avoid eviction.

Dr Fiona Lemmens, a Liverpool GP and Chair of NHS Liverpool CCG, said:

“There are many non-medical factors which can impact on a person’s health. As GPs we regularly see patients whose problems are rooted in things happening in other areas of their life, including those struggling with money or housing problems. The strain created by these type of issues increases the risk of developing conditions such as depression and anxiety.

“The Advice on Prescription service gives GPs and other health and care professionals a clear route to help patients who might need practical advice and support. This is good for individuals as it creates an opportunity for them to tackle problems which are having a negative effect on their health, while also reducing pressure on GP practices.

“We’ve very proud of the service and the positive impact it’s having. It demonstrates how we need to recognise the wider issues that impact on physical and mental wellbeing, and the importance of addressing the cause of problems rather than simply treating the symptoms.”  

Debbie Nolan, Project Manager, South Liverpool Citizens Advice Bureau (CAB) said:

“Citizens Advice Liverpool are pleased to be the third sector delivery partners on the Advice on Prescription programme, and that is it making such a real difference to the lives and health of so many people in Liverpool. 

“Advice on Prescription is an excellent example of collective and partnership working which is providing help and support to people with a range of non-medical issues such as debt, housing and loneliness and isolation in conjunction with local GP and their teams.”

You can read a full copy of the report here.