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“It just relieves a lot of the pressure ....
it takes the worry away”
Evaluating the impact of welfare rights advice for people with health problems.
Suzanne Moffatt Emma Noble
Institute of Health & SocietyNewcastle University
“
1993 Citizen’s advice and general practice – BMJ
1998 Acheson Report – tackling health inequalities
BUT Welfare rights advice services in health care
often funded by ad hoc and short term sources Need for ‘evidence base’
Background to welfare rights and health
Researching the impact of welfare rights advice
Department of Health funded pilot study 2001-2005
126 people aged over 60 in Newcastle u Tyne Recruited randomly via inner city General Practice Offered domiciliary welfare rights adviceSampleMean age 71 (range 60-93)Poor healthNone below poverty line, but most low income
Outcome of welfare rights advice for people aged over 60
Type of Award Percentage of Participants
(N=113)
Received no awardReceived some type of award(s)
40%60%
Evaluating impact
2 methods
◦Quantitative study Wide range of physical, mental health
outcome measures
◦Qualitative study Interviews with 25 people plus 10 carers
at baseline and follow-up (18 months)
Welfare Rights Advice
Financial benefitNon-financial
benefits
Necessities Occasional expensesCapacity to cope with crises
Peace of mindAbility to participate
in societyMaintaining
independence
Impact of welfare rights advice for people aged over 60: findings from interviews
June 2008, Durham County Council and Macmillan Cancer Support
3 dedicated welfare rights advisers
Advice in a range of settings
Interim findings, service and evaluation on-going
Evaluation of WRA service for people with cancer and their
carers
1/3 live in the most deprived areas of England, 10% live in the least deprived areas
Life expectancy/early deaths from cancer worse than the average for England
Poor access to welfare benefits: Macmillan Cancer Support
Background to Service
Interview Study: 44 clients and carers from January 2009 -
present 15 followed up by July 2010 Topic guide
Statistical Study: Descriptive analysis of 2 yrs of quantitative data
Methods to Evaluate Service
Sample Attributes35 clients1 carer
Category No of Participants
Age 30-3940-4950-5960-6970-7980+
598671
Indices of Multiple Deprivation
1 (most deprived)2345 (least deprived)
1512531
Number of benefits
01234Awaiting tribunal
4148523
Employment Status
Short/long term interruptions work
Occupational sickness pay v SSP
ESA/IB: ability to work again
Over SPA: already reduced income
Carers
For some, cancer did not affect their financial situation
Individual Circumstances
Specific Impact Loss of earnings or unemployment Travel/parking costs Heating bills Dietary needs Clothing needs
Overall Impact Reduced stress & anxiety Increased security
Impact of Receiving Benefits
“It takes the pressure off.....you know it takes the worry away. You can concentrate on getting yourself better or making your life as comfortable as you can...it’s one less thing to worry about … It gets one of your main concerns covered if you like.....I think the worry would have killed us off, not the cancer”(female, aged 65 )
Individuals were advised about benefit entitlement
Practical assistance with completing forms
No longer had to cope alone with complex benefits system
Expert advice, timed to suit individuals
Characteristics of Service
Welfare rights services should be available as a multi-disciplinary approach for everyone with cancer.
A dedicated service allows health care professionals to refer individuals for expert advice whenever it is needed.
Without this service, many people affected by cancer will miss out on benefit entitlements at a time when they need it most.
Conclusions
Final report available early 2011
Interim findings: open access on-line journal should be available in 2-3 months
Findings widely disseminated after completion of study in 2011
Contact: S.M.moffatt@ncl.ac.uk e.j.noble@ncl.ac.uk
Dissemination
Recommended