Developing new pathways to health and financial support

With funding from Guy’s & St Thomas’ Charity we are working with partners in Lambeth and Southwark to deliver the ‘Covid Financial Shield’ project.

Why a Financial Shield is needed

Research has shown that people living in urban areas with multiple long-term health conditions are more likely to have fewer healthy years than others. People who are Black, Asian or from a minority ethnic group are likely to be more at risk. Financial health, housing and work can all drive health inequalities.

Against this backdrop, the economic impacts of the COVID pandemic are disproportionately affecting lower income households living in rented accommodation, families with children (especially single parents) and people from minority ethnic backgrounds. Many of these groups were more likely to be over-indebted before the outbreak, and there have been alarming increases in arrears on rent, Council Tax and household bills amongst these since. Many have also had to borrow more simply to make ends meet.

The inter-connected nature of financial and health problems requires a joined up response. We know that financial problems can negatively impact health.  For example by creating or exacerbating stress, anxiety and depression or because people can’t afford essentials and cut back on food and heating. We also know that health problems can impact financial well-being by limiting the ability to work, or because managing a long-term condition creates additional living costs.

But identifying people with both health and financial problems can be difficult. Neither health agencies nor creditors have a full view of people’s circumstances. The opportunities to assist through primary care and creditor recovery procedures may be missed. People may also need greater help to access the financial support that is available within their communities.

How will the Financial Shield work?

The Financial Shield project is testing new ways to meet the needs of people with, or at risk of developing long-term conditions and who are experiencing financial difficulty by:

• Creating new pathways to support. We are working with local GP practices, community groups and creditors to better identify and target people for support.
• Embedding new Financial Support Link Worker roles within social prescribing teams.
• Providing residents with more time and space, without the threat of debt enforcement, to address their financial and health problems. Creditors, starting with the two local authorities and four housing associations are working together to provide a joint response for people in rent and Council Tax arrears.

The project has already led to the creation of a new ‘Joint Creditor Forum’ operating across the two Boroughs. This currently brings together Lambeth and Southwark Councils with four Housing Associations – Optivo, Metrpolitan, Hyde, and Southern Housing.

Recognising the need for a joined up approach to collecting rent and Council Tax debts, the Forum has put in a place a new Joint Debt Recovery Protocol for residents within the Financial Shield project.

Once notified that a resident is engaging with the Financial Support Link Workers, participating creditors have agreed to suspend any recovery action for outstanding debts for up to 60-days. This provides the resident with the time and space they need to receive support about possible benefit claims or other help that they could access. At the end of the 60-days the Financial Support Link Worker provides a single report to the creditors setting out how much the resident can realistically afford to repay towards any outstanding arrears.

Where the resident is both a tenant of one of the participating Housing Associations and also has a debt outstanding to their local authority, the creditors will jointly consider how any repayment amount should be divided between them, and will co-ordinate communications to the resident about this through the Financial Support Link Worker. And, if there are payment problems in the future, the participating creditors will discuss how best to proceed together rather than pursue individual, and potentially conflicting recovery strategies.

Evaluating the project

Working with Cordis Bright, we are evaluating both the processes followed in the delivery of the project as well as its impacts on residents, creditors and health agencies.

For example, we will be assessing how well each of the new pathways to support has worked in identifying and pro-actively engaging our priority groups, as well as the difference that has been made by the implementation of the Joint Debt Recovery Protocol and the Financial Support Link Workers.

As the project involves a multi-agency response at a time of immense pressure, we have also included an evaluation stream looking at the system level. This is seeking to yield insights into how we can more effectively support partners to coordinate on a new piece of work in the middle of a crisis.

Ultimately, the evaluation will also be seeking to provide an assessment of the costs and benefits of the programme, and will inform decisions by creditors and other commissioners of services as to the business case for ongoing investment.

Finally, should the project fail to deliver material improvements for residents (or be impeded in doing so by, for example, policy or institutional barriers), we will be capturing the reasons for this. Where appropriate, we will report on any wider government intervention that may be needed to improve financial and health outcomes amongst the target group.

Sharing our insights

We will be sharing further details of the project’s processes, outputs and outcomes over the course of the next fifteen months. These will include releasing details of our Theory of Change and Evaluation Framework, and providing details of the new assessment tool that we will be embedding within the project.

We will also be arranging occasional virtual roundtable events to discuss key findings as these emerge, and to reflect on the project in its wider context.

A dedicated project website will be launched in late February which will be used to update stakeholders on the project as it progresses.

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