A citizens' advice service in primary care: improving patient access to benefits

Abstract

The links between deprivation, poverty and ill health are well known, but many people with significant health problems do not claim welfare benefits to which they are entitled. Accessing advice within primary health care may be one way of tackling this problem. The aim of this development project was to develop and evaluate over a 3-year period a welfare rights advice and information service that would not only complement the work of the primary health care team, but also target those patients who were most in need. The service was developed using an action research approach. Three models were used with different primary health care teams. The evaluation consisted of both qualitative and quantitative elements. The qualitative study used semi-structured one-to-one interviews with 11 patients who consented to be contacted, two Citizens' Advice Bureau workers and 26 primary health care team members from 10 general practices in Gateshead covering a wide range of practices and patients (approximately 73 000) from all socioeconomic groups, and additional focus group interviews with three further primary health care teams. Quantitative data were collected by the Citizens' Advice Bureau on 683 patients and benefits received. A welfare rights service with an attached Citizens' Advice Bureau worker was seen as beneficial by the primary health care team. The work of the primary health care team was complemented by the CAB worker's additional expertise. Many patients entitled to benefits who would not otherwise have sought advice from a Citizens' Advice Bureau worker were referred by primary health care team members. It was found that targeting people unable to access the surgery reached those most in need in the project group. For those referred, a cumulative total of £1 641 865 was gained during the lifetime of the project. Many patients were referred and as a result received benefits. Optimum use of the service was achieved by restricting the service to the housebound. The use of a dedicated telephone line appeared to maximize the use of the workers' time, and also made few demands on the time of the primary health care team.

Developing homelessness prevention practice: combining research evidence and professional knowledge

“…2002). Evaluations suggest that the schemes complement the work of the primary healthcare team, allow easier access to services, and are particularly beneficial for older people who are reluctant to use community advice centres (Galvin et al . 2000, Sherratt et al .…”

Who uses welfare benefits advice services in primary care?

“…Qualitative evidence suggests that this is indeed the case. Service users report finding it easier to access the service in a setting which is familiar, unstigmatising and nearer to home (Moffat et al . 1999, Emanuel & Begum 2000, Sherratt et al .…”

“…Primary care trusts also appreciate closer working with advice services, both because the advisers give a better service to patients than National Health Service (NHS) staff do (Sherratt et al . 2000) and because the service saves staff time (Fleming & Golding 1997, Coppel et al . 1999, Sherratt et al .…”

“…1993). Collaboration between NHS and advice staff facilitates case‐finding (Scully 1999, Emanuel & Begum 2000, Sherratt et al . 2000).…”

Patient Advice and Liaison Services: strengthening the voices of individual service users in health‐care organizations

“…However, clients may prefer PALS to other services because its use is not embarrassing. The location of welfare benefits advice services in health‐care settings, for example, is known to attract clients who would not have used such services elsewhere because of stigma 33,34 …”