Training Courses

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Training courses available to GMPA’s network over the next 6 months

Over the last 2 years we have delivered a small number of paid for training courses in partnership with Policy North Training. The courses equip stakeholders with the knowledge they need to fight poverty both in Greater Manchester and across the UK as a whole. This includes the following course

Maximising support for people on low incomes – taking place on Thursday 28th January and Monday 28th June. This course is for housing providers, VCSE and public sector organisations who work with people experiencing poverty and who wish to understand how to maximise support for their service users. Please sign up if you’re interested in understanding more about the current social security landscape and the financial and other help that’s available to low-income service users. To attend this course BOOK HERE.

Understanding poverty measurement, definitions and data – taking place on Thursday 25th March and Tuesday 11th May. This course is for people who want to understand more about how poverty is measured and how to access robust, accurate and up-to-date data. By the end of this one-day course participants have developed an understanding of what key poverty datasets tell us, how best to access data sources and how to use this knowledge to support the work that they do, whether that be designing services or writing funding bids. To attend this course BOOK HERE.We have two other course running during the first half of this year:

Identifying poverty data in Greater Manchester – Thursday 15th April – BOOK HERE.

Exploring the poverty premium – Friday 25th June – BOOK HERE.

Full course overviews and costs can be downloaded from the training page of our website.


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GM Inequalities Commission survey

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Achieving a fairer Greater Manchester is the focus of Inequalities Commission as new survey launches

People across Greater Manchester are to be asked to help tackle inequality to inform the work of the city-region’s Independent Inequalities Commission.

The drive to make Greater Manchester a more equal society will be informed by the online survey designed to  capture the views and experiences of residents.

The Commission, which reports to the Mayor of Greater Manchester, Andy Burnham, and the 10 local authority Leaders, wants to hear from people who have a passion in making Greater Manchester a fairer and more equal place to grow up, get on and grow old – in particular those with knowledge of the city-region’s inequalities or who have experience working with marginalised groups.

The Independent Inequalities Commission is chaired by Kate Pickett, Professor of Epidemiology and Deputy Director of the Centre for Future Health at the University of York.  Kate is encouraging people to complete the survey, which closes on 31st January, “Working alongside my fellow Commission Members, I am really keen to hear the views of the people of Greater Manchester on how they would create a more equal society.

“Greater equality is better for everyone, but I know that there are barriers and issues such as poverty, low pay, poor health, and unattainable standards in education and skills that are an embedded part of people’s lives. That’s why we want to hear from you about your ideas on how we can get to grips with the root causes of inequality and change everyone’s lives for the better.

“The Commission should be informed by the views of people from as many different backgrounds as possible – please do encourage others you know to take part in this conversation.”

To find out more and undertake the survey log onto


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Wigan Equalities commitment

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Why Wigan Council have made it their own responsibility to consider poverty
GMPA is keen for socio-economic duty to be included in equalities legislation and early in 2020, as part of our work in response to the spread of COVID-19, we developed a briefing. Some public bodies, including Wigan Council, are taking matters into their own hands.

Councillor Paula Wakefield, Lead Member for Equalities and Domestic Violence at Wigan Council, explains why in Wigan Borough, a key consideration when developing new policies, is now the impact the policy will have on lower income households.

“I understand from personal experience the effect that coming from a lower income family can have on your life.  My family were in a relatively stable situation until my father died when I was 13. He had received contaminated blood products as part of a treatment he had for his Haemophilia. He went on to die from Hepatitis C.

It was the early 90’s and there was massive stigma and discrimination surrounding these conditions. We lost our home, and my father had lost his job and his life insurance. When he died we were forced into bankruptcy.

The impact of suddenly living in a low, single income household affected everything. I stopped asking my mum if I could go on school trips or holidays as I knew she couldn’t afford it. My brother and I received free school meals and bills for essentials like utilities suddenly became a real struggle.

I had done well at school but knew that higher education wasn’t an option. We couldn’t afford for me to go to University, I knew I had to get a job and bring money into the family as soon as possible. If you live in a lower income household, your life choices and pathways become limited, through no fault of your own.

Perhaps because of my background, addressing any type of inequality will always be a passion of mine, so when I was offered the Lead Member role for Equalities and Domestic Abuse at Wigan Council, I knew it would be a perfect fit. In one of the first meetings in my new role we discussed tackling the way people are disproportionately affected if they come from lower income families.

I was informed that a decision had been made by the Government not to include socio-economic disadvantage as part of the Equality Act but that we could include it in our own Equality Commitment, which is already a statutory requirement, in the same way that we had adopted carers and veterans into our Commitment.  I made the decision that this would be a priority and last year Wigan Council added socio-economic disadvantage to the protected characteristics listed in our Equality Commitment and our Equality Impact Assessments.

The fact that socio-economic disadvantage is now part of our Equality Commitment means that every time a new policy is developed, we are required to consider the impact it will have on those from lower income households. If we think it may have a detrimental effect, we discuss what we can do to make sure that does not happen.

Considering poverty as part of our Equality Commitment has also helped to raise the profile of the issue. Wigan Council is taking action to improve the life choices for those from lower income families in many different ways including making sure that high quality health services are accessible in lower income areas, providing quality, affordable homes and building more of the right homes, harnessing the power digital connectivity has to improve people’s opportunities and creating local economic growth through our Community Wealth Building Strategy.

Cllr Paula Wakefield for GM Poverty Action

Councillor Paula Wakefield

It is so important for councils to adopt socio-economic duty. The coronavirus pandemic has shown that, yet again, it is the lower income families that are disproportionately affected and we must do everything we can to mitigate it.

We must continue to campaign for socio-economic disadvantage to be included in national legislation. But it’s also important to remember that there are small changes we can make locally, that can have a huge and positive impact on lower income families.

Everyone deserves the same life chances – no matter where you are born or how much money you have and if a Local Authority can help on that journey, why would we choose not to?”


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Supporting fuel poor households in GM

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By Andrew Pinches, Groundwork Greater Manchester

Fuel poverty affects a significant proportion of the UK population and is associated with negative effects on both physical and mental health. It is currently estimated that approximately two and a half million households in the UK live in fuel poverty. Fuel poverty is measured using the Low Income High Cost (LIHC) indicator, which considers a household to be fuel poor if:

•   they have required fuel costs that are above average (the national median level of £1,378); and

•   were they to spend that amount, they would be left with a residual income below the poverty line.

Greater Manchester currently has the highest number of households in fuel poverty in the North West, with Gorton currently having the highest percentage of households in fuel poverty (20.5%) in the UK. It can also be noted that more than 80% of Greater Manchester’s parliamentary constituencies sit above the national average for proportion of households in fuel poverty.

One of the main issues in GM currently is that 80% of the houses in use are over 40 year’s old and deemed energy inefficient. As energy efficiency is a driver for fuel poverty, low income families in Manchester are already in danger of fuel poverty from just moving into an energy inefficient home

Energyworks image for GM Poverty ActionIt can be seen from this graphic, that that there are 3 main drivers for fuel poverty: Energy efficiency, energy prices and income. If a household has high energy bills, low income and an energy inefficient house then they will more than likely be classified as fuel poor.

Improving any one of these parameters can help bring a household out of fuel poverty and alleviate the associated stresses.

Energyworks supports the residents of Greater Manchester with all three drivers of fuel poverty:

•   Energy Prices – Providing support and tailored advice with switching tariffs and providers, helping set up affordable payment plans and supporting residents with energy debt to find affordable solutions.

•   Energy Efficiency – With the installation of FREE small measures such as low energy lighting (LED bulbs), draught-proofing and the installation of radiator panels, residents can use less energy to achieve the same level of heating and lighting in their homes. Larger measures, including Cavity Wall Insulation, Loft insulation and Boiler Replacement, are also available through grants for eligible residents.

•   Income – Through trusted partners, referrals can be made to secure additional income for low income families through increased or additional benefits, grants for essential items/white goods and food and fuel vouchers.

Energyworks is funded at both national and local level with funders such as Ofgem, LEAP and the Local Authorities across GM. Having multiple funders at all levels allows us to go that extra mile for customers ensuring that we give the best possible tailored service to every person. Each customer we speak to is also offered an information pack that they can refer back to at their leisure.

To refer in to the Energyworks team please email  or call us on 0800 090 3638.


For details of fuel poverty across Greater Manchester by Local Authority and LSOA, please refer to GMPA’s Poverty Monitor

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Review of 2020

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It has been a tough and challenging year for people across Greater Manchester. The pandemic has had huge short-term consequences for the city-region, and the economic and health effects will last long beyond 2020.

Everyone has had to adapt to multiple and changing demands during this year. This has been no less true for us at Greater Manchester Poverty Action (GMPA). We can say confidently that GMPA has shown its value to Greater Manchester, helping shape responses to hardship caused by the pandemic and informing the ongoing fight against poverty. We have been able to engage in COVID-19 related work, and at the same time taken forward key pieces of our 2020 workplan (recruiting to the Food Poverty Programme Coordinator role, running the GM Living Wage Campaign, working towards a Poverty Truth Commission in Tameside, publishing the GM Poverty Monitor and launching our report on local welfare assistance schemes).

As we head into 2021, we’d like to wish you all the best for the festive season. We hope you get the chance to have a rest and that you stay safe.

Best wishes,
The GMPA Team.

Strengthening the role of local welfare assistance

Local welfare assistance schemes, operated by local authorities across England, play an important role in responding to the needs of people facing a financial crisis, and help to prevent people reaching a crisis in the first place. However, there’s been limited policy discussion about how the effectiveness of these schemes could be maximised.Infographic for GM Poverty ActionGMPA’s new report (released last week) – Strengthening the role of local welfare assistance – identifies a series of recommendations for local authorities and their partners in Greater Manchester to adopt. The report draws on good practice from both within and outside the city region.

Visit our website to download the report, the tools developed to support implementation of the recommendations and to listen to the report author Simon Watts discussing the recommendations with our Chief Executive Graham Whitham.

In 2021 we’ll be working with councils and others across the city-region to implement the key findings.

Delivery during COVID-19

As a result of the pandemic GMPA has focussed on the immediate crisis caused by COVID-19. Whilst we are still working towards our vision of a city region free from poverty, we have had to adapt our workplan for 2020. During this period we focused our delivery on the following areas:

  • Gathering intelligence from food banks, food pantries/clubs and meal providers. This information has been used by the GMCA, GM Health and Social Care Partnership and each of the ten GM boroughs to coordinate food provision and support. Specifically:
    •  GMPA has been advising how to support residents on low incomes who would usually access support through services that have had to close or adapt their operations. We are using the intelligence described above to inform this work.
    •  Maintaining online maps of food aid providers and other support services available to people on low incomes. The food providers map has received 21,000 hits since the beginning of March.
  • Maintaining an understanding of how local authorities, the GMCA and other stakeholders are supporting people experiencing poverty. Specifically we have:
    •  Shaped the Equality Impact Assessment tools developed by local authorities to assess the impact of community responses (the provision of food, access to prescriptions and other welfare support) to the pandemic on different groups of the population. We developed a policy briefing and presented this to the GM Humanitarian Assistance Group in April. The briefing focussed on ensuring socio-economic status/poverty was included within the Equality Impact Assessment tools and explained how this could be done and the issues that should be taken into account. This was taken up by local authorities as a result of our work.
    •  Supported local authorities in allocating additional hardship funding from central government to people struggling financially during the pandemic. This included developing a policy briefing and presenting it to the GM Humanitarian Assistance Group. This focussed on maximising choice, dignity and control for recipients of local welfare support and considering how it could best meet immediate needs whilst also addressing the underlying causes of poverty.

Greater Manchester Poverty Monitor 2020

In October we launched an updated and improved Greater Manchester Poverty Monitor 2020 detailing some of the key statistics relating to poverty across the city region. The aim of the Monitor is to support policymakers and practitioners to understand levels of poverty in their area to help inform and shape responses to the issue.

The Poverty Monitors revealed that prior to the pandemic:

  • 620,000 people were living in poverty;
  • 200,000 children were in households with an income below the poverty line;
  • 157,000 households were experiencing fuel poverty;
  • Around a quarter of a million people were claiming help towards housing costs;
  • 20% of all jobs in Greater Manchester were paying less than the Real Living Wage.

The Monitor also found signs that already high levels of poverty in the city region are likely to have got worse during the COVID-19 pandemic:

  • The number of people claiming unemployment-related benefits in GM rose by 93% between March and August 2020.
  • There has been a sharp increase in the number of people claiming Universal Credit in each of the city region’s ten boroughs.

In response to the findings of the Monitor, GMPA back national calls on the government to:

  • Introduce a UK wide anti-poverty strategy
  • End the two-child limit on benefits and the benefits cap
  • Boost Child Benefit payments, and
  • Make permanent the Universal Credit uplift introduced at the start of the pandemic.
    Keep the lifeline for GM Poverty Action

GMPA Programmes

Food Poverty Programme:

  • We recruited Dr. Sian Mullen to the Food Poverty Programme Coordinator post in June 2020;
  • We are developing two pilot projects in Tameside and Oldham that approach the issue of food poverty from an advice and cash first approach;
  • In addition to the contribution to GM’s food poverty Covid-19 response, we helped convene and run the GM Food Cell and the GM Food Operations Group;
  • We are also leading on the development of the food poverty section of Good Food Greater Manchester’s Good Food Vision;
  • We submitted evidence to Parliament’s “COVID-19 and food supply” committee, and produced several other briefings for GM local authorities’ food and humanitarian leads on issues such as Healthy Start Vouchers.

Greater Manchester Living Wage Campaign:

  • We have continued to meet online as a campaign group through the Covid-19 pandemic, chaired by Campaign Coordinator John Hacking;
  • We ran or contributed to several events and meetings through the year, especially during Living Wage Week in November, engaging key employers and making the case for the Real Living Wage;
  • We have supported Salford’s, Oldham’s, and Manchester’s bids to become Living Wage places;
  • Greater Manchester announced its ambition to become the first real Living Wage City Region in the UK. We are offering our experience, assistance and support to achieve that ambition as soon as possible.

Tameside Poverty Truth Commission:

  • We recruited facilitators Beatrice Smith in April and Lizzie Bassford in December 2020;
  • We are bringing in the funds necessary to commit to the Commission, and are recruiting commissioners, with the aim of launching in summer 2021. Tameside Poverty Truth Commission for GM Poverty Action






i3oz9sReview of 2020
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A review of Living Wage Week 2020

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Three weeks on from Living Wage Week (9th to 15th November) we’ve had chance to draw breath and reflect on an incredibly busy and successful week. The week started on Monday with a North West event organised by the Living Wage Foundation. At this event, Steve Rotherham the Liverpool City Region Mayor announced the new real Living Wage rate as £9.50 (£10.85 in London).

At the same event the GM Mayor Andy Burnham called on partners and stakeholders to work together to make Greater Manchester the first real Living Wage City Region in the UK. We are offering our experience, assistance and  support to achieve that ambition as soon as possible. This is a significant step change in the fight against low pay in GM and we look forward to working with many of you in the coming months to make this ambition a reality.

Living Wage Week was obviously very different this year and our Campaign activities focussed on three online events with our partners to highlight a range of issues relating to the Real Living Wage and its importance in building back better from the pandemic:

Tuesday November 10th – Pay All Key Workers the Real Living Wage Rally
GM Living Wage Campaign and GM Citizens held an online rally in support of the Real Living Wage for all key workers. We heard testimonies from key workers and about national progress towards the Real Living Wage in social care. Key speakers were Steve North and Conor McGurran from UNISON.

Wednesday November 11th – Bolton: A Real Living Wage
GM Living Wage Campaign and our partners in Bolton, Boo Consulting and Coaching celebrated and promoted the Real Living Wage in Bolton. In the webinar we heard from accredited Living Wage employers in Bolton as well as employers who are interested in joining the movement.

Thursday November 12th – Exploring Challenges to Paying the Real Living Wage
In partnership with The Greater Manchester Employment Charter this event looked at the Real Living Wage in the context of the post pandemic economy. We had a panel, made up of representatives of the GM Living Wage Campaign, the Living Wage Foundation, USDAW and a representative from Rowlinson Knitwear, a Real Living Wage accredited employer. The event can be viewed here

There were a lot of other things going on. The Living Wage Foundation along with partners in Salford produced a short film promoting the Real Living Wage and Salford’s ambition to become England’s first Living Wage City. You can view the film here.

Our colleagues in the Greater Manchester Housing Providers Partnership (GMHP) (many of whom are already Real Living Wage accredited employers) released a report on the work they have done to support residents into work and the commitment they are continuing to make towards the Real Living Wage movement in GM. The report can be read here.

John Hacking GM Living Wage coordinator for GM Poverty Action

Greater Manchester Living Wage Campaign Coordinator John Hacking

Best Wishes and Stay Safe.

Greater Manchester Living Wage Campaign Co-ordinator, John Hacking

Email John Hacking
Twitter: @GMlivingwage           Facebook:




i3oz9sA review of Living Wage Week 2020
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The Good Food Bag Update

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By Jenni Pocsai, Operations Manager, The Good Food Bag

Jenni Pocsai, Good Food Bag for GM Poverty Action

Jenni Pocsai

The Good Food Bag is a meal kit service funded by Irwell Valley Homes and One Manchester. The Good Food Bag provides low cost, healthy meal kits to organisations, as well as selling directly to customers in areas of food insecurity. They have initially started in Sale West, in Trafford. The idea is simple; for just £7 people get a bag with ingredients and a simple step by step recipe card to cook a nutritious meal to feed a family of four. Not a family of four? No problem – the meals are just as tasty the next day, so enjoying a left-over lunch, or super speedy supper another day in the week takes care of any leftovers!

Since starting in Trafford in October, the Good Food Bag has partnered with Healthy Me, Healthy Communities to provide the meal kits to those accessing their community grocers.  This is bringing a new group of budget food finders to the doors of the grocers in Hulme and Gorton.  The same idea will be launching in January with The Good Food Bag available at Lucy’s Pantry, run by Emmaus in Salford.

The idea is a simple one, make more options for good value food available to people where they already are. We want to help those who are inexperienced cooks to make their food budgets go further. By learning new recipes and how to put foods together, the offerings from community grocers and other schemes will make more sense and be more cost-effective long term.

Sasha Deepwell, Chief Exec of Irwell Valley explains “It’s more than just providing a food parcel, it’s offering choice, it’s developing skills and inspiring confidence, it’s affordable and it’s feeding families right now. We have a few budget friendly food offerings in Manchester, but none are like The Good Food Bag. It’s part of a new trend towards purchased food, planning ahead for if surpluses run out, and providing a more sustainable solution to help people out of food insecurity.’’

Registered housing providers have certainly played their part in the pandemic, supporting communities who have been hit hard by lockdown and the subsequent recession. But this problem is not going away anytime soon, and the key will be to invest in long terms solutions and try to find a way forward with purchased, rather than donated food – but still provide low cost, high quality food to families on their doorsteps.

Nicole Kershaw, Chief Exec at One Manchester said, “The Good Food Bag is a great way to help those families hardest hit by the pandemic. It’s not a handout, it’s a helping hand when people need it most.  With The Good Food Bag, I know we can make a difference to people’s lives.” In a time where making a difference counts more than ever, find out how you can get involved here.


i3oz9sThe Good Food Bag Update
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Debt and its impact on health

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Responding to the debt crisis and its impact on health
by Simon Watts, Public Health Registrar on placement with GMPA

Turn2us logo for GM Poverty Action article on debtNew research based on a survey of 2,500 adults was published by Turn2Us last week revealing the levels of indebtedness which are now facing many residents across the UK:

•  One in three families are getting into debt as a result of the pandemic;

•  One in five people are now ‘always or most of the time’ running out of money before pay day; pre-Covid this number was closer to one in nine;

•  Younger age groups, those with a disability or those from a Black or Asian background are all more likely to run out of money before payday than other groups;

•  Of those surveyed who have accessed debt since March, nearly two thirds could only manage for less than a week if they lost their primary income source.

This shows how little financial resilience many people have. As a result, multiple sources of debt, which at some point must be repaid, have become increasingly relied upon.

The Office for National Statistics find that those in the most income deprived areas are likely to rely on debt more, and further analysis suggests average unsecured debt level is now a staggering £15,000 per household. This is less surprising when you consider the high interest rates associated with payday loans, which can exceed 1500% APR and that those lower income groups, who can’t access affordable credit options, pay an average of £527 more when they buy a household appliance. These are examples of the poverty premium, whereby if you earn less, your costs are higher.

And debt is not just a Covid related problem. The insolvency rate before Covid across most local authority areas in Greater Manchester was at or above the peak following the 2008 recession; we entered the pandemic in a bad position in terms of debt.

The impact of problematic debt is wide, leading to relationship loss, loss of your home, inability to get a home, or a phone contract. The legacy of having debt problems, even once the debt has been written off or repaid, is felt for a long time. The health impact of debt can be severe, with a review of the evidence on debt and health finding that debt was associated with depression and other mental illnesses and in some cases suicide, as well as physical health problems. Given that certain groups of the population (identified above) experience the biggest problems with debt, these negative health impacts are not evenly distributed and contribute to widening health inequalities between groups.

UK debt levels are a public health crisis. The Turn2us research makes several recommendations, including increasing funding for Local Welfare Assistance Schemes (LWAS). GMPA very much support this suggestion, as well as other recommendations in the report including reducing waiting time for Universal Credit (UC) and maintaining the £20 UC uplift, but we would also support further action.

Forthcoming GMPA research into LWAS highlights the excellent support offered by debt advice and money management teams across Greater Manchester; but these services are getting busier. A focus on prevention is needed that seeks to reduce the number of people entering debt crisis, but also ensures those whose health is suffering as a result of debt can access the right support. This isn’t just about helping those already in financial crisis, though that is important. It is also about lower income groups not always able to access affordable credit, it’s about responsible lending, illegal money lending, discussing the dangers of debt with young people and much, much more. And the approach needs to be consistent and coordinated across the city region, so that where residents live doesn’t determine their likelihood of getting into problematic debt.

Simon Watts for GM Poverty Action article on debt

Simon Watts

If you, or someone you know, is struggling with debt and money management, support is available from your local authority and other partner organisations. This website provides a useful directory of the support available, and you can find a range of information and advice services listed on the Maps of Support Services page of GMPA’s website.


i3oz9sDebt and its impact on health
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Socio-Economic Duty

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Is it time for voluntary adoption of the Socio-Economic Duty in Greater Manchester?
By Graham Whitham, Chief Executive

Over thirty people, including local Members of Parliament and councillors, joined us on Wednesday evening last week for a webinar on voluntary adoption of the Socio-Economic Duty. The webinar was jointly hosted by GMPA, Just Fair and The Equality Trust. There were contributions from all three organisations, and from the Equality and Human Rights Commission.

The Socio-Economic Duty is the missing piece in the UK’s equalities legislation. Although the Equality Act 2010 contains a Socio-Economic Duty, it hasn’t been enacted. That means that public bodies do not need to give due regard to poverty and socio-economic status when making strategic decisions and designing services, in the same way that they have to for protected characteristics.

One way to overcome the failure to enact the duty is for public bodies to adopt it voluntarily. GMPA believes that public bodies in Greater Manchester should think about how they can apply the duty. This would mean that socio-economic assessments are included when our local public bodies are undertaking equality impact assessments of projects and activities and when taking policy decisions.

What does applying the Socio-Economic Duty mean in practice?

Applying the socio-economic duty means paying ‘due regard’ to the desirability of reducing the inequalities caused by socio-economic disadvantage and poverty, reducing inequalities of outcome caused by socio-economic disadvantage, and actively considering how to reduce inequalities of outcome when taking decisions and designing services. Key questions that public bodies should ask to ensure socio-economic status is fully considered when making strategic decisions and designing services:

  • What are the potential impacts of the proposal/decision as we currently understand them?
  • Are there any unintended consequences of the proposal/decision on people experiencing poverty?
  • How could the proposal/decision be improved so it reduces or further reduces inequalities of outcome, with a particular focus on socio-economic disadvantage?
  • How will this policy or service assist you to reduce inequality in outcomes overall?
  • How can we ensure the views and experiences of people in poverty inform decisions and service design?
  • If you are now planning to adjust the proposal/decision, could it be adjusted still further to benefit particular communities of interest or of place who are more at risk of socio-economic disadvantage?

Some public bodies in Greater Manchester are already making progress on this. GMPA is keen to work with them and others so that voluntary adoption of the duty becomes widespread across the city region.

Graham Whitham, CEO GMPA

Graham Whitham, CEO GMPA

At the webinar we heard about the importance of taking socio-economic inequality into account when designing services and making decisions, particularly in light of the inequalities exposed by the COVID-19 pandemic. During the pandemic, GMPA worked through the GM Humanitarian Assistance Group to support local authorities on inclusion of socio-economic status in their equality impact assessments of responses to the pandemic. You can read the briefing we published at the time here.

Please do contact GMPA if you’d like to explore adoption of the duty further.


i3oz9sSocio-Economic Duty
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Poverty as a Health Issue

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By Simon Watts, Public Health Registrar on placement with GMPA

Poverty can cause ill health, but ill health can lead to poverty. We are seeing this more visibly with Covid-19, but this was apparent before the pandemic. As apublic health professional, I am passionate about preventing ill health. This short piece argues that poverty is one of the root causes of ill health and that these two large areas of public policy should not be considered in isolation.

Poverty can cause ill health in several ways. Through my recent research into local welfare assistance I have heard stories of residents living in cold, carpet-less, houses and not being able to afford to eat or pay their bills. These stories have clear links to poor physical and mental health and show the importance of strong welfare support in preventing ill health. Good housing, education and fairly paid jobs are also some of the things that will reduce poverty and protect people’s health longer term. These societal factors have a direct impact on health, but often aren’t talked about in the context of health. Improving health is about the NHS, right? Partly, but the NHS treating illness is only part of the picture. And, treating ill health is usually more expensive than preventing ill health in the first place.

Investing in poverty to improve health

Those on the lowest incomes are more likely to be in poor health and more likely to access emergency healthcare services. This is extremely distressing for the residents it impacts and their families, but it also puts pressure on local health budgets. This has been the case for a long time, but more could be done to change it. Investing what little funds there are available locally to reduce poverty could improve resident’s health and save CCGs and local authorities money in the longer term.

Similarly, we invest in a range of public health advice about how to lead a healthy lifestyle; what to eat, the need to take the right amount of exercise. However, we know that some groups are less able to act on this advice, particularly those on lower incomes who might face additional pressures and stress, so the health gap between low and high income groups widens further (Naidoo & Wills, 2016). Why is that? If your material, basic needs aren’t being fulfilled, why would a balanced diet, or taking regular exercise even be on your mind? Health is not a choice when you are struggling to make your rent or feed your family. Trying to tackle important lifestyle issues without tackling poverty will fail and will leave some lower income groups behind.

If we don’t tackle poverty as one of the underlying causes of poor health, we will continue to pour money into health treatment services without addressing one of the key root causes of that ill health.

There are positive examples of progress though. Across Greater Manchester there are a range of services which work with residents to help improve their circumstances. One of these services, Focused Care, work with residents to support them with underlying challenges in their lives such as housing issues or benefits; when these issues are resolved residents may then have the space and time to focus on their longer term health.

Similarly, my recent work on local welfare provision in Greater Manchester has identified some local authorities which offer strong support for those in financial crisis, helping people get back on their feet and improving their mental and physical health as a result. But access to that support is variable across the city region.

Local authority leadership and governance around poverty mitigation and reduction is needed to improve living conditions, and ultimately health. There are Greater Manchester authorities which have strong structures in place to help reduce poverty, led by elected members, but in some authorities poverty appears to be less engrained in decision making. It is worth looking to Scotland, where action plans on poverty reduction are a mandatory requirement for each local authority, as well as the need to consider inequalities in every policy decision through the Fairer Scotland Duty.

Targeted health interventions can reduce poverty

Poor health can also cause poverty, through no longer be able to work for example. Ideally more ill health would be prevented in the first place, which would reduce financial hardship but, as discussed, preventing ill health is complex. However, the health system can help prevent more severe illness if practitioners know about warning signs and symptoms early enough and work with individuals to manage them.

An example of innovation in this space is a GP pilot in Greater Manchester, funded through the commissioning improvement budget. The pilot involved contacting residents who hadn’t visited their GP for several years, starting with those who had historic risk factors such as high blood pressure or a history of smoking. If those residents didn’t respond, they were followed up, even if that meant multiple phone calls or a home visit.

Traditionally a patient might not have been followed up if they couldn’t be reached three times. Changing that approach meant GP practices persistently seeking out residents who wouldn’t normally engage, helping them proactively manage their health issues, which if left unmanaged could have resulted in a health crisis.  The pilot was disrupted by COVID-19, but this approach is supported elsewhere and could help reduce severe illness and the associated financial hardship.


Simon Watts for GM Poverty Action

Simon Watts

I am convinced that a strategy of proactively supporting the health of our most vulnerable residents will make a positive impact on their health and wealth, when complemented by a wider ranging, local-authority-led poverty mitigation and reduction strategy that targets the underlying causes of poverty. This should be supported by poverty and health being considered in all policy decisions.

The cost of not addressing poverty could be higher from a health and societal perspective than investing in interventions that can reduce poverty. Using elements of the healthcare budget, such as commissioning improvement funds, to support vulnerable groups and poverty reduction could reduce pressure on the healthcare budget longer term.



i3oz9sPoverty as a Health Issue
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