In January we launched GMPA’s second Money Advice Referral Tool, in Oldham and we are now working on rolling it out to four more boroughs in Greater Manchester.

GMPA believes that responses to poverty should focus on getting more money into people’s pockets and supporting people to avoid high interest debt. That’s why one of our strategic priorities is to support local efforts to boost household income and financial resilience. A ‘cash-first’ approach to local welfare, and an ‘advice first’ approach to other support services is key to this.

GMPA’s Money Advice Referral Tools support and foster cash and advice-first approaches by connecting people to advice and other income maximisation support. The aim is to help people to get all the money that they are entitled to, and to reduce the need for referrals to food banks, by increasing referrals to other kinds of support.

Pilot phase

The programme grew out of GMPA’s work on food insecurity, and we agreed with partners in Tameside and Oldham to pilot the tool in their boroughs. Both tools have now been co-produced and launched with partners in each borough. At the launch of the tool in Oldham in January 2022, Councillor Zahid Chauhan, Cabinet Member for Health and Social Care, said: “I’m glad to see this support tool available to people at a time when many are needing it the most. The rising costs of living is hitting many people in Oldham hard and is a real crisis. This ‘cash-first’ approach will help get money into the hands of those who are truly struggling. If you’re finding things tough right now just know that you’re not alone and help is available. I encourage you to use this tool to make sure you’re accessing all the support you are entitled to.”

We have contracted an independent evaluation team to assess the impact of this pilot, and we look forward to hearing more about its use and the benefits to people experiencing poverty.

Rollout in up to four other boroughs

We have received funding from the Trussell Trust to roll out the tool in more boroughs in Greater Manchester, and have received expressions of interest from those who would like to work with us through this programme. We will make an announcement about the additional boroughs in April 2022. We are recruiting a Programme Officer to support the delivery of this work. It is vital that people are supported to maximise their incomes and to find routes out of poverty, and we expect most of Greater Manchester’s ten boroughs to have such a referral tool, or at least to have one in development, by the end of 2022.

You can find out more about the programme, and register to use the Oldham or Tameside tools, here.

The National #KeepTheLifeline Campaign

As you are no doubt aware, in October the Government plans to cut the £20 a week (£1040 a year) uplift paid to those in receipt of Universal Credit and Working Tax Credit introduced at the beginning of the pandemic. For years before the pandemic, cuts and freezes to social security had already left many families living with constant financial insecurity.

This cut will have a huge impact on six million families and will be the biggest cut to the basic rate of social security since the modern welfare state began, more than 70 years ago.

Many charities, think tanks and leading organisations plus six former Conservative work and pensions secretaries   are urging the Government not to go ahead with this cut, which will further weaken social security support, cause severe hardship for families who are already struggling to stay afloat and generate a surge of people being pulled into poverty.

There is also an ongoing call on the Government not to discriminate against families receiving ‘legacy benefits’ such as Employment Support Allowance, Jobseeker’s Allowance and Income Support by not giving them this uplift.

Since signing a joint open letter to the Chancellor last September, an ongoing campaign led by the Joseph Rowntree Foundation (JRF), together with many organisations including GMPA, determined to prevent this cut, has been active.  If this is something you feel strongly about, there are many ways to get involved.

JRF have produced some very helpful tools.  You can read more about the campaign here and why this lifeline must be kept. 

•  There is a web page with information for Universal Credit and Working Tax Credit claimants including a template for writing to their MP.  A separate web page with information for legacy benefit claimants, again with a template for writing to their MP and a web page for supporters with write to MP instructions.

•  A ‘Campaign guide’ – for small organisations or leaders who are keen to get involved. It has details of the campaign, links to assets, write to MP guidance and suggested tweets.

•  A ‘Stakeholder toolkit’ – for larger organisations with networks.

What you can do to help

If you do one thing, write to your MP and/or request a meeting (see the helpful guide from the End Child Poverty Coalition for how to prepare). It is so important that MPs hear from as many different voices as possible about the impact of the cut – from charities, local leaders, claimants and supporters. We need them to know that this is a huge risk for families and communities, and for them politically.

Tell your network about the cut

Sadly, despite the severe impact this cut is likely to have on families, the complexity of the system and lack of communications means that too few recipients are aware it is due to happen and that it will affect them.

Raise the issue on your social media

Use the #KeepTheLifeline and help to keep this issue trending.

There are plans for a national day of action on August 17th.  Keep an eye on social media #KeepTheLifeline for more information. 

By Graham Whitham

At GMPA we are delighted to have published a new guide for local and combined authorities on voluntary adoption and implementation of the socio-economic duty. The guide is for use by organisations across England, including here in Greater Manchester.

We believe the socio-economic duty is a central element of the framework that localities seeking to address poverty should adopt. The duty ensures that local authorities assess the impact of policy and practice on socio-economic disadvantage. Adoption of the duty should be done meaningfully. The guide provides detail and advice on how to ensure that is the case, working closely with people with lived experience of poverty.

There’s a lot of interest in the duty in Greater Manchester following GMPA’s advocacy work on it over the last year or so. Wigan are applying the duty locally, and Salford and Trafford have committed to doing so. The Independent Inequalities Commission recommended adoption of the duty by the Greater Manchester Combined Authority in their recent report.

The scale of socio-economic inequalities in the UK have been highlighted by the pandemic. In spite of this, the UK government continues to choose not to enact the socio-economic duty nationally (the duty is contained in Section 1 of the Equality Act 2010). If enacted, the duty would legally require public authorities to actively consider the way in which their decisions increase or decrease the inequalities that result from socio-economic disadvantage.

As the duty hasn’t been enacted, some areas have taken matters into their own hands. The duty is now in force in Scotland (‘Fairer Scotland Duty’) (and is also being taken forward in Wales), and some combined and local authorities in England are voluntarily implementing it.

The need to formally recognise and address socio-economic disadvantage alongside other forms of inequality has never been more clear, as those from socio-economically disadvantaged backgrounds have experienced some of the most severe health and economic impacts of the pandemic.

We believe that, if implemented, the socio-economic duty would provide a powerful foundation for the fairer society we all want to see. In the absence of action at a national level, we need to identify what we can do locally. Voluntary adoption of the duty can bring a number of benefits including:

• Improving outcomes for local people experiencing socio-economic disadvantage.
• Supporting cross organisational and cross departmental working.
• Raising awareness of socio-economic inequalities within organisations and among partners.
• Ensuring widespread organisational commitment to, and consideration of, socio-economic inequalities.
• Supporting the participation of low-income residents in decisions that affect them, especially in the context of (proposed) cuts to services.
• Achieving greater consistency in practice – and an increased likelihood of maintaining such consistent practice across political administrations and between changes of individual leadership and turnover of staff.
• Improving systematic approaches to equality impact assessments and assessment of policy and practice more broadly.
• Strengthening systematic data gathering and analysis, especially in the conduct of equality impact assessments, thereby strengthening accountability.
• Supporting the effective and efficient allocation of resources.

The guide is broken down into six sections:

1. Meaningful impact assessments to understand the consequences of socio-economic disadvantage
2. Using data effectively as a tool for decision-making and accountability
3. Encouraging strong and visible leadership
4. Principles of working in partnership with people with lived experience of socio-economic disadvantage
5. Engaging with residents, civil society, and voluntary and community sector organisations
6. Ensuring access to justice, and monitoring impact and compliance

The Guide has been developed by GMPA in partnership with Amnesty, Compassion in Politics, Equally Ours, Just Fair, Runnymede, Shelter, The Equality Trust and Thrive Teeside. It is available here.

Please get in touch if you’d like to know more.

Graham Whitham, CEO GMPA

Greater Manchester Real Living Wage Campaign Update

By John Hacking, Greater Manchester Living Wage Campaign Co-ordinator.

May 12th was a very significant date for the campaign to make Greater Manchester a Real Living Wage City Region as it saw the first meeting of the City Region Living Wage Action Group chaired by the newly elected Mayor of GM, Andy Burnham.

Greater Manchester Living Wage Campaign (GMLWC) has been working towards the goal of making GM a Real Living Wage City Region for a number of years and the announcement in November 2020 by the  Mayor that it was his intention to make this vision a reality, was a massive step forward for our campaign to see a real improvement in the lives of thousands of low paid workers in our area.

Since the announcement I have (as reported in previous newsletters) been working with partners and stakeholders across GM to create the Living Wage Action Plan which was unveiled on May 12th. The Living Wage Action Plan Group will now work to outline a clear path towards the goal of all employers in the city-region paying the living wage and offering living hours by 2030, as recommended by the Independent Inequalities Commission in its report published earlier this year.

I have been, and will continue, to work on the Plan to ensure that there are ambitious targets and that there is the widest and most diverse possible involvement from all sectors and communities across GM.

The Action Plan Group will be chaired by Lou Cordwell, Chair of the Greater Manchester Local Enterprise Partnership and is made up of businesses, unions, local authorities, civil society, faith groups, social enterprises and voluntary organisations.  The Plan will focus on key sectors of the GM economy: ‘anchor institutions’, including large public sector organisations; local authorities; health and social care; hospitality and leisure; large employers; small and medium enterprises; and the voluntary, community and social enterprise sector.

GMLWC along with GM Citizens will lead on the campaigns sub-group  focussing on using our local networks of Real Living Wage activists and advocates to target employers across GM working with local and national campaigns.

As part of the work to involve a wide and diverse group of people and organisations in the Campaign Subgroup, we will be holding a meeting of the GMLWC group in June. If you are on the database you will receive more information in the next couple of weeks. If you aren’t but want to be then please send your name, organisation (if applicable) and email address to me.

Greater Manchester Living Wage Campaign Coordinator John Hacking

In addition to this, we continue to work with partners across GM on a range of local campaigns. One of the activities we promote, and support, is to encourage more local authorities to become Real Living Wage Employers. As reported previously Bury Council recently made a commitment to become a Real Living Wage Employer. In the latest in our series of podcasts we spoke to Councillor Eamonn O’Brien, Leader of Bury Council about a range of issues related to the fight against poverty and in particular the plans to make Bury Council the 4th local authority in GM to become a Living Wage Employer. You can listen the podcast on our website here

John Hacking, Greater Manchester Living Wage Campaign Co-ordinator
Twitter: @GMlivingwage     Facebook: facebook.com/gmlivingwage

The Greater Manchester Living Wage Campaign is a Greater Manchester Poverty Action programme.

New local child poverty figures show worrying trends

By Graham Whitham, CEO GMPA

Last week the End Child Poverty Coalition released new analysis showing child poverty rates across the UK by local authority area over the six years leading up to the pandemic. Even before the economy was hit by the pandemic, child poverty was becoming more entrenched in areas with already high levels of poverty and deprivation.

Of particular concern is the increase in child poverty in the North East, with the largest increases in child poverty between 2015/16 and 2019/20 happening in Newcastle upon Tyne (up 12.8%), Gateshead (up 11.2%), Redcar and Cleveland (up 10.6%) and County Durham (up 10.5%).

Whilst the increases in Greater Manchester haven’t been as sharp as in parts of the North East, there have been significant increases in Manchester (up 6.4%), Oldham (up 5.1%) and Bolton (4.1%). Across Greater Manchester as a whole, only one of our ten boroughs (Trafford) saw child poverty fall over this period – as shown in the table
below:

Nationally, the highest rates of child poverty remain concentrated in large conurbations like London and Birmingham.

In response to these concerning figures, the End Child Poverty Coalition is calling on the UK Government to recognise the scale of the problem and its impact on children’s lives and to create a credible plan to end child poverty which must include a commitment to increase child benefits. Given the extent to which families are already struggling, the planned £20 per week cut to Universal Credit in October 2021 should be revoked. The support should also be extended to those still receiving financial assistance from the old benefit system, referred to as ‘legacy benefits’, before they are switched to Universal Credit.

To read the full report please visit the End Child Poverty Coalition website.

GMPA is a member of the End Child Poverty Coalition steering group.

by Graham Whitham

It was good to see the launch of the Greater Manchester Independent Inequalities Commission report last month. The Commission was launched in October 2020 with a six-month mission to examine inequalities across the city region, consider how they should be tackled and outline some specific and hard-hitting recommendations. The Commission viewed inequalities within a framework that considers how interacting and intersecting inequalities create barriers that stop people from living the good lives that they want.

COVID-19 has exposed the extent of these inequalities in Greater Manchester. To address this, the Commission’s report calls on everyone in the city-region to work towards an agreed set of wellbeing and equality targets that aim to leave no-one behind. Alongside this are a series of recommendations under the themes of People Power, Good Jobs and Decent Pay, Building Wealth and Services for a Good Life. You can read more about the recommendations here.

GMPA supported the work of the Commission by bringing together a ‘Poverty Reference Group’. The group was made up of people with lived experience of poverty who have been involved in engagement and co-production projects across Greater Manchester (including poverty truth commissions, the Elephants Project, Creative Inclusion, the BME Network, GM Coalition of Disabled People, Migrant Help, Support & Action Women’s Network, and Legislative Theatre). The aim of the group was to inform and reflect on the work of the commission, complementing other engagement work (including engaging with the Equalities Panels). The meetings generated a range of innovative recommendations that were grounded in real world experience of poverty, including how to:

•  Reduce barriers to employment, and tackle stigma and bias in recruitment and in the workplace;
•  Improve job quality, and increase access to education and training;
•  Listen meaningfully to communities;
•  Give communities the power to tackle for themselves the problems that affect them.

A number of key areas that GMPA has been working on are included in the report, including a call for the Combined Authority to adopt the socio-economic duty and, building on the Poverty Reference Group, the establishment of a new Panel for people with lived experience of poverty to inform and shape policy.

GMPA wants to see a city-region where we put tackling socio-economic disadvantage at the heart of what we do. We have more councils (working with partners) with poverty strategies in place and examples of good practice and innovation in tackling poverty across Greater Manchester. The Real Living Wage is become more embedded, with plans to create a Living Wage City Region. GMPA is working hard to create a stronger focus on preventing and reducing poverty.

Graham Whitham, CEO GMPA

We need to go further and embed a focus on poverty and socio-economic disadvantage in everything we do. It is helpful therefore, that the Commission has articulated a clear framework for understanding the intersection between socio-economic disadvantage and poverty and other inequalities.

Next week Greater Manchester goes to the polls for the Mayoral Election. It is important that together with whoever wins, we implement the recommendations of the Commission.

Next steps

By Graham Whitham

In December, GMPA launched our Strengthening the role of local welfare assistance report. The report identifies good practice and recommendations from across the country and considers how these can be applied to local welfare assistance schemes here in Greater Manchester.

Local welfare assistance schemes are an important means through which local authorities can respond to the needs of residents facing a financial crisis. Relatively small interventions delivered through these schemes can help meet a person’s immediate needs and prevent them from falling deeper into hardship. However, national research has found that there’s often a lack of awareness of schemes, that they are poorly advertised and difficult to access.

In Greater Manchester, where all local councils have schemes in place, there is some existing good practice and a real opportunity to strengthen support in each of our boroughs. Taking the recommendations detailed in the report, GMPA has developed a checklist for local authorities and their partners to use to assess their schemes and understand what further improvements could be made. Importantly, at a time when local authority finances are coming under even greater pressure, most of the recommendations come at no extra cost.

We are pleased with the engagement we’ve had on the report to date. This month we held events for elected members, council officers and other stakeholders from across GM, and we’ll continue to work with councils and their partners over the course of this year.

Of particular relevance as we (hopefully) begin to recover from the pandemic, is the focus in the report on taking a ‘cash first’ approach to supporting people. This means that the default way in which someone facing hardship is supported is through a monetary payment rather than in-kind support such as a fuel voucher or food parcel.

Local welfare assistance schemes represent an obvious opportunity for local authorities to adopt this approach as a key role of schemes is to support residents with essential living costs for those in financial crisis, such as buying food or heating their home. Whilst most of the schemes in Greater Manchester offer this support, it is usually in the form of vouchers.

There has been a range of research highlighting the benefits of cash payments over any other form of support for those in financial crisis due to its:

a) Flexibility, choice, speed and convenience – vouchers have to be used with certain companies or certain locations or for certain products; cash can be used anywhere and if issued electronically, is available immediately. Vouchers may mean someone having to travel a distance to buy food, costing them money and time, when they could have used their local shop if they had access to cash, benefiting the local economy. There is a much greater risk that vouchers won’t be used compared to money.

b) Preservation of dignity – having to use vouchers can be stigmatising and may reduce access to the support that residents desperately need.

c) Administrative efficiency (when processed electronically) – once an electronic system is set up to pay cash it can be processed quickly and remotely, without the need for face-to-face visits. This approach removes the need to make arrangements with third parties (e.g. voucher providers) further reducing administrative pressures.

Graham Whitham, CEO GMPA

Adoption of a ‘cash first’ approach by local welfare assistance schemes across Greater Manchester would help contribute to addressing the atomisation of poverty that we’ve seen over the last ten years. You can read more about the importance of this approach in our ‘Cash first’ briefing and in the Strengthening the role of local welfare assistance report.

Events in March will explore strengthening local welfare provision

Local welfare assistance schemes can play a central role in the local safety net, meeting people’s immediate needs and averting deepening hardship and deprivation.

Lack of government guidance and support on how schemes should operate means that they have evolved differently in each locality and not everywhere in England has a scheme in place. All ten of our Greater Manchester boroughs have worked hard to retain local provision and there are some examples of good practice locally. However, we also know that more needs to be done to scale up that good practice across the city region, raise awareness of schemes and ensure local support best meets the needs of low-income residents.

Research by GMPA has found that the type of support, how support is accessed, knowledge of schemes and the level of funding that goes into them varies considerably from one borough to the next.

As we enter a period that will lay bare the economic damage of COVID-19, Greater Manchester Poverty Action’s latest report (published in December) – Strengthening the role of local welfare assistance – provides a series of recommendations to improve schemes.

The recommendations include taking a ‘cash first’ approach to supporting people, simplifying the application process, taking a case worker approach to supporting residents that helps prevent future financial hardship and ensuring schemes can be accessed by different population subgroups.

Most of the recommendations in the report come at no-cost. Where there are cost implications, upfront investments are suggested that will deliver savings in the long run by improving outcomes for residents and reducing pressure on other services.

Local authority delivered local welfare schemes need to be joined up with other help in each locality, enabling councils, housing providers and VCSE sector organisations to coordinate support.

Alongside the report, GMPA has produced tools for local authorities and their partners to use to enhance schemes and measure their effectiveness.

GMPA will be holding an event on Tuesday March 23rd, from 10am using Zoom to explore the findings and recommendations from the report.  This event is aimed at people working for local authorities, housing providers, VCSE sector organisations and other stakeholders. To book your place click here.

At the event you’ll hear from report author Simon Watts and Graham Whitham, GMPA Chief Executive. There will be opportunity for questions and presentations will take attendees through the support tools developed alongside the report.

At the launch event for Living Wage Week 2020 on November 9th, the Mayor of Greater Manchester, Andy Burnham, called on every sector partner and stakeholders to work towards making Greater Manchester the first Real Living Wage City Region in the UK. He urged businesses, local government, the public sector, trades unions and the voluntary, faith and community sectors to work together to make a step change in the movement to create a more just and equal society and an economy that works for all.

The Mayor said: “This announcement clearly demonstrates Greater Manchester’s commitment to the Real Living Wage and good employment in the city-region – ensuring that our citizens earn enough to make ends meet, creating an inclusive economy and helping us to build back better.” and he added that he planned to convene an Action Group in GM to oversee proposals to increase the number of accredited Living Wage Employers across all sectors in all ten city-region’s boroughs.

The GM Living Wage Campaign (GMLWC) welcomed this announcement and we have committed ourselves to work with the Mayor and others to achieve this ambition. The goal of Greater Manchester being a Living Wage city region has been a key aim of the GMLWC since it’s inception.

Since the announcement in November the GMLWC Campaign Co-ordinator John Hacking has been working with the GM Combined Authority, The Living Wage Foundation and GM Citizens UK to map out the steps and actions needed to achieve Living Wage City Region status. This process will ultimately see GM accredited as a Living Wage city region by the Living Wage Foundation.

To achieve this accredited status, a GM Real Living Wage Action Plan will be formulated which will include work by a series of sub-groups on the various aspects of the Action Plan to agree the details of the action plan including how partners and stakeholder can get involved, what the timescales are, what the challenges are likely to be and how they might be overcome.

As the Mayor acknowledged “I recognise that individual organisations will need to engage with this ambition at their own pace, and that this may prove especially challenging for some in the current environment.”

There are likely to be sub-groups covering areas such as local authorities, private businesses of all sizes, housing, the VCSE sector, campaigns, and others. There will be a focus on health and social care as a key sector.

GMLWC Co-ordinator John Hacking is keen to ensure that the regions’ campaign supporters and activists can be involved in the drive to achieve Living Wage city region status as they have a wealth of knowledge, experience, and information to contribute to this process.

This a good time for the GMLWC to discuss how we can make the best and most effective contribution. To this end there will be a meeting on Tuesday February 23rd, 2021 at 12.30pm.

The meeting is open to all who are interested in campaigning for the Real Living Wage in GM and will focus on the work to be done to achieve Living Wage City Region Accreditation. There will be an opportunity to hear the latest update on the Living Wage City Region Action Plan and how to get involved. We want to hear your ideas and suggestions that can help us to make this ambition a reality and improve the lives of tens of thousands of low paid workers and their families. There is much for us to build on but a real prize for us to gain. It would be great to see as many people as possible getting involved.

If you want to attend the meeting please book at Eventbrite.

In addition, if you have ideas, questions or comments ahead of the meeting wewould be delighted to hear from you.

Greater Manchester Living Wage Campaign Coordinator John Hacking

Best Wishes and Stay Safe.

Greater Manchester Living Wage Campaign Co-ordinator John Hacking
Email: john@gmpovertyaction.org
Twitter: @GMlivingwage
Facebook: facebook.com/gmlivingwage

The Greater Manchester Living Wage Campaign is a Greater Manchester Poverty Action programme.

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.

Conclusions

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.