The following case study looks at action taken by Renfrewshire health and social care partnership (HSCP). This was to the support health visitors to deliver routine enquiry on money and debt worries as well as increase referrals to Healthier Wealthier Children (HWC).

HWC is a formally evaluated programme that provides income maximisation advice. This is via a formal partnership between health visiting services and the local money and welfare rights advice service for children and families.

Reason action was taken

As noted in our take the right actions page, one of the key ways to reduce health inequalities is by having effective partnerships across sectors. This was a partnership between Renfrewshire

• health improvement team
• children’s services.

Child poverty is a big problem in Scotland and a fundamental cause of health inequality. It limits the health, social and educational outcomes for our children. The impact of this can last a lifetime.

Income maximisation is one of the poverty reduction strategies. The Child Poverty (Scotland) Act 2017 also places a duty on all NHS boards and local authorities to report annually on what they are doing to address child poverty. This includes any income maximisation measures taken to provide pregnant women, and families with children, with 

• information, advice and assistance about eligibility for financial support
• assistance to apply for financial support.

By increasing the number of referrals to HWC, it was anticipated that household income would increase for families in Renfrewshire.

Action taken

The health improvement team, in partnership with advice workers, provided awareness raising sessions with all health visitors in the area. These were delivered via presentations on the different income maximisation opportunities, such as the Best Start Grant, with a strong emphasis on the local HWC referral pathway.

This was followed by a question and answer session where health visitors could ask more about referrals to HWC. A briefing paper to support the sessions, with key information for the health visitors, was also developed.

As the health visitors deliver services in different locations across Renfrewshire, it was a challenge to organise awareness sessions that would allow all of them to attend. To address this, sessions were delivered at their team meetings as these had already been scheduled.

You can find out more about the actions taken within Renfrewshire, including a video, on our page on example financial inclusion referral pathways.

People who helped

Support was received from

• Renfrewshire Council Adviceworks service, who deliver the HWC project
• Renfrewshire HSCP Children’s Service Manager.

The children’s services manager highlighted the need for their staff to promote this project. By having this support this delivered a key message to staff in terms of their responsibility to contribute towards addressing poverty. 

The HSCP health improvement team contacted the Children’s Service Manager and updated them on the success of the HWC programme in previous years. They also made sure they were updated on the statutory duty the Child Poverty (Scotland) Act 2017 placed on key health professionals to provide information, advice and assistance on eligibility for financial support such as Income Maximisation.

Impact and lessons learned

Increased referrals

After the awareness sessions, referrals to the HWC project increased. There was also an increase in the number of health visitors making referral.

From 1 April 2018 to 31 March 2019 HWC received 511 referrals from 55 different members of child services staff.

Referrals increased from 35 in quarter two of 2018 to 90 in quarter three.

Financial gains increased from 2017/18 to 2018/19 by £180,948.

The increase in number of referrals and the increase in number of staff referring was in line with expectations from the intervention.

The long term change will see

• more health visitors deliver universal routine enquiry on money and debt worries
• more referrals to HWC
• an increase in income maximisation for the patients.

Increased knowledge and understanding

There was an increase in knowledge and understanding on the duties the Child Poverty (Scotland) Act 2017 now places on health visitors in their role.

Improved support for the child poverty action plan

The sessions allowed Renfrewshire HSCP to contribute actively to supporting Renfrewshire's Child Poverty Action plan. This includes reducing health inequalities by addressing one of the three drivers of child poverty - income of social security and benefits in kind, through increasing the take up of benefits.

Further information

You can find out more about ways to reduce health inequalities within our reducing health inequalities section.

Find out more about financial inclusion referral pathways within our child poverty section.

This case study is based on information provided by Jim McSorley from Renfrewshire HSCP. If you would like to discuss further, you can contact our Health Promoting Health Service (HPHS) team by email at nhs.HealthScotland-hphsadmin@nhs.net.