Healthier Wealthier Children (Renfrewshire) ANNUAL REPORT. Advice Works. April 2012 March Melissa Ford

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1 Healthier Wealthier Children (Renfrewshire) ANNUAL REPORT Melissa Ford April 2012 March 2013 Advice Works

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3 Healthier Wealthier Children: The Project 1 Who Does The Project Support?. 2 Referrals Made to HWC. 3 Graph 1 Who referred into HWC 3 Referral Sources. 4 Graph 2 Who referred into HWC 4 Table 1 Breakdown of Referrals... 5 Client Appointments. 6 Diagram 1 Breakdown of Appointments... 6 Appointment Type Case Studies 8 Support Provided 9 Diagram 2 Breakdown of Support Provided 9 Benefit Claims Made. 10 Graph 3 Claims Made 10 Table 2 Numerical Breakdown of Claims 10 Appointment Case Studies. 11 Contact Made With Clients. 13 Table 3 Breakdown of Contact Provided 13 Outcomes of The Project. 15 Health Staff Experience of Referring into. 15 HWC : Survey Results. Financial Gains. 20 HWC : Sustaining the Service. 21 Conclusion. 22 Appendix Appendix Appendix 3. 25

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5 The purpose of this report is to provide an update and overview of the Healthier Wealthier Children (HWC) (Renfrewshire) project for the period April 2012 till end of March HWC is a financial inclusion model funded by Renfrewshire Community Health Partnership that aims to sustain better links and referral pathways between health and financial inclusion services in order to address child poverty. The project focus is on improving awareness about the support mechanisms and services that can contribute to dealing with and preventing child poverty at a local practice level, bringing together financial inclusion services and health services. It is recognised that certain life circumstances such as having a baby or a child with a disability, being an asylum seeker or kinship carer or having addiction problems can increase the risk of families falling into poverty, particularly for women. Healthier Wealthier Children provides an easily accessible income maximisation service for health and other early years services to support families around these times. HWC continues to maintain established links between health services and financial inclusion services in order to contribute towards addressing child poverty. HWC and the local health improvement team continue to work together to develop and promote the service. The Healthier Wealthier Children project was established in 2010 to contribute to reducing child poverty by targeting Welfare Rights and Debt Advice support to pregnant women and families with young children experiencing, or at risk of, child poverty. Due to the success of the project HWC Renfrewshire has received a further three years funding, enabling the project to continue to provide a service until March Please see appendix 3 for further background information on the project and the key findings from the evaluation carried out for the whole of the HWC project by Glasgow Centre for Population Health. Healthier Wealthier Children Renfrewshire has secured additional funding to continue to provide the service until March Page 1

6 All referrals are usually contacted within 3 days of being received at Advice Works. Clients are usually offered an appointment within 7-10 days of first contact with a client. Based within Renfrewshire Council's Advice Works, the Healthier Wealthier Children Income Advisor, Melissa Ford, provides quality in depth benefit support with minimal waiting periods for clients referred into the project. This includes assistance to maximise clients incomes and begin to address any money worries the family may have. Onward referrals are also made to other support services available locally. The criteria for the client group referred into the project are: Pregnant Woman or Families with children under 5 or Families with children under 19 with additional support needs In addition: Household must have income under 40,000 and/or Have additional pressures on the household such as being a kinship carer, having mental health or addiction issues or problems with benefits due to immigration The HWC project continues to target specific staff to encourage referral routes between health and early years and financial inclusion support. Those targeted by Healthier, Wealthier Children (Renfrewshire) include: Maternity Services, particularly midwives Health visiting teams Parenting support workers Early years education service providers The project also allows for self referral. Melissa Ford. Income Advisor Healthier Wealthier Children. Renfrewshire. Referrals into the project are made by completing the HWC referral form and staff are encouraged to include any additional barriers, such as mobility or literacy issues on the referral form to allow the Income Maximisation service to support the needs of these clients. Page 2 The following report for the HWC income advice service will illustrate in more detail where referrals have been generated from, who has benefited from the support and the variety of assistance that has been provided to clients using the project.

7 There were 431 clients referred into HWC Renfrewshire between April 2012 and March As shown below in Graph 1 the project has seen a steady increase, of about 10%, in the number of referrals that were received in the previous financial year (389 clients). Number of Referrals to HWC No. of Refs HWC has seen just under 10% increase in the number of referrals into the project in compared to referrals received in Graph 1 Since its inception in November 2010 the project has received a total of 887 referrals, with a consistently high referral rate from health based staff A questionnaire, to look at the experience of staff from the health setting referring into the project, was distributed to key referral groups targeting questions around their experience with Healthier Wealthier Children. Further information regarding health staff s experience of referring into the project and service development steps evolving from this feedback is included on page 16 of the report. Up to March 2013 HWC has received 887 referrals since the project s inception in November Graph 1 and Table 1 on the following page provides a breakdown of who has made the 431 referrals into the service for April 12-March 13. Page 3

8 Over 75% of all referrals made to HWC Renfrewshire were made by Health Based Staff. Health Visitor referrals accounted for 62% of all referrals received by Healthier Wealthier Children (Renfrewshire) between April 2012 and March Graph 2 Graph 2 above highlights that over 75% of referrals received were from NHS based staff with over 62% of all referrals being made by health visitors. This is a significant increase from 67% (total health based staff referrals) and 50% (referrals made by health visitors) for previous year s referral source. These referral figures signify that HWC Renfrewshire has sustained referrals from its key target referral source and continued to build upon this. The project has seen an increase in referrals from Social Services teams supporting families with young children and children with disabilities indicating a proactive multiagency approach between health and social services. Page 4 Table1 overleaf provides a numeric breakdown of the referrals received.

9 Staff Group No. Of Refs Received Health Visitor 269 Social Work Children & Families 15 Self /Returning Referral 45 Social Work Children with Disabilities Team 4 Housing 2 Antenatal (Community Midwife) 35 Home link Workers 3 Advice Works 32 Children & Families First 1 School Health Nurse 2 Family Support Worker 4 Health Support Worker (other) 1 Antenatal (Hospital Midwife) 2 Community Learning Disability Nurse 2 Other 1 Community Mental Health Team 6 Practice Nurse 2 Public Nurse 5 Trust built up between clients and the HWC (Renfrewshire) service allows clients to return if they have a change of circumstances. Table 1 Table 1 above provides a breakdown of number of referrals received from each staff/service group. The project continues to see a steady number of self referrals made to the service. These referrals cover clients that are not currently working with any other agency who could have made a referral into HWC for them or those that may have heard of the project from ie friends or former clients. It also covers previous clients that have returned to the service either due to changes of circumstances or because they have concerns regarding how they may be affected by the Welfare Reform changes. It is predicted that the HWC service may prove a vital support to clients facing changes under the Welfare Reforms. It is predicted that the HWC project will experience an increase in the number of clients returning to the service both as self referrals and worker referrals as the Welfare Reform changes begin to take effect. HWC plans to monitor more closely the source of self referrals and re-referrals and record any noticeable patterns. Page 5

10 HWC (Renfrewshire) continues to provide a flexible service to meet the needs of its clients and to arrange appointments at accessible venues taking account of care responsibilities. This is a key strength of the model. The project recognises that the service is supporting those with young children, people with care responsibilities and families with additional support needs. It therefore continues to provide a flexible service to meet the needs of its clients and to arrange appointments at accessible venues around care responsibilities. HWC continues to offer a variety of ways to carry out appointments to successfully cater for the needs of its clients. This can be an office appointment at a time and venue suitable to the client, it may be a telephone or appointment and where necessary a home visit. The model of practice established during the developmental phase of the project proved to be a successful approach and is still employed by the service. Contact is made with clients prior to arranging an appointment to confirm what type of support is required and what kind of appointment would be appropriate. The contact also gives the client an opportunity to opt for a telephone appointment if this suits and identifies any emergency issues. Telephone appointments can be very useful for clients with straightforward enquiries or those with responsibilities which would hinder them from attending an office appointment. Between April 2012 and March 2013 there have been 462 appointments made with HWC (Renfrewshire) clients by the Income Advisor. Diagram 1 below breaks down these appointments. Diagram 1 Between April 2012 and March 2013 there were 462 appointments confirmed with HWC (Renfrewshire) clients. Page 6

11 There has been a small increase in the number of appointments made by Healthier Wealthier Children in when compared against figures (20 more appointments made). The project has also experienced a reduction in the amount of episodes where clients failed to attend their pre arranged appointments. 112 failed to attend appointments for compared against 141 in This is a positive sign for the service and an indication that referrals into the project are targeting families that are actively engaging with the support provided. Out of the 350 appointments attended by clients, 242 of these were initial appointments with 108 being follow up appointments for more complex cases or families with language barriers where face to face appointments are necessary. Number of fail to attend appointments in have decreased by nearly 21% compared against appointments not attended in It should be noted that many clients referred into the service are returning or new clients who are looking for some support but a full appointment is not needed, for example they may only be looking for some quick advice, wanting to know where to get a claim form or requesting referral to other support services. Whilst advice and support is provided to these clients they have not been noted statistically as an initial appointment and therefore not record as support provided. HWC intend to look into this for future reporting to allow the service to better reflect the level of assistance provided. Page 7

12 The mini case studies below highlight the different types of appointments available through the project. They indicate how tailored arrangements have been beneficial to clients using the service. Allowing, in some instances, access to support that may otherwise have been unavailable. HWC offers office appointments throughout Renfrewshire at times and venues that suit clients and hopefully reduce any travel costs to attend appointments The project is supported by the NHSGGC Interpreting Services. This has allowed HWC to provide ongoing support to clients referred in from the BME community. All HWC appointments are followed up either with repeat appointments, if required, or by a telephone call to ensure claims are outcomed and to confirm and act upon any further support required. Page 8 For clients who find it difficult to engage with services (therefore do not manage an appointment) letters are issued prior to closure of a case, inviting them to return to the service if circumstances change this confirms a HWC contact name and number and allows client to know the door is always open.

13 Clients are referred into the project for assistance with a variety of benefit and money issues. It may be that a family wants a check to ensure that they are receiving all the benefits that they are entitled to. Pregnant women may want to confirm what benefits they can claim or wonder how their income and consequently budget is going to be affected. The project also supports clients to identify and make claims, appeal benefit decisions and assist with establishing a benefit outcome. Often clients access HWC to help them with money issues, such as rent or fuel provider arrears or benefit options. It is frequently the case that a client will be referred into the project looking for support with one concern, such as rent arrears. However during the appointment other issues may emerge eg problems with Tax Credits or a claim missing from their household entitlement. HWC (Renfrewshire) continues to strive to provide a one stop support service where, as far as possible, clients are assisted with all their benefit issues by the project. There have been just over 1350 separate episodes of support provided to clients who accessed the HWC Renfrewshire service between April 2012 and March There have been over 1350 separate episodes of support provided to clients who accessed the service between April 2012 and March Diagram 2 below illustrates the different types of support that Healthier Wealthier Children (Renfrewshire) has provided for its client. It is the intention of the project to provide a one stop support service where (as far as possible) clients are assisted with all their benefit issues by the HWC service. Diagram 2 Appendix 1 details the support type provided in more detail. Page 9

14 There have been 327 benefit claims identified and made with clients. This includes Charitable Trust applications. The following (graph 3) and table 2 illustrate the claims that HWC have supported its client to make during the report period of April 2012 March There have been 327 claims identified and made with HWC (Renfrewshire) clients between April 2012 and March Graph 3 Table 2 Claim Type No. Of Claims Made 10 Page 10 Buttle Applications 9 Carer s Allowance 7 Free School Meals 2 Educational Maintenance Allowance 1 Child Support Allowance 1 Sure Start Maternity Grant 30 Maternity Allowance 7 Job Seeker s Allowance 9 Income Support 17 Healthy Start Vouchers 27 Housing Benefit/ Council Tax Benefit 55 Child Benefit 37 Community Care Grant 12 Disability Living Allowance 25 Tax Credits 69 Discretionary Housing Payment 8 Employment and Support Allowance 7 Other 4

15 As has been noted, whilst some HWC referrals may only require a one off appointment for a benefit check, for example, with no further intervention needed many cases are referred to the service with multiple issues in the household. The following example cases aim to highlight the range of support provided by HWC (Renfrewshire) and illustrate the assistance clients have received. Weekly Gain : Child Benefit Child Tax Cr Further CTC Child DLA Plus 1578 backdated money. Also client was no longer subject to underoccupancy rules, saving her per week in rent liability. Client reported that the peace of mind she had that she had made all appropriate claims correctly was as helpful to the family as the actual increase in their income, potentially therefore improving mental health and wellbeing. 11 Page 11

16 Weekly Gain: Healthy Start 3.10 Child Benefit Tax Credit Income Sup Plus one off payment of 500 Feedback such as this from clients indicates that the project has a positive impact from a heath perspective in addition to a financial one Advice regarding Welfare Reform changes is likely to be in high demand as the changes are implemented and benefit income is potentially affected. 12 Page 12

17 The issues that are dealt with by the Healthier Wealthier Children (Renfrewshire) project vary in their complexity and also the amount of contact that is required with the client to establish a positive outcome. HWC aims to be adaptable in the ways it contacts clients in order to provide a flexible service. In addition to face to face contact, support is provided via letters, telephone calls, s and text (both to clients and on their behalf of the client to other agencies). With the use of signed client consent extensive follow up work can be carried out for the client without them having to be present this is very useful for families working, those with young children and carers. HWC continues to provide a flexible approach in order to meet the needs of its service users. Follow up contact letters, outlining what has been discussed at appointments or further action client needs to take, have proved useful for clients for whom English is not their first language or those who may find it difficult to remember information provided. This approach that was established in the development stage continues to promote positive engagement with clients using the service. Between April 2012 to March 2013 there has been 813 significant contacts made with or on behalf of clients who have accessed the service during this period. These contacts are broken down below in Table 3 There have been some changes in the way statistics for the project are recorded. To better represent the work carried out by the service. Contacts Made With / On Behalf of Clients Telephone Call Telephone Appointment Outreach Appointment Homevisit Letter /Text/Fax No. of Contact 2012/13 No. of Contact 2011/ Table 3 In the majority there is little difference between 2012/13 figures when compared to 2011/12 with the exception of number of telephone calls. There has been a dramatic decrease in the number of telephone calls noted for 2012/13. This is clearly as a result in what calls are recorded as a significant interaction. Only calls of ie over 10 minutes whereby benefit information is provided, are now noted for statistical purposed (although many other calls such as keeping in touch calls still continue to be made). Previously all calls to clients, whatever the nature, were noted. 13 Page 13

18 Touch base contact helps to sustain engagement with clients especially those who find it difficult to maintain contact with support services. Whilst clients are engaging with Healthier Wealthier Children they are regularly contacted to update and confirm how things are progressing. These touch base calls or texts help to sustain engagement with clients especially those who find it difficult to maintain contact with support services. In addition they assist in identifying any other issues that may have developed. During the development stage of the project it was hoped that this approach would build relationships between the service and clients to encourage them to return to the service in the future should they need assistance. With the increase in clients returning to the project as self referrals it appears this objective has been successful. It is the intention of HWC Renfrewshire to begin, for to record the number of new referrals that are previous clients being referred or self referring back into the project to better track this development. 14 Page 14

19 One of the key aims of the Healthier Wealthier Children project was to maintain the links, established during the developmental phase, between health services and financial inclusion services in order to contribute to addressing child poverty. To analyse the success of the project during its second full financial year the following have been examined in more detail: Have Health Services continued to refer into the project and if so have they felt the service has supported the clients they have referred to Healthier Wealthier Children, thus maintaining the links formed with financial inclusion services? Has the project been able to continue having a financial implication (increase in income) for clients using the project has it contributed to addressing child poverty? Evaluation has been carried out on a local level to establish whether Healthier Wealthier Children has continued to sustain the objectives of the project identified in the developmental stage. Has the project maintained longer term what it established in the development stage for example in terms of numbers of appropriate referrals and level of service provided to clients? Over 75% of all referrals into Healthier Wealthier Children were generated from health service staff. This indicates that not only has the project maintained it s focus on the key referring groups but that it has continued to develop and expand its links between Health and Financial Inclusion Services. Many of the referrals from Social Work have been generated from families that have multiple agencies working with them and feedback indicates that it was often the health service staff that brought the attention of the service to other agencies working with clients. Over 75% of referrals were from Health based staff indicating a continuation of the positive uptake of the service by Healthier Wealthier Children (Renfrewshire) key referral group. During the run up to the end the funding of the project for the following year had not been confirmed. Despite this period of uncertainty referrals continued to be made, further reflecting the confidence in the service. To obtain some qualitative feedback from health staff currently referring into the project, HWC forwarded a short questionnaire to staff inviting them to feedback on their experience of working with the service. It was hoped this would also identify potential areas of improvement. 15 Page 15

20 94% of Referrers agreed that Healthier Wealthier Children was an easy project to refer into. In total 32 responses were received, the majority of these responses were from Health Visitors (82%) which is representative of the largest staff group making referrals into the project. Responses were received from different practice bases covering a good geographical spread of Renfrewshire. The following identifies the questions asked within the questionnaire, highlights key points made and HWC intended responses to these potential areas of improvement. 94% of respondents agreed with this statement, giving an above average score of agreeing to strongly agreeing that the project is easy to refer into. Currently referrals into the project can be taken via paper referrals (preferred method) posted into the project or sent via secure . In addition telephone referrals can be taken when a paper referral can not be made. This telephone referral can be to either the Income Advisor s mobile or office number (both with voic service) or Advice Works main office number. The project aims to make clearer all ways health service staffcan make a referral into the service to address any potential barriers. One respondent gave a neutral response, neither agreeing nor disagreed with this statement and one participant did not agree that the project was easy to refer into. In the additional feedback comments one respondent stated: 16 Page 16 Although the preferred method of referral to the project is via paper referrals (as this captures essential information needed) telephone referrals are also accepted when a paper copy can not be made. If the Income Advisor can not be reached then Advice Works main number can be used, This is staffed during normal opening times and referral details will be taken and forwarded to the HWC project. Based on this feedback HWC aim to address this barrier by reiterating to health staff all mediums by which referrals can be made and also look at streamlining the paper referral form - thus making it more time effective.

21 84% of all respondents confirmed that they feel able to contact the project for an update on client s they refer into the project. This is an encouraging response for the project and a good indicator of the level of interaction between the project and those referring in. This positive relationship is imperative to the continuing success of the project Two of the respondents neither agreed nor disagreed with this statement and only one participant did not agree that they felt able to contact HWC for an update on cases that had been referred into Healthier Wealthier Children. As HWC (Renfrewshire) only consists of one Income Advisor it may be difficult to reach her on the office number. It is hoped that the referrers feel able to leave voic s, or use the Advice Works main number to contact the service for an update. All messages left are responded to when received. 84% of referrers felt confident that the could contact the project aims to update on cases that they had referred into the service. In the initial stages of development health staff noted that regular feedback from referrals made into HWC was not required. It may be therefore that people referring into the project are unsure who to contact to gain feedback or whether this is an option of the service. Especially new staff that have become aware of the project post development stage. One respondent fed back uncertainty over where the service was based now which may also provide a barrier to gaining feedback. To address these potential issues the project will confirm that feedback can be sought as required and who/how to contact to obtain this. This may include some development work for the project, visiting health staff with refresher information about the project. 17 Page 17

22 91% of referrers felt confident that the service provides their clients with accurate and ongoing support. 91% of respondents agreed or strongly agreed (79%) with this statement. Additional statements regarding this question seem in the whole extremely positive, including comments such as: Three respondents provided a neutral score for this statement - although no particular feedback identified any lack of confidence in the service provided. No participants indicted that they were not confident in the support provided to the clients they refer in. Confidence in a project is vital for a positive uptake of the service, this attitude towards HWC is reflected in the number of referrals the service continues to receive. 94% of all responses agreed or strongly agreed (80.6%) with the statement 94% agreed that the project has a positive impact on the families it is supporting. HWC has had a positive effect on it's clients. Option additional feedback statements provided support this opinion of the project. Two responses to this question neither agreed nor disagreed with the statement regarding the impact of the engaging with the service. No responses to this question indicated that that HWC did not have a positive effect on the families it is supporting. 18 Page 18 Being able to see and reflect on the impact making a referral into HWC can have on a household will encourage staff to continue referring into the project.

23 HWC was encouraged to note that 91% of all responses received for this statement gave an average or above average score rating. Of this 91%, 72% of responses indicated feedback from families as being good or very good. Additional information given by respondent further highlights the positive feedback received by the HWC service. Only one response to this question indicated that feedback was very poor and 2 responses highlight a poor feedback from families. No additional information was provided for these scores to identify the source of the issue. The very poor and poor scores seem slightly out of alignment with the feedback to other questions and as a service improvement issue HWC will aim to look into these statements further. It is unknown whether the poor feedback was due to the actual service provided or the service being unable to make any changes to the client's circumstances ie because their income is already maximised or (due to regulations governing benefits) claims have been unsuccessful. Feedback received is a positive indicator that the project is maintaining its goal of strengthening links between Health and Financial Inclusion by offering a reliable and accessible service. To summarise, HWC view the feedback provided by the questionnaire as a positive indicator that the project is maintaining its goal of strengthening links between Health and Financial Inclusion by offering a reliable and accessible service. It appears that in the majority HWC clients are reporting back positively to the source of their referral. It is hoped this will further encourage existing and new health staff to employ the project as a tool to support the families they visit. It is reassuring for the HWC to know that it continues to have a positive effect on the families accessing the service and that health staff feel confident to refer into the project. Without the support of the staff referring into the project Healthier Wealthier Children would be unable to continue to provide assistance to families experiencing or at risk of experiencing poverty. 19 Page 19

24 From Inception to date HWC has made 1,474, gains for clients who have engaged with the service. It is difficult to measure the impact Healthier Wealthier Children has continued to have on addressing Child Poverty of families living within Renfrewshire as increasing income into a household is only one of the many ways to address child poverty. However there is no doubt that financial gains for clients who have used the service will positively contribute to their household. The project has continued to see significant gains for the families that have been supported by HWC (Renfrewshire) Income Max service. There has also been a slight increase in the gains made for clients for 12/13 when compared to the previous year. These outcomes are recorded as below: April 2012 March 2013 the HWC (Renfrewshire) Income Advisor role cost 30,000 to deliver and achieved 712, in gains for clients using the service. For every 1 spent delivering the Income Advisor role has been raised for the local community One Off Payments These include all monies that are paid to client as non re curring payments such as lump sums of backdated benefits or tax credits. Also grant claims such as Sure Start Maternity Grants or Community care Grants. Weekly Gain This includes any increase in income that is paid regularly to the client such as more Tax Credits or benefits or maybe an award of Disability Living Allowance. It is expressed as an annual gain for the family. Total Gain This accumulates the above payments. It is the total annual In- come gained for clients due to assistance from the Healthier Wealthier Children Project (Renfrewshire) expressed as an annual amount. 20 Page 20

25 During the development of the project HWC (Renfrewshire) aimed to establish a service that was straightforward to refer into whilst keeping its focus on the key referral group. It was envisaged that this service would have minimal waiting times and offer a range of benefit support. It was also hoped that by maintaining this level of services clients would feel able to return to the service should their circumstances change. The below bullets identify some key points about the delivery of the project Clients continue to be contacted within 3-5 days of the referral being received at HWC base. During there has never been a waiting list for client appointments are usually arranged within 7 days of the first contact with clients. Throughout the project has not had a dedicated development worker at a local level however, with the ongoing support from the local health improvement team HWC (Renfrewshire) has sustained and surpassed the number of referrals made in referrals were made into the service in Over 92% of the referrals were from health based staff or services directly involved with families or disabled children. Health Visiting staff continue to be the highest referrer, indicating that they are embedding this into their practice. Where HWC is not able to assist active referrals are still made to alternative support. Over 87 onward referrals were made for ie debt or fuel poverty support, specialised budgeting advice or housing issues. Every client that is referred into the project that does not engage is still sent a letter prior to closure of the case. This letter highlights contact numbers for the project and confirmation that should circumstances change in the future client can contact the HWC service direct. 21 Page 21

26 HWC Renfrewshire has concluded its second full year of service provision on a positive note by continuing to sustain its aims and outcomes for service users whilst maintaining the core ethos of the project. The number of referrals, engagement with the service and financial gains have remained a consistent indicator of the positive impact HWC has had. The additional three years funding has been a significant reflection of the need for the service and the impact the project is having on a local level. The security this funding also brings to the project can only strengthen the links with health staff and fortify referral routes by removing any uncertainty of the project s future up to March The Welfare Reform changes that begin to come into affect from April 2013 will impact on many Renfrewshire families and it is predicted that the demands on Advice Services dealing with Benefits and Debt Issues will increase dramatically. Having a dedicated post with a named contact where previous families supported by the project, or new households becoming aware of the service, can access ongoing assistance is going to be fundamental during this period of change. HWC appears to be embedded as a good example of inequalities sensitive practice for health staff. The questionnaire issued to health based staff has provided not only confirmation of the attitudes and opinions of those using HWC as a resource, it have also yielded valuable insight into potential areas of improvement for the service. Healthier Wealthier Children aims to explore these issues in the near future with the health improvement team and address any barriers experienced by staff and clients to streamline the service. HWC Renfrewshire has established itself as a valuable resource for both staff referring into the project and the clients it supports. The unique position of the service means that it can reach and support clients that potentially may not have sought support for their benefits or debt issues. It is important that Community Planning Partners endeavour to maintain this model to support families experiencing or at risk of experiencing child poverty. 22 Page 22

27 Benefit Check : A check based on the families circumstances that is carried out with client to ensure they are getting all the benefits that their household is entitled to. This will highlight if the family can make any other claims and if they are getting the right amount within their benefits. Tax Credit Check: A check to confirm that family do not have any issues specifically with tax credits. This includes checking the award, confirming the correct year income is being used, any shortfall and assistance with overpayments of tax credits. Debt Check : A check to confirm that the family have no creditors/debt that they wish to address, such as loans and credit cards they are struggling to repay. If debts are identified (and they are not simple debts a referral to Advice Works Money Advisors is made. Debt Advocacy / Support: Any support provided to address debts identified during debt check. This includes contacting creditors with view to establishing a repayment plan for client. Assistance with Rent Arrears/Housing Benefit: Any support provided to help establish housing (and council tax) benefit including forwarding of additional information to housing on client s behalf. Assistance with any issue re housing benefit such as support to revise a decision. Help with addressing rent arrears. Advice on Benefits: Any support provided to client regarding eligibility for benefits such as discussing criteria for Disability Living Allowance. Advice re sanctions of benefits or future possible entitlements. Other Support letter / Advocacy: Any other help that is not related to benefit or debt for example assisting clients to write letters to Councillors or banks. Assistance with Fuel Poverty: Help with fuel poverty such as referral to Warmer Homes, looking for support with arrears of fuel or establishing repayments/meters for arrears. Assistance to Appeal: Support to appeal/review any benefit decision. Better off Calculation: Benefit check to see how much better off clients would be if they took up employment, changed their working hours or made a claimant swap for benefits. Claim for Benefits: All claims made for benefits with client 23 Page 23

28 Telephone Call: Any call to or on behalf of client. This is more than i.e. a call to arrange an appointment, It involves providing support or a call for longer than approx 4-5 minutes. Telephone Appointment: Appointments that are carried out via telephone calls to clients at a time and date that suit. These can be initial appointments or follow up appointments with clients. They can be followed up with office/home visits as required. Useful for benefit checks and straightforward queries. Outreach Appointment: Appointments that are carried out at outreach venues throughout Renfrewshire at a time and date that suit. These can be initial appointments or follow up appointments with clients. They can be followed up with office/home visits as required. Homevisit Appointment : Appointments that are carried out at clients home as they are unable to get to an office venue and a telephone appointment does not suit. These can be initial appointments or follow up appointments with clients. They can be followed up with office/home visits or telephone calls as required. Letter: Any letter sent to or on behalf of a client. This may be a letter to a creditor or the DWP or it may be a letter to the client outlining what was discussed at an appointment. /Text/Fax: Any , text or fax sent to or on behalf of a client. This may be an to housing benefits or it may be a text to the client updating or arranging an appointment. 24 Page 24

29 Further Reading. Healthier Wealthier Children The Overall Project Glasgow Centre for Population Health carried out an evaluation of the overall Healthier Wealthier Children Project, combining the outcomes from all HWC individual projects throughout Greater Glasgow and Clyde. The key findings are outlined below: Over 15 months, the project achieved a total financial gain in excess of 2.25 million for pregnant women and families accessing HWC money advice services; Most of the 2,500 plus referrals for advice came from midwives and health visitors which suggest they have an important role to play in addressing child poverty; Joint work between NHS and HWC money advice staff led to new approaches being developed such as out-reach, home appointments and telephone assessment with a client group that had not traditionally accessed mainstream advice services. The final HWC evaluation report can be downloaded from : aluation_report_of_the_hwc_project The HWC literature review, which was completed in September 2011, can also be downloaded from : ure_review Further information and resources on operational aspects of the project can be found on the NHSGGC website at: 25 Page 25