Transformation Partners in Health and Care > Community Led Prevention > The impact of our workstreams > Proactive and preventative models in health care – Social welfare legal advice

Proactive and preventative models in health care – Social welfare legal advice

This workstream aimed to: 

  1. Support ICBs to increase the provision of and better integrate social welfare legal advice within healthcare and other settings
  2. Convene pan-London groups to continue building momentum and support the culture shift on SWLA within healthcare
  3. Develop resources, build the evidence base and communicate the impact of integrating social welfare legal advice

Key impacts and achievements 

ICS and borough-level support:  

  • ICS engagement: Engaged each of London’s ICSs to share the findings from the report and what the London Health Board recommendations would mean for them
  • Provided consultative support: Provided consultative support to ICB leads in developing plans for integration
  • Stocktake of provision: Undertook a substantial stocktake within Tower Hamlets, NEL and NWL

Pan-London activity:  

  • Convened a Pan-London Community of Practice (CoP): The purpose of the CoP was to share best practice and challenges, evidence, models of care and work together to advocate to leaders. The CoP has been convened four times over the past year and has over 40 members
  • Convened an Advisory Group: The purpose of the Advisory Group was to provide oversight to ICBs and steer the work/tune to health system needs, set agendas, provide leadership, and map future work
  • Website development: Created a web space for this programme that could be further developed as a repository of resources
  • Case studies: Gathered and developed examples of good practice from across London

Why was this work important?

Social Welfare Legal Advice (SWLA) refers to the provision of free, independent, quality-assured advice on social welfare issues relating to civil law including: debt, welfare benefits, housing, employment, education, discrimination, immigration, community care and consumer rights.   

Social Welfare problems are impacting on health and contributing to worse outcomes among more vulnerable groups. These issues contribute to health inequalities by exacerbating the impacts of hardship among groups who are already more vulnerable to poor health outcomes and experiences.  

Social welfare legal advice makes a key contribution to improve some of the most fundamental social and economic determinants of health, and improving health and wellbeing outcomes for the most disadvantaged, maximise income, reduce indebtedness, and prevent homelessness. 

Ongoing changes to the welfare system and the cost-of-living crisis have led to increased demand for social welfare advice and support on welfare benefits, debt, housing and immigration issues at the same time as advice services are struggling due to lack of resources. 

Partnerships, networks and funding  

TPHC were commissioned by the GLA to deliver a support package to London ICSs, through bespoke support, and convening pan-London groups to help build momentum and support the culture shift within the NHS.  

Through this commission we created a platform for all those interested or involved in better integrating social welfare legal advice within healthcare and other settings across London. This community of practice convened over 40 staff across primary care, secondary care, VCSFE and public health in London. The CoP met between June and October 2024 to share ideas and brainstorm solutions to key challenges.   

Main projects and outputs  

Report 

Case studies 

What have been the common challenges? 

The common challenges to this have been: 

  1. The widespread understanding of the potential role that social welfare legal advice can play in reducing health inequalities hasn’t translated into it featuring in ICS or Place Based Partnership discussions and planning
  2. Provision of social welfare legal advice is not a statutory requirement and is mostly funded by local authorities, trusts and foundations. The case still needs to be made for the NHS to support in co-funding advice provision
  3. Social welfare legal advice provision is patchy across London and there are advice deserts and gaps in provision for certain equality groups
  4. There is a lack of sustainable funding for advice providers – funding is often short-term and providers can be competing for the same funding pots
  5. There are challenges in recruiting and retaining the advice workforce due to workload, pay, benefits, lack of progression, etc
  6.  There is a lack of space in GP practices to accommodate SWLA advisors – especially due to the demand for face-to-face support

What have been the key enablers? 

  1. In November 2023, the London Health Board members endorsed the principle that “free social, welfare and legal advice should be available to any Londoner who needs it” and to ensure that London’s ICSs have plans in place for such provision
  2. The advice provision that is available across London is good quality and there are many examples of partnership working between advice providers
  3. There are great examples of good practice where social welfare legal advice has been integrated with different parts of the healthcare system – through the stocktake work, the team have gathered several case study examples
  4. There is mostly widespread acceptance of the value of SWLA to both patients and the healthcare system – however, there is still a journey to go to make this universal and for it to translate into an understanding of healthcare co-funding advice

Resources 

Key external resources  

Full list of resources for Proactive and preventative models in health care – Social Welfare Legal Advice workstream

This section of the website represents the historical record of a legacy programme which is no longer managed by TPHC, as of mid 2025.