Impacting health and wellbeing holistically – Are you ready to ELBA?
ELBA is a social mobility charity and we work with large businesses and community organisations to address the underlying drivers of, and barriers to, people from all backgrounds making progress in their lives. Mainly this is related to economic progress via work, or through support of community cohesion and social capital. But we are also starting to look at how the power of an alliance of larger businesses such as ELBA business partners could have an impact on health and wellbeing in the community – the link between health inequalities and economic exclusion being well documented.
So here’s a surprising fact. Of all people who have a health problem, only around 20% get access to legal and associated advice which might help them tackle the underlying contributors to their poor health – eg about benefits, or housing or employment issues. 80% do not get access to expert legal advice that might help them break the cycle of poor health, poverty and poor employment. The figure appears to be remarkably consistent between the US, Australia and the UK, – or so I heard at a seminar on Health Justice Partnerships organised by ELBA friends and supporters, Allen and Overy.
The idea behind a Health Justice Partnership is for law firms to establish an advice presence in the same locations as health services – usually GPs surgeries or health centres. The advice is provided pro-bono – another form of employer supported volunteering – and the lawyers also take on caseloads. It’s a great idea and the principle of co-location of non-health services with GPs is well established – Bromley by Bow Centre here in east London have been pioneers, and there are great examples elsewhere, Derbyshire for instance.
But one of the lessons from the seminar was that co-location does not equal integration. If the services are in the same place but the client is merely signposted from one to the other, it does nothing to break the merry-go-round of referrals and appointments that people in disadvantaged situations face. Attending appointments becomes almost like a full time job – endless queueing and never quite finding the right solution.
True integration comes when the staff from co-located services work as one team – sharing data and client information and also the same canteen and water cooler. When the appointment system and cases notes are on the same PC platform accessible to all staff, and when clients experience the service as a single entity. Of course, one barrier is the different language that each profession uses. In times gone by, Guilds would jealously guard their trade secrets and make their expertise appear to be a dark art, known only by the few initiates. The medical and legal professions can still seem a little that way, though thanks to the internet that is eroding over time.
A great UK example of a Health Justice Partnership we heard about was in Newham, where UCL Centre for Access to Justice are setting up a legal advice service in a health centre and striving to achieve the levels of integration that we heard about in the best examples elsewhere. That got me thinking – what if there was employment advice in the same place and access to training? And what about financial literacy training and workshops too – after all, financial hardship and money troubles lie at the heart of many mental health and family related problems. ELBA is slowly expanding our work in financial literacy and wellbeing – and service integration is definitely something we will be exploring with our partners and funders in the coming months.
