Working towards a Best Start and Bright Futures: reflections on an NHS child poverty partnership

In the series, we will explore three different models of children and families’ services delivering interventions to tackle the root causes of child poverty. This first blog outlines the Healthier Wealthier Children (HWC) model in NHS Greater Glasgow and Clyde (NHSGGC), and considers how the model can support wider efforts to tackle child poverty. 

Launched in 2010, the HWC project is a children and families financial inclusion initiative that works closely with antenatal and community child health services to target pregnant women and families with young children experiencing, or at risk of, child poverty.

The project differs from traditional NHS provision as it addresses poverty and its damaging effects in a direct way by routinely enquiring about financial worries and making onward referrals to money advice services. Both midwives and health visitors continue to play a key referring role.

Since the project launch in 2010, there have been over 45,000 referrals to money advice services, which has led to families receiving an average annual income boost of between £1,000 and £3,000.

These positive results reinforce the value of having non-stigmatising conversations about money worries and offering timely support to financially vulnerable groups. This has included lone parents, young mothers, people living with disability, Black and Minority Ethnic families, and families with more than three children. Various case studies vividly capture how this type of support can dramatically reduce families’ stress levels by accessing unclaimed social security payments, tackling fuel and food poverty, managing debts, improving budgeting skills, and supporting parents that want to go into education or paid work.

Operating across six Scottish local authority areas and facing year-on-year funding challenges, why has this ‘non-traditional’ model lasted? Thinking about the commitment from different partners at various stages, several key ingredients were important. Initially, the Scottish Government funding in 2010 to set up the project and building the research evidence were both important catalysts. This in turn supported new alliances among NHS, council and third sector staff committed to tackling child poverty, which encouraged a shared sense of leadership, ownership, and accountability. The switch from collecting research data to monitoring referrals and financial gains for families ensured that the project became a visible part of NHS governance and reporting structures. The regular monitoring also helped identify and address any system-wide risks. Finally, the longstanding commitment of senior leaders and links to NHS and local planning groups encouraged good working relationships across different areas and workforces.

Looking back, it has been rewarding to watch this vital work grow over the last 13 years and avoid becoming a short-term pilot that fades into memory, which is all too common. Today, the work continues to evolve and further innovation has led to money advice services being based in a Special Needs in Pregnancy Service and a Children’s Hospital.

Despite achieving such positive results, the model is operating within a very difficult landscape that has been shaped by UK Government austerity policies, COVID-19, the cost-of-living crisis, and rising child poverty rates. In Scotland, one in four children now live in poverty, which is placing greater burdens on families and in achieving the Scottish Government target of fewer than 10% of children living in relative poverty by 2030.  

The national plan to tackle child poverty (Best Start, Bright Futures) outlines a series of  important  actions to boost family income. They include increasing the Scottish Child Payment to £25 per week by the end of 2022 and placing money advisors in up to 150 GP practices in some of Scotland’s most deprived areas. Placing advisors in practices is a positive step, but it is vital that antenatal and community child health services − which are often a first point of contact − have equal access to referring families on to money advisors, particularly in areas were aspects of the HWC model are less developed.

Responding to such early years gaps by expanding this tried and tested model could help address the rising child poverty levels and boost wider efforts to reclaim the estimated £19 billion UK social security benefits that remain unclaimed every year.    

In Scotland, there are around 47,000 births each year. In  this tough economic climate, many of these households will have to juggle stretched budgets. The HWC project serves as a timely reminder of the value of bolstering collaborative efforts to ensure that all children do indeed have the best start and bright futures.

The other blogs in the series can be accessed here:

The power of working together: when health and financial wellbeing services join forces 

With a little detour via Australia, Healthier Wealthier Families makes it to Sweden