Multiple long-term conditions

Shannon’s story

Talking about work and health

Introduction

People living with long-term conditions often struggle financially because of the ways their health impacts their finances, and their finances impact their health. Because of this, every person with long-term conditions should be assessed for their financial vulnerability.

Shannon, a participant in the London Financial Diaries, is financially vulnerable as defined by the Financial Conduct Authority (FCA) because of her long-term health conditions and lack of financial resilience.

Shannon’s health conditions strongly impact her ability to find employment and housing. If better supportive conditions were in place, however, some of her struggles could be mitigated.

Meet Shannon

Shannon is a 55-year-old single mother with four teenagers. She is registered as disabled with knee, shoulder, neck and spine injuries, schizophrenia, and other mental health conditions.

Collectively, her conditions present substantial barriers to Shannon being able to access formal employment. While she does receive means-tested benefits, she is lacking disability and sickness benefits, despite her conditions.

Shannon is very conscious that, if she were offered the opportunity to work, it would require exceptional flexibility from employers to accommodate her health conditions and absenteeism related to her conditions and many medical appointments.

While Shannon worked several low-paid jobs on and off, the lack of support with affordable and reliable childcare became a considerable hurdle for working a consistent schedule. After searching a while, she did eventually get a job as a security guard at a hospital, where she worked 10-hour shifts.

She appreciated the income but often questioned whether the strain the long hours and constant childcare juggle placed on her was worth it.

Borrowing and health

As a single parent of four children, Shannon felt she could never get ahead of things. She constantly worried about the bills and repaying loans. Shannon was working at the time she was pregnant with her fourth child, but her benefits were cut off as a result of her starting the job.

Because there was no transition period from receiving to no longer receiving benefits, she was left in a lurch without any income for a whole month. This could have been resolved if there had been a slow reduction in benefits over two to three final payments.

Because of the unexpected reduction in benefits and the waiting period before receiving her first pay check from the hospital, Shannon couldn’t pay her rent, Council Tax and other bills, and had to borrow money to commute to work.

Her precarious working conditions at the hospital negatively impacted her health conditions, especially when she couldn’t take paid time off work when she needed it. These frequent situations became mentally and financially taxing for Shannon.

Shannon talks about not being able to get time off work through ill-health

Unfortunately, job insecurity often prevents people from taking time to recover after a health shock or trauma. Shannon was working at the hospital on switchboard controls when the 7/7 London bombings happened.

She described how traumatic that day had been for her and how she needed time to regain her mental health. Not only is there immense pressure on frontline essential workers, but the precarity of these types of jobs also has huge health impacts, which creates an extra burden on those already managing multiple long-term health conditions.

Quote from Shannon, saying 'When the bomb went off in the West End, I was working and I was on the Controls. So I remember that being horrible and I was feeling horrible anyway. We kept getting those phone calls, what about their family and that, and I didn’t have any information to give them. Sometimes you’re told to just cut them off and I felt really horrible and after that everything went downhill. I went to my doctors and took time off and next thing I know I got a letter to say that they didn’t need me anymore.'

When Shannon was unable to cover her family’s living expenses she borrowed money from her aunt and relied on her 16-year-old son to get a job and help out. She managed to transition from working in security to working as a receptionist at the same hospital. While her work hours were more reasonable, her pay was not.

In her security job she was paid weekly, but as a receptionist she received a pay check once a month. Because the period between pay checks was so long, Shannon often skipped meals to save on groceries.

When that was no longer feasible, she borrowed money from family and FCA-regulated lenders to get by between pay days and cope with emergency expenditures.

Shannon working at a hospital switchboard

Mental health

Shannon struggled with her mental health and constantly worried about being evicted. One Housing Officer threatened her with eviction and took her to court three times.

This pressure made her anxiety levels go up, which led her to start taking drugs to cope with the fear and stress. Eventually, the drugs caused a brain haemorrhage, so Shannon became determined to stop using. Despite taking drugs during the time she was employed at the hospital, she never missed work because of them.

Shannon told us that her worry over her finances made her long-term health conditions worse, but more recently she has been getting better at talking more about her struggles rather than bottling everything up inside.

Having a support system greatly improved Shannon’s mental and financial wellbeing. She explained that when she was diagnosed with psychosis her family really gathered around her and started helping her sort out her bills and pay off debts. Receiving this support made her feel better mentally, but also gave her a sense of belonging.

Our recommendations

Shannon’s story shows us that there are steps that that organisations she interacted can take to protect the health and finances of people like her:

To help people deal with sudden changes to their benefits, DWP and local Job Centres should make referrals at the right time to local organisations that can help claimants plan for changed financial circumstances.
People living on benefits with long-term conditions often have minimal savings. DWP should consider classifying people with long-term conditions as a ‘vulnerable group’, and provide weekly payments by default rather than on application.
To help people deal with reduced welfare benefits, DWP should smooth downward changes to benefits over 2-3 payments rather than one, especially for types of payments with higher success of re-instatement upon appeal.
DWP and Job Centres should strengthen language in notifications, to improve uptake of local money/debt advice and other FCA-regulated support when amounts of benefits paid to claimants change substantially.
The Financial Conduct Authority (FCA) should assess whether their guidance on affordability assessments is being followed by lenders, and whether new rules are needed, for example regarding affordability, and the higher living costs facing many people with long-term conditions.
The FCA, when supervising firms on its forthcoming guidance on treating vulnerable customers fairly (CG20/3), should encourage lenders to prioritise flexible support for people with multiple vulnerabilities, including long-term illnesses and low or erratic partnerships. They could do this by including vulnerable customers input in design and delivery of services or through partnerships with community and other money and debt organisations.

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Multiple long-term conditions

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Daliya is a 27-year-old mother with multiple long-term health conditions living in South London. Her income fluctuated from month to month and her financial struggles had a huge impact on her mental health.

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Luisa’s story

Luisa is a 28-year-old mother of two young children, aged one and four. She lives with depression and anxiety. When Luisa's finances caused her depression to worsen, this manifested itself through physical symptoms.

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Read the full FinWell report

FinWell: London financial diaries