Financial Shield project: Supporting health by tackling financial stress

Achievements and impact

The project has already delivered significant results:

• £1.67 million in financial gains recorded for residents, with a median of nearly £4,000 each.
• High return on investment: every £1 spent generates an average of £3.79 in recorded financial gains.
• Relief from enforcement action: around 350 residents accessed temporary breathing space from rent and Council Tax debts.
• Better health outcomes: more than half (53%) of residents reported improved mental or physical health.
• Reduced NHS demand: a third of participants made fewer GP visits.
• Strong resident satisfaction: people report reduced stress, improved financial security, and greater ability to manage health conditions.

Insights and recommendations

The Financial Shield model shows that co-locating financial support within healthcare produces lasting social, financial, and health benefits.

Key insights include:

• Targeted, flexible support is effective: Case studies show that small-scale emergency assistance, combined with benefits and debt advice, can significantly improve residents’ ability to manage health and financial pressures.
• Embedding financial support into clinical teams adds value: Quality assured advice agencies employ our FSLWs. In Lambeth, these are co-located in GP practices, enabling close collaboration with healthcare professionals and improving referral pathways.
• Proactive communication improves access: Structured referral routes – including GP-led identification, SMS campaigns, and self-referral options – have also helped reach residents who are less engaged with traditional advice services.
• Including face-to–face support is important: In Southwark, one in six of all residents contacted by our SMS campaigns request an appointment with the FSLWs, based in Citizens Advice. While the majority request phone consultations, forty percent request face-to-face support.
• Data sharing to support breathing space arrangements can provide better outcomes: Giving residents the chance to opt-in to cross-sector data sharing has enabled councils and housing associations to offer joined-up enforcement relief and improved access to financial support. These provisions could be improved further by extending partnerships to include energy and water providers.
• Specialist services remain essential for residents with the most complex needs. Effective referral pathways to specialist advice, particularly in debt, housing, and immigration, should also be embedded into future commissioning plans.

Recommendations for Health Commissioners:

1. Financial advice and support is integrated into plans for neighbourhood health centres and services. This could be by co-locating quality assured teams in health settings; by providing more structured referral routes; or a combination of both.
2. Advice services working with primary care can deliver through wider partnerships. This includes working with local authorities, housing associations and other agencies that collect payments from residents in their areas.
3. Data sharing mechanisms are fully explored to facilitate partnership working, both to improve outcomes and to measure impacts.
4. Partnerships are provided with opportunities to influence wider advice strategies, including the provision of specialist advice services serving their areas. For example by feeding into Money and Pensions Service debt advice commissioning plans.
5. To support long-term funding, partners should work together to develop a shared model for evaluating the social impact and cost-effectiveness of their integrated services. Discussions concerning who is best placed to co-ordinate this work involving Government as well as local partnerships are now required. Department for Work and Pensions should particularly explore how it can help local partnerships to better track the outcomes from their benefit advice work with residents.

Finally, many of the residents using our service have incomes that are clearly inadequate to meet their basic needs.  Income inadequacy can remain a problem even after residents have secured all their entitlements, with clear negative implications for health, employment, and housing. Our welfare and health systems need to work together to improve outcomes. Adequate benefit levels are essential to provide the foundations for improved health and deliver on the ambitions of the 10-Year Health Plan. Recent efforts to restrict eligibility criteria and reduce levels of support risk undermining this. We therefore recommend that Government ensure:

6. All future welfare changes are subjected to a rigorous impact assessment with respect to their impacts for health and the delivery of health services.