More than health care: why the NHS is a force for tackling poverty

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As the Covid-19 pandemic has highlighted existing health inequalities in UK society, it has also renewed a focus on poverty. People experiencing poverty are at the deep end of health inequalities, and are also more likely to be a part of minoritised groups who also experience health inequalities as a result of, for example, race, gender and disability. It’s important that work addressing health inequalities is also explicit about the impact of poverty, because those affected by poverty have a high risk of the worst health outcomes.  

Poverty affects one-fifth of the UK population, and it is likely on the rise. Although the data is yet to be confirmed, modelling by the Legatum Institute suggested 700,000 additional people were experiencing poverty at the end of 2020 as a result of the Covid-19 pandemic. While the pandemic’s long-term impacts are not yet understood, economic projections around its impact on the UK economy paint a gloomy picture for the next few years. It’s also clear that the immediate impacts are falling unequally, with those already badly off experiencing the worst effects.  

The NHS has a key role to play in tackling poverty – just by existing it already helps to protect people and families from potential ruinous costs of health care. But how it delivers services, and works in partnership in local communities, can also make a difference for people experiencing poverty. Our new report sets out practical steps the NHS can take at all levels to tackle poverty. 

In our work for NHS England and NHS Improvement, we brought together people with a broad range of voices and experiences across sectors, including lived experience, to discuss what the NHS currently does well, and what it could do more of, to tackle poverty. 

The NHS is a large employer, particularly in poorer communities, and workshop attendees highlighted the potential for local NHS organisations to further their anchor role in these contexts...  

One thing that stood out was the quality and breadth of conversations among those attending our workshops – even with the constraints of an online meeting. People from different sectors spoke powerfully about their work and its impact, and made new connections with others doing similar work. This seemed like a small example of the potential for the NHS to work in partnership and spread good practice.  

People attending our workshops shared examples of initiatives where, as service providers, NHS organisations already help to address poverty – for example, by working with local citizens advice services to provide access to social welfare advice in GP services and other health settings. On a wider level, the NHS is a large employer, particularly in poorer communities, and workshop attendees highlighted the potential for local NHS organisations to further their anchor role in these contexts – for example, by working with education providers to develop pathways from training to secure jobs for local people.  

Alongside the actions the NHS could take, a key theme for the discussions was raising awareness of the NHS’s role in this space – that poverty is something the NHS can, does and should address. This has to involve meaningful engagement with people with lived experience of poverty, which in turn requires leadership with humility, recognising that the NHS does not have all the answers. This approach is also important for local NHS organisations’ engagement with other sectors, for example, recognising voluntary and community sector organisations as a core partner. But where it does this engagement the NHS can also be a powerful advocate, highlighting the effects of poverty clinicians witness (as paediatricians did last year to support the campaign for free school meals for low-income families during the holidays).  

This has to involve meaningful engagement with people with lived experience of poverty, which in turn requires leadership with humility, recognising that the NHS does not have all the answers.

NHS England and NHS Improvement has a key role supporting this work, and has already made a commitment to addressing poverty as part of wider work to reduce health inequalities in the NHS Long Term Plan. Our report adds more detail on what this national role could look like by, for example, developing the narrative on how the NHS can tackle poverty, connecting and spreading good practice and supporting NHS organisations to further this work, and advocating across government for a focus on health inequalities and poverty in broader work such as the ‘levelling up’ agenda. 

As health leaders plan for recovery after the pandemic, there is an opportunity and an imperative to consider how the NHS can further tackle poverty. Our work suggests the NHS does this best when working with other sectors and by ensuring people with lived experience are meaningfully included.

Want to find out more?

Our new commissioned report sets out what the NHS, as the largest economic institution in the country, needs to maximise its contribution to tackling poverty.

Read the report

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