It's time to start talking openly about the impact of money worries

Have you ever had a life-changing conversation? We often hear people saying how important a teacher was in their development, and the impact they had on their careers and lives. We also know health professionals play an important role in people’s most vulnerable moments – from treating life-threatening illnesses and managing chronic health conditions to accompanying them when their lives, or the lives of their loved ones, are facing the inevitable. When it comes to patients’ perception of the quality of these engagements, good communication is key.  

Many people struggle with money issues, and research shows that there is a relationship between money and health. If we know that good communication can make a difference, isn’t it time we started having conversations about money in health care settings?

Money isn’t just money – it’s health 

Money problems are linked to health problems – and the relationship goes both ways.  

Socio-economic inequality can lead to health inequality. In England, people in deprived areas live, on average, 10 years less than those in wealthier neighbourhoods. And the gap in healthy life expectancy is even bigger – up to 19 years for women in the most deprived areas. These most deprived groups also experience lower financial wellbeing.

Experiencing health problems can also put people at risk of financial difficulties. UK data estimates that people experiencing long-term health conditions or disabilities are more likely to experience poorer financial wellbeing. This is even lower for those experiencing cognitive and mental health conditions.

Worse health also increases a person’s likelihood of experiencing persistent debt problems. Not only can problems with debt have a detrimental impact on health, but being in poor health also affects a person’s likelihood of experiencing persistent debt problems. People in problem debt are three times as likely to report that their health is ‘bad’ or ‘very bad’ – 21% compared with 7% for those not in problem debt. Financial difficulties are also a risk factor for suicide. The National Institute for Health and Care Research (NHIR) has recently launched a call for proposals to investigate the health impacts of interventions designed to address unmanageable debt. 

Talking about money can be intimidating

People with financial difficulties often struggle to share their worries openly, due to feelings of embarrassment, shame or stigma. They may find it easier to open up with organisations in their community, and GP surgeries and health centres could potentially be trusted spaces where people could share these worries. Yet data shows that many health professionals feel unequipped to have these money conversations. Reasons for this included feeling it wasn’t their place to discuss these issues and fear of causing embarrassment.

Given that NHS England estimates 1 in 5 GP appointments relate to non-medical issues, such as loneliness or seeking advice on housing or debts, the question is whether the health care system has a role to play in supporting patients with low financial wellbeing. At the Money and Pensions Service our hypothesis is that it does, and the good news is that there is promising evidence that it works. 

 A solution: early intervention and compassionate conversations 

Early intervention, providing mandatory training and referral systems to welfare, money and debt advice, can help prevent a range of health issues, and especially mental health, by solving financial issues in their initial stages. 

This could potentially be cost saving for the NHS – a referral system to Citizens Advice from the NHS in Liverpool suggests that people (mainly those from the most socio-economically disadvantaged groups) who receive social prescribing and welfare advice (for example, with applying for welfare benefits, managing debt and improving their housing situation) may require fewer GP appointments, A&E attendances and prescribed medications due to improved overall health and reduced stress levels.

Providing health care professionals with a basic understanding of the impact of money worries on a patient’s health, and knowing how and where to signpost patients to the right services, can be life-changing for many. Training can be light touch, and many resources are already available. In collaboration with the Department of Health and Social Care, MaPS co-developed a financial wellbeing training module for health and social care professionals on All Our Health e-learning platform.

Another resource is Money Guiders – MaPS’ flagship money guidance training programme that aims to give practitioners the confidence to have money conversations. The programme provides skills and tools for practitioners who have (non-regulated) money conversations in their day-to-day public facing roles. The programme has been rolled out across different health organisations around the UK, including employment advisers in the NHS Talking Therapies in England, helplines in major national charities such as Mind and Macmillan, and health visitors in Scotland.

Many people in need want to have these conversations but don’t know how and where to start them. They just need someone to show up in a safe and trustworthy environment, without judgement but with compassion and empathy. And to make them believe that things can change, and that they can change for the better.