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Why Does Primary Care Play a Pivotal Role in the Cost of Living Crisis?

26 Feb 2024
By Hattie

I recently read an article about the cost-of-living crisis that said, “Although the cost-of-living crisis affects us all, the impact has been felt most keenly by those on low incomes, families with children, ethnic minorities, the elderly, and those living with disabilities.”

After looking into this further, it’s clear that those most affected by the crisis are also more likely to be frequent attenders in GP surgeries and that got me wondering about the role primary care plays in the cost-of-living crisis and how this might change the kind of organisations and companies we should be working with.

Financial strain and its impact on mental health

Money doesn’t buy happiness, but it does buy food and pay essential bills. As we become more financially vulnerable, our ability to be in control of making sound financial decisions weakens and our mental health deteriorates too. In fact, according to data for England from the Money and Mental Health Policy Institute, nearly half of people in debt also have a mental health problem.

Research from the Joseph Rowntree Foundation shows more than a million people in the UK are taking on debt just to cover essential bills and charity Debt Justice estimates 12.8 million adults are falling behind on bills or finding repayments a ‘heavy burden’.

With many turning to unscrupulous lenders or ‘buy now pay later’ providers to help fix their financial situation, we’re also witnessing a surge in people turning to gambling. GamCare, a charity that aims to raise awareness and aid those affected by gambling, is also reporting an increase in calls from people who have relapsed as financial pressures heighten

"Although the cost-of-living crisis affects us all, the impact has been felt most keenly by those on low incomes, families with children, ethnic minorities, the elderly, and those living with disabilities."

Lucy Malcolm, HSJ

Financial strain and its impact on physical health

Although the connection to mental health might be more obvious, acute and chronic physical health conditions are also affected by the cost-of-living crisis.

Analysts from Citizens Advice found that 30% of renters cannot heat their homes to a comfortable temperature – increasing to 45% of disabled tenants. Those forced to choose “eating over heating” may then end up living in cold and damp conditions which increases the risk of heart attacks and strokes and exacerbates pre-existing arthritic and respiratory conditions.

Higher food prices also mean people are less able to afford more nutritious food. As a result, many are at risk of malnutrition and, due to convenient and nutritionally poor food being more affordable, obesity – a major risk factor for three of the greatest burdens placed on our healthcare system – diabetes, cancer and cardiovascular disease.

Why is primary care important?

‘The current cost of living crisis is likely to cast a deep shadow over people on low incomes, long after those who are better off feel that the sun has come out once again.’ – Helen Barnard, Joseph Rowntree Foundation.

Due to the disproportionate impact on the most vulnerable in society, there is an increased demand for primary care to support those in need as they frequent this environment regularly and tend to seek advice from a clinician more than others.

NICE guidelines are now recommending that GPs should ask people about gambling during consultations, in the same way, they ask about smoking or alcohol use, and there are proposals for doctors to ‘prescribe’ money off energy bills for patients.

But doctors’ leaders are warning that piling extra pressure on GPs is not the solution and that they do not have the time or the skills to do the work of the welfare system.

RCGP chair Professor Martin Marshall has said: ‘Action does need to be taken to address this and minimise the impact of the rising cost of living on people’s health, something that will impact on our most vulnerable patients most. But this cannot fall to GPs and our teams to facilitate.’

"Action does need to be taken to address this and minimise the impact of the rising cost of living on people’s health, something that will impact on our most vulnerable patients most. But this cannot fall to GPs and our teams to facilitate.

- RCGP chair Professor Martin Marshall"

What can be done?

In a recent interview Dr Subodh Dave, Dean of the Royal College of Psychiatrists, said “Clinicians can play their part by enquiring about their patients’ financial situations and how this might be affecting their mental health” But I wonder if that’s enough?

If, for instance, a GP or nurse poses this question to a patient and the answer is ‘yes’, what then is the next step? You can’t get a referral to a financial specialist in the NHS and I am pretty sure that there are no OTC medicines that improve your bank balance or increase your salary. So, what is the pathway of care in this instance?

This is why I strongly believe that patients and healthcare professionals want and need to know about external financial advice services, social care organisations, charities and even brands that can help with financial issues as well as provide support from a mental health perspective.

Our Head of Marketing visited the Best Practice Show recently and a recurrent theme was the importance of health education for patients to reduce health inequalities and to encourage patients to live healthier lives. Seems fair to suggest that this could also be a suitable route to pursue for the cost-of-living crisis too?

Given this, how about more information for the patient in the waiting room, whether that’s with posters on the latest council-run schemes or leaflets with a list of support services for mental health and money worries?

Similarly, we can educate healthcare professionals on the additional tools they can signpost their patients too when their usual routes of prescriptions and referrals won’t do.

Over the next couple of weeks, we will be doing a deeper dive into this, but in the meantime, if you would like to speak to a member of the team about reaching millions of patients every month, many of whom are vulnerable and/or from the lower quintile for deprivation then contact us and one of our team will get in touch.