Medical advice: Physical co-location with legal support the ‘gold standard’
Clients who obtained legal advice at their GPs’ surgeries have reported “a range of positive outcomes, including on their mental and physical health” as well as their finances, research for the Ministry of Justice (MoJ) has found.
The advice was delivered under health justice partnerships (HJPs), which enable GPs, nurses and receptionists to book legal advice sessions for people, often at their surgeries.
Meanwhile, government officials and academics said they regarded locating advisers in surgeries as the “gold standard” approach because it facilitated genuine “joined-up working”, with positive impacts both for users and the wider justice system.
Researchers from IFF Research and York Health Economics Consortium interviewed the heads of 13 HJPs – 11 involving Citizens Advice, one a law centre and another a housing association.
They also interviewed a small group of seven clients, who were “experiencing a range of mental and physical health issues and sought legal advice for a number of reasons relating to finances (benefits and pensions), relationships or housing”.
Some were referred for legal advice by their doctor or nurse, others “signposted” to advice.
“Clients spoke positively about the referral experience and the provision of advice. In many cases, clients reported that their legal issues had been resolved and suggested a range of positive outcomes, including on their mental and physical health, finances or housing situation.
“In addition, some clients reported feeling more confident about knowing how to deal with a similar issue in the future and who to seek advice from.”
Researchers recommended that the issues should be explored with a larger group of clients.
They said nine of the 13 HJPs examined in detail between January and March 2022 for the study, Evaluation of integrated advice hubs in primary healthcare settings, ran advice sessions in GP surgeries, the rest delivering it at other locations or remotely.
GPs, nurses, physiotherapists or receptionists booked appointments in 12 cases, with the remaining HJP using ‘signposting’ to an advice agency. In most cases (eight out of 13), health information was shared with the legal advisers.
Researchers interviewed six HJP “stakeholders”, including government officials, academics and strategy specialists in the advice sector.
They “spoke positively about different types of models but suggested that physical co-location is the ‘gold standard’ approach, as it facilitates genuinely integrative and joined-up working, which positively impacts outcomes for users and the wider system”.
More evidence on the different models was needed, alongside examples of best practice.
“Views on the potential positive impact of a national agenda on HJPs were mixed, with some concerns about moving away from localised support and the uncertainty of priorities in an ever-changing political landscape.”
Researchers recommended that further work should “robustly estimate the impact of HJPs on the speed of resolution of legal problems, better social-economic outcomes and improved health outcomes” by carrying out ‘before’ and ‘after’ surveys with clients.
Further research should also include in-depth interviews with healthcare professionals and frontline advisers.
The HJPs in the feasibility study were funded by local authorities and primary care networks or clinical commissioning groups, as well as other sources, such as charities.
Researchers said the economic costs and benefits of HJPs should be studied, alongside changes in the use of resources in the justice and healthcare systems.
Dame Hazel Genn, a professor of socio-legal studies at University College London, told a conference last month that conditions for the growth of HJPs were more favourable than they had been for many years.
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