Matter for Discussion: Financial hardship

Members can view a recording of the debate here.

There are well-documented variations and inequalities in health across the population. Outcome measures of morbidity and mortality are far higher in deprived areas, along with variations in the types of care people can expect (King’s Fund, 2020). 

Among the key drivers for health inequalities are financial hardship and poverty, and these have become steadily worse over the last decade across the UK (Marmot et al, 2020b). This has been exacerbated by the pandemic (Marmot et al, 2020a) but is also due to rising living costs, increases in fuel prices, interest rates, and rising inflation, which may reach a 40-year high over the next year (Forbes Advisor, 2022). All of this has a far greater impact on lower income households. 

The pandemic caused financial hardship for many, with loss of income and jobs as a result of business and industry closures and significant cuts to self-employment grants. It is a sobering thought that in the 21st century, many people are now having to make choices between heating their homes and eating. There is also a clear correlation between mental health and poverty (Joseph Rowntree Foundation, 2016).

The stigma associated with poverty means that opportunities to help and provide support for individuals are easily missed (Salisbury, 2022). As nursing staff are well respected and trusted, they are in an ideal position to start conversations with patients and families on how they are managing financially. They can offer support and practical advice - for example, directing  people to sources of information about benefits, and signposting to food banks, charities and community organisations. 

It is important that nursing staff do not shy away from discussing financial hardship and providing support, and that they help tackle the stigma surrounding people struggling financially (Douglas, Avenell and Mohamed, 2022).

This is a public health issue and this debate will help focus thoughts on where nursing staff and the RCN can offer assistance. But by raising the issue, we can also identify where and how nursing staff are working to support people experiencing financial hardship. 

This debate provides an opportunity for nursing teams to share their experiences as part of the RCN’s resources on the role of nursing staff in public health (Royal College of Nursing, 2021b). This can, in turn, highlight the impact that financial hardship is having on the UK’s health. 

Nursing staff are in a good position to understand local needs, link up services for their patients and clients, and to influence policies, particularly at local level (Donovan and Warriner, 2017). The aim is to expand the RCN’s current public health resources, especially on the inclusion of health (Royal College of Nursing, 2021a), to provide members with further information and tools to develop skills and confidence in starting conversations about money.

Reading lists for each agenda item can be found here.

References

Donovan H and Warriner J (2017) Nurse’s role in public health and integration of health and social care, Primary Health Care, 27(8) pp. 20-24. Available at: https://journals.rcni.com/primary-health-care/nurses-role-in-public-health-and-integration-of-health-and-social-care-phc.2017.e1294 (Accessed 20 April 2022)

Douglas FC, Avenell A and Mohamed S (2022) Conversations about financial hardship should not be off limits, British Medical Journal, 376, 9 Mar. Available at: https://www.bmj.com/content/376/bmj.o577.full (Accessed 20 April 2022)

Forbes Advisor (2022) Inflation and interest updates, Available at: https://www.forbes.com/uk/advisor/personal-finance/2022/04/13/inflation-rate-update/ (Accessed 20 April 2022)

Joseph Rowntree Foundation (2016) Poverty and mental health: a review to inform the Joseph Rowntree Foundation’s Anti-Poverty Strategy. Available at: https://www.mentalhealth.org.uk/sites/default/files/Poverty%20and%20Mental%20Health.pdf (Accessed 20 April 2022)

King’s Fund (2020) What are health inequalities? Available at: https://www.kingsfund.org.uk/publications/what-are-health-inequalities (Accessed 20 April 2022)

Marmot M, Allen J, Goldblatt P, Herd E and Morrison J (2020a) Bring back fairer: the covid-19 Marmot Review, Available at: https://www.health.org.uk/publications/build-back-fairer-the-covid-19-marmot-review

Marmot M, Allen J, Boyce T, Goldblatt P and Morrison J (2020b) Health equity in England: the Marmot Review ten years on, Available at: https://www.health.org.uk/publications/reports/the-marmot-review-10-years-on (Accessed 20 April 2022)

Royal College of Nursing (2021a) Inclusion health care, Available at: https://www.rcn.org.uk/clinical-topics/public-health/inclusion-health-care (Accessed 20 April 2022)

Royal College of Nursing (2021b) The role of nursing staff in public health , Available at: https://www.rcn.org.uk/clinical-topics/Public-health/The-role-of-nursing-staff-in-public-health (Accessed 20 April 2022)

Salisbury H (2022) Health, poverty and stigma, British Medical Journal, 376, 18 Jan. Available at: https://www.bmj.com/content/376/bmj.o116 (Accessed 20 April 2022)