Citizens Advice have had considerable experience in providing advice services in GP surgeries. Such services have proven to increase the accessibility of advice. Not only do they provide the possibility for health workers to refer patients experience a complexity of health, social and economic problems, but, by being placed in the everyday setting of health services, it removes some of the perceived stigma of attending Citizens Advice. Furthermore, for older people and people with disabilities, health service based advice can be accessible in a way that town or city-centre services are not. Partnership between Citizens Advice and Dorset County Hospital is new, though Dorchester and district advisers already provide an outreach service to 6 Dorset general practices that is highly rated by users and practice staff and some lessons from this will be useful. There have been a small number of similar projects in highly specialised hospitals or units but none in a District General Hospital.

What did the project involve? 

This project sought to enable a wide range of expertise to be brought into co-designing a scheme that would place a Citizens Advice service in a district general hospital. As well as bringing in the expertise-by-experience of health service users, this ideas exchange brought in a range of academics working in relevant policy and practice areas from UWE and UoB, along with activists in civil society organisations working on social prescribing issues.

This took the form of a half day workshop to identify current issues and concerns, and the key aims and hoped-for outcomes of the service. The workshop:

• Drew together expertise from patients and their families, health service staff, Citizens Advice workers, academics and civil society organisations to develop an innovative scheme for providing a Citizens Advice Service within a District General Hospital.
• Identified needs of patients and families whilst in hospital for advice services, and how these can be effectively delivered through a Citizens Advice Service.
• Identified what a good advice service would look like in order to support robust evaluation.
• Developed relationships with interested and relevant researchers and other civil society organisations and activists that then sought to support the sustainability and potential scaling up of this project.

Who are the team and what do they bring?

• Morag McDermont (Law, University of Bristol) has been working for some years with Citizens Advice throughout the UK on research that looks at the role of voluntary sector advice services in supporting people with problems with a legal dimension.
• Charles Campion-Smith (Trustee, Dorchester, Sherborne and District and North Dorset Citizens Advice)
• Dorset County Hospital (DCH) senior management, Clinicians and Social workers.
• Users and patients and patient representation service – Patient Advice and Liaison Service (PALS)
• Geraldine Macdonald (Social Work, Policy Studies, University of Bristol) a registered social worker, Geraldine Macdonald has been a long-standing advocate of the importance of rigorous research in social care and specialises in the evaluation of complex social interventions.
• Richard Kimberlee (Social Prescribing Network / University of West England) is an expert on social prescribing, which connects people to projects and activities that will support their mental health.
• Ben Barker (Greater Bedminster Partnership) is engaged in developing social prescribing schemes in South Bristol.

What were the results?

After the successful half day workshop the team developed a one year pilot scheme of the Citizen’s Advice service within Dorset County Hospital which was funded by the friends of Dorset County Hospital. The project received further funding to ensure an external evaluation of the pilot scheme.