The following case study looks at the action taken within NHS Tayside to train their health and social care staff on poverty sensitive practice.

Reason action was taken

As noted in our take the right actions page, one of the key ways to reduce health inequalities is by training the workforce to understand their role in this.

There is still a lot of stigma attached to being in poverty, both in terms of

• people not wanting others to know that they are in poverty
• service providers not reflecting on their practices and being aware of their behaviours when in contact with those experiencing poverty and inequalities.

NHS Tayside wanted their service providers to treat people in a sensitive way and deliver a positive experience.

Training that could be extended

Dundee City Council Equally Well team (now known as the Community Health Team) and the Welfare Rights team developed poverty sensitive practice training for a wide range of frontline staff. Training for Trainers has been further developed in which members of NHS Tayside attended. This allowed them to learn the use of the materials and what training standards could be applied.

Training learning outcomes from this include to

• raise awareness of poverty including in-work poverty
• reduce the stigma associated with being in poverty
• support poverty sensitive practice
• raise awareness of how to signpost people in poverty to sources of support.

It has been recognised nationally as a model of good practice and won the Scottish Public Sector Award in 2016 for employee development and skills.

The NHS Tayside Workplace team were keen to adapt and provide this training within all three local authorities in Tayside in partnership with the Welfare Rights teams. This could then be extended to include

• NHS Tayside staff
• local authority staff
• staff within housing associations.

They wanted to get people to change their understanding of poverty, think about their own roles and consider how their beliefs, behaviour and attitudes might be impacting on those who may be experiencing poverty. 

The Dundee City Council teams reported that consistently, local people experiencing poverty and inequalities said the way they were treated affected their personal wellbeing and experience of using services.  The training aimed to explore poverty so that participants could make links between how services are delivered and feelings of stigma and exclusion.

Action taken

They approached the Welfare Rights teams to discuss opportunities for working in partnership to roll out this training. 

Three members of the NHS Tayside Workplace team were assigned to work with Welfare Rights teams within

• Angus
• Dundee
• Perth and Kinross.

Training presentations were adapted to reflect information within each of these local authority areas. 

Approximately three sessions are now provided on an annual basis within each area.  A maximum of 16 participants attend each.

From 1 April 2018 to 31 March 2019, 6 sessions were delivered with 65 attendees. Attendees were from local authority, NHS Tayside and housing associations.

People who helped       

All work within the NHS Tayside Public Health Directorate has an inequalities focus. This work fully supported the NHS Tayside Child Poverty Action Plan. 

Welfare Rights teams within Dundee City Council, Angus Council and Perth & Kinross Council fully supported this work. 

Home Energy Scotland sent a representative to all training sessions to advise participants of the help and support available for service users from them on things such as fuel poverty and benefits checks. NHS Tayside Crisis Contacts and the Money App are also promoted at all training.

Impact and lessons learned

All training sessions were evaluated after they took place. Comments from the participants included the following.

• “I am now aware of how complex in work poverty is.”
• “Was not aware of all the resources that are available.”
• “Enjoyable and thought provoking.”
• “Would recommend to all health professionals but would be good for general public – might reduce stigma.”
• “Heightened awareness of poverty.”
• “Be more aware of colleagues’ situations.”
• “Never judge peoples circumstances.”
• “Challenge discrimination.”
• “Investigate further when speaking to people in a crisis.”

This training will continue throughout 2019-20.  Additional sessions are planned for family nurses, midwives and health visitors.

Further information

You can find out more about ways to reduce health inequalities within our reducing health inequalities section.

Find out more about poverty within our poverty section.

This case study is based on information provided by Pat Davidson from NHS Tayside. If you would like to discuss further, you can contact our Health Promoting Health Service (HPHS) team by email at nhs.HealthScotland-hphsadmin@nhs.net.