1 Poverty proofing delivery partner model
Children North East are working in partnership with Rotherham, Doncaster and South Humber (RDaSH) NHS Foundation Trust to fulfil its ambitious promise to “poverty proof” all of its services by September 2026. The trust has committed to piloting a bespoke Delivery Partner Model developed in partnership with Children North East (CNE).
Poverty Proofing is a nationally recognised tool, designed to educate and enable health care professionals to identify, acknowledge, and reduce the impact of poverty. Advocating for equality of access to healthcare services and technologies will positively impact the overall health outcomes of everyone.
A locally trained team (LTT) of families have been trained and are being supported by Children North East to carry out this work in line with the ethos and principles of Poverty Proofing.
- Phase 1: 3 model audits carried out by Children North East.
- Phase 2: a further 6 audits carried out by the locally trained team with support from Children North East.
- Phase 3: all other trust services will engage in the Poverty Proofing process during 2025 and 2026. Children North East will deliver training to all staff; the locally trained team will carry out scoping of services and engage families and staff in consultations; and the trust strategy team members will deliver feedback and write reports for each service. Moving forward, services will become more poverty informed, learning how to work with their families to identify barriers, so that poverty becomes everyone’s business and no-one is left out or left behind.
This whole system approach is unique and has accountability at every level and a commitment to alleviate barriers that apply across the whole system.
2 Poverty proofing Doncaster health visitors (age 0 to 5)
The locally trained team engaged with Doncaster health visiting (age 0 to 5) and stop smoking in pregnancy and beyond service during May and June 2025, to understand the experiences of families who are living in poverty.
The work was carried out with families and staff to build up a rich picture of the challenges and barriers faced by those accessing or attempting to receive these early years services in Doncaster.
The health visiting (age 0 to 5) service follows a whole family approach, working in partnership with children, young families and families. The team of highly trained NHS professionals possess experience and expertise in all aspects of children’s and young family’s health and wellbeing.
The health visiting team includes specialist community public health community nurses, community nursery nurses, health promotion practitioners and perinatal wellbeing practitioners. They provide a professional public health service based on best evidence of what works for individuals, families, groups and communities. They enhance health and reduce health inequalities through a proactive, universal service for all children aged 0 to 5 years and for vulnerable populations targeted according to need. Health visiting is a proactive, universal service that provides a platform from which to reach out to individuals and vulnerable groups, taking into account their different dynamics and needs, and reducing inequalities in health. Pre-school children and their families are a key focus. The health visiting team have a vital role in safeguarding children and families. They also deliver the stop smoking in pregnancy and beyond service for Doncaster.
The service is flexible in its approach to service delivery; visiting families in their home and at family hubs, and other venues that meet the needs of families. The service also delivers groups including antenatal solihull, breast start, baby massage, first friends and introduction to solid foods.
In Doncaster, 16.6% of the population was income-deprived in 2019. Of the 316 local authorities in England, Doncaster is ranked 48th most income-deprived, with 1 being the most deprived.
Save the Children tell us that:
“All children deserve the best start in life, we must aim to fulfil every child’s right to thrive. The earliest years of a child’s life lay the foundations for their health, wellbeing and future outcomes. What babies and young children experience affects how they learn and develop. Persistent exposure to adverse environments and experiences in the early years, such as poverty, often means that young children don’t have equal access to the conditions that enable them to do well. Relative poverty for households where there is a child under five continues to rise rapidly, though economic disadvantage does not inevitably lead to poor outcomes for children. Key factors play a significant role in mitigating the causes and effects of poverty. Our responsibility is to maximise the chances of good outcomes for babies and children through multi-sector, long-term commitment and proportionate investment so that all families are given fair access to opportunities for their children.”
3 Poverty proofing ethos
No activity or planned activity should identify, exclude, treat differently or make assumptions about those whose household income or resources are lower than others.
3.1 Voice
The voice of those affected by poverty is central to understanding and overcoming the barriers that they face.
3.2 Place
We recognise that poverty impacts places differently, and so understanding place is vital in our response. Organisationally we also need to be clear about why and how decisions are made. This understanding of context is essential.
3.3 Structural inequalities
The root causes of poverty are structural. What structural changes can we make at an organisational level to eliminate the barriers that those in poverty may face?
4 Poverty proofing process
4.1 Stage 1: training and consultation with staff
68 Staff Attended 3-hour training on learning half days in May and June 2025. We also received 63 survey responses from staff and spoke to 20 staff.
4.2 Stage 2: scoping
Time was spent gathering information about the setting and how it works. This stage included conversations with staff and management.
4.3 Stage 3: patient and community consultations
We received feedback from 18 families who uses the service.
4.4 Stage 4: feedback session
The report was shared with the Service Manager, Zoe Parker, to consider the findings. We then produced this final report.
4.5 Stage 5: review
Around 12 months after completion, the trust will complete a review, identifying impact, good practice and potential considerations moving forward.
5 Common themes
The next sections of this report highlight the most common themes to come out of the Poverty Proofing consultations. For each theme the report covers:
- what works, what you do now that supports those experiencing poverty
- the barriers and challenges faced by those experiencing poverty
- recommendations, each recommendation comes with a set of considerations for “poverty proofing” the service
The themes are presented alphabetically, and this does not imply any hierarchy of importance. The themes for Rotherham inpatient services were:
- communication
- health-related costs
- navigating and negotiating appointments
- families empowerment
- staff awareness and guidance
- travel
5.1 Communication
Communication is important to consider in Poverty Proofing both from a health literacy perspective of how information is communicated and understood and in ensuring there are reciprocal lines of communication between services and service users. O’Dowd (2020) reported that availability of care was a particular concern for those on a low income and there were significant inequalities in care availability for the most deprived areas. Communication is a key factor in ensuring availability of care.
5.1.1 What works
5.1.1.1 The service is welcoming
Families who used the service overall felt that the service is welcoming. Most families with agreed or strongly agreed when asked this question.
“I have felt comfortable at every visit. It’s a safe space.”
“Always friendly when we attend our first friends session in Stainforth.”
“The first friend session is really great service we get to share ideas and also have a space to share our concern privately or publicly.”
5.1.1.2 Families value the staff and the service provided
Families provided good feedback about the service overall. For example of 102 stories told on Care Opinion shows that 97 families would recommend the age 0 to 5 service and one would not.
“I’ve meet Lisa on both my health visitor checks with my son on the 1 year and 2 year review. She is friendly, professional, very informative and knowledgeable. She instantly puts you at ease and is a great asset to the health community. It was so nice to see her friendly face again today. It was so nice to hear all the positive feedback on my son and that I’m doing things right.”
5.1.1.3 Staff use different ways to translate information
Where it is found that a person needs a document translating, staff will use the best means available to them at the time.
“Your place and online interpretation apps can help with some forms, for example, Royal Society for the Prevention of Accidents (ROSPA) for safety in the home so far are not in other languages, this is being looked at around funding, we use translation service and apps.”
“Family Hubs have access to a device which we can ask to use which acts as a translator, it can photograph text and translate from leaflets et cetera.”
5.1.2 Barriers and challenges
5.1.2.1 The language we use may mean some families do not understand what is being asked of them, or what is available
A number of staff said that the way we communicate with families might be a barrier to them understanding what is on offer to mitigate poverty. It is important to understand a person’s communication needs and ability, so they know what is available and what support they will receive.
5.1.2.2 Interpreters
In some cases, families using the service require the use of interpreting service to be able to discuss their needs and treatment. Staff reported that the main issue that they experience is with interpreters, and that the service can be unreliable.
“We try and book then quite far in advance and then we get an e-mail the day before to say they’ve not been able to get a translator. It just seems to have happened much more since the changed from… to…, but it’s not as good a service… we can’t even sometimes get certain languages on the phone as well, so it is more of a struggle.”
“Translators are driving at time of translating.”
5.1.3 Recommendations for communication
5.1.3.1 Communicating with families based upon their needs and ability
- Make sure families are asked about their communication needs and preferences.
- Make sure communication needs and preferences are recorded in SystmOne.
- Check with families that they understand what is being communicated to them. Get them to explain what is being said.
5.1.3.2 Interpreting services
- This is a consistent theme across the Poverty Proofing audits, and the trust should make sure the new provider of the service has a reliable approach which is more appropriate for patients and staff.
- Report any missed interpreter appointments through Radar as an incident
5.2 Health related costs
“Money buys goods and services that improve health; the more money families have, the more or better goods they can buy.” (Joseph Rowntree Foundation, How does money influence health? 2014).
The Food Foundation (2023) found that in order for the poorest fifth of the population in the UK to meet the Government recommended healthy diet guidance they would need to spend half of their disposable income, compared to just 11% for the least deprived fifth.
In 2025, Moneyhelper said about a child’s early years:
“You’re already nearly £600 down in the first month but add in the costs from the other eleven months and even with very basic costs of £95 a month (based on product data from price comparison site idealo), you’re looking at £1,645. But in reality it could be much more, as LV estimates parents spend a whopping £12,400, per year on raising a child. With many having taken maternity leave and therefore a cut in their pay it’s likely to be putting a strain on your budget. It’s estimated that in years one to four parents are typically spending on average £63,224 in childcare fees.”
This would be before any affordability is taken into account, where families may be experiencing poverty and low income.
5.2.1 What works
5.2.1.1 Staff do try and find ways to support families with the costs of bringing up children
Staff recognize the financial challenges that families face, and do go out of their way to support families with items that may be beyond direct health costs. This reflects how caring they are for the families they support.
“The Health Visiting East team have raised money to buy shoes for families, pamper packs for mums.”
“I delivered baby things to a family hub that was gifted for families who are struggling to purchase these basic things.”
5.2.2 Barriers and challenges
5.2.2.1 Cost of prescriptions
There are some instances where families will need prescriptions after pregnancy or 12 months after giving birth (when prescriptions are free). They may be above or below income thresholds to receive free prescriptions. It may be that these families are entitled to Universal Credit or another benefit and should be referred to Citizens Advice for a money check. Families told us that help with the cost of prescriptions would be a good thing to introduce. In some instances, it is also the case that the prescription given doesn’t adequately meet the need.
“Some families may… above the cap for getting extra benefits, so would have to pay for their prescriptions, so would go without medicines.”
“Additional continence produce because we use at least double of what’s prescribed daily.”
“Some families more than others must cover the cost more than others, especially single parent families.”
“There are some families who will not hear they are struggling though.”
5.2.3 Recommendations for health related costs
5.2.3.1 See if families are entitled to support with transport
- Make all staff aware that the NHS Travel Costs Scheme exists. Provide clear information on who can apply and what they are entitled to claim for (this may not only be families who are on benefits, others can be eligible through the NHS Low Income and Healthcare Travel Costs Schemes).
- Refer families to Citizens Advice Doncaster to see if they are entitled to support with transport costs and attending day centres (link at the end of this report).
5.2.3.2 See if families are entitled to help with prescription costs
- Advise patients about the HC2 form and how to fill it in effectively.
- Advise that patients who are paying for prescriptions whilst their HC2 form is being processed, should keep their receipts to be reimbursed.
5.3 Navigating and negotiating appointment
Life can be particularly unpredictable when living on a low income. The challenges, for example around childcare or zero hours’ contracts can make attending appointments very difficult. Pressures on the NHS around waiting times and stretched services can mean there is little scope for flexibility and strict discharge policies are applied for those who miss appointments, effectively severing access for those with changeable circumstances. Furthermore, social problems often accompany poverty, and sometimes life can be chaotic, which makes consistent appointment attendance difficult. Availability and flexibility of care are important for improving access to health care for those on a low income.
The King’s Fund (2021) report states that:
“Services need to be flexible, accessible, responsive and offer continuity of care.”
5.3.1 What works
5.3.1.1 The service is pro-active in contacting families about appointments
For one part of the service a lot, not all, of the appointments offered by the service are home visits. The service will make contact to confirm appointments and send reminders to families in advance of visits.
“We usually send text message reminders to remind of appointment and some clinician will sometime ring the patient if it’s a home visit to let them know that they are on the way.”
5.3.1.2 The service will follow-up if an appointment is missed or cancelled
If for any reason the person and their child isn’t at home when a visit has been arranged, a note is left and a follow-up telephone call is made to re-arrange.
“If a patient contact to cancel an appointment mostly these come through via single point of contact (SPOC) and the message is then passed to the clinician so that they can arrange to rebook the patient as they will be on their allocated caseload.”
5.3.1.3 The service is flexible where appointments are held
Some appointments are offered or take place in the health hubs in Doncaster. If a person’s circumstance means they can’t make it to the health hub, they will be offered a home visit.
5.3.2 Barriers and challenges
5.3.2.1 Complexity of health systems
A number of staff said that the health system itself can make it difficult for families to get the support and treatment they are entitled to. Not only does this mean it can delay a person’s support, it can also mean that it can prevent families from accessing other healthcare.
5.3.2.2 Hidden costs of accessing services
Staff told us that there were indirect costs to families, such as childcare or time off work, that could make attending appointments difficult.
“Childcare issues, I have had a few families where parents have required counselling but have had to opt for telephone rather than face to face due to having no childcare options.”
5.3.2.3 Waiting for other health services
Staff told us that there were instances where families needed support as they waited for other parts of the health system to provide care. This can put strains on families and staff whilst they wait.
“Support for those parents who are waiting for mental health support and autism.”
“The time and stress it takes to get paediatric appointments, dietician, salt appointments. This may not be for us to fix but this is some of the struggles that we get to it those waiting.”
5.3.3 Recommendations for health related costs
5.3.3.1 Help create simpler health systems
- Identify on the patient pathway where families come into contact with other health and care services.
- Look to work with those organisations to make the process as simple as possible.
- Make sure families understand what the steps are, either being taken by the service or that they need to do themselves.
- Access peer support for the person to help them navigate the system where it is needed.
5.3.3.2 Home visits
- Consider offering home appointments to families identified as being on low-income or with increased health risk, where this isn’t currently offered.
- Consider offering home appointments where possible, especially during the initial period of accessing the service. This could allow families to feel more comfortable and open up more than in a clinical setting.
5.3.3.3 Appointment times
- Consider if appointment times are meeting the needs of the whole family and if there are any caring responsibilities that create a barrier to accessing appointments.
- Identify which appointment times are suitable with patients during assessments or treatment sessions.
- Explore the possibility of providing more out of hours appointments so that those with zero hours contracts or the self-employed have more choice when booking appointments reducing the potential loss of earnings.
5.4 Families empowerment
Being in poverty can be hugely disempowering and contribute to reduced literacy skills (Literacy Trust, 2012), lower educational attainment, lower levels of confidence and less engagement with health behaviours and healthcare (Sheehy-Skeffington and Rea, 2017). Services can support this by tailoring support to different education and literacy levels, working alongside patients and families to build health literacy and confidence in managing their health as independently as possible and ensuring there are opportunities to share their views and shape services.
5.4.1 What works
5.4.1.1 Families feel supported
There was overall positive feedback that families felt supported by the service. Families said they would feel that the service would help if they struggled with costs of their care, with the way they feel treated creating confidence. This was also supported through staff views.
“First visit is in antenatal, tend to talk about support first. Can notice things during home visits (do not have the right to explore it more like social care but do ask gentle questions around food et cetera). Most families will tell Tammy in their first appointment if they are struggling.”
5.4.1.2 Staff will guide families to other support available
Staff told us that they would guide families to other support and advice that is available to help them in their child’s development. For example to “Tiny Happy Families” which is help develop a child’s language skills, with simple activities and play ideas to help learn about babies and toddlers’ early development. Some families said that staff do guide them to other support that is available, which can be about supporting the house.
“Tiny hands and BBC website link for white goods and early years now in the hubs.”
“They do share with us some free resources that are available so I think they would know where to signpost for such help.”
“They all seem willing to help where they can.”
“They should know where to refer to get help.”
5.4.2 Barriers and challenges
5.4.2.1 Access to data to use digital devices
A number of staff said one thing could you change in your practice to make life better for families experiencing poverty is access to digital devices. Comments were made about families not being able to afford credit on the phone, meaning opportunities to ask questions and rearrange appointments may be missed. Families also told us that access to digital devices would be a good thing to introduce. Citizens Advice Doncaster run a programme on behalf of the integrated care board to help with digital literacy, devices, and data: like the barrier on what financial assistance available, families and staff may not be aware this is also available.
5.4.2.2 Support for families who might have financial challenges
Staff told us that they can work with and recognise that families have financial and other challenges that impact upon their quality of life. Whilst staff do signpost families to support available, this is something that could be more consistent. It can also be difficult to discuss. Many families also told us that more financial assistance programmes, along with staff training, would be a good thing to introduce. Giving clear communication about what is available was also something families said we should introduce.
“It would be great to receive information on community resources and financial help available for healthcare as a standard.”
“It would be great to get information on where to get help especially now when things are tight.”
“While on mat leave I think it would be great if there was information shared that we can relay if there was like a booklet that tell us all the things we can get discount or free that would be great. We get a lot of leaflets but once you lose them its gone.”
“It is difficult, we get a lot of families that are immensely proud of all they know no other than what they are living with at that time… So, it is, you know, trying to sort of, you know, support them in a way to get them help. But, you know, some families are extremely proud and will not go there. But like you say, it is signposting them, given the opportunity to look at that independently as well and giving them that empowerment.”
“Special education needs (SEN) for children, services changing policy or process leaving children without safe equipment which is extremely expensive to purchase themselves. For example, safe sleeper bed for a child. Just over £4000 to purchase one of these, which is unaffordable for most families if you work or are on benefits.”
5.4.2.3 Families might not feel confident in talking to staff about money
We asked families if they felt whether they could talk to staff if they were struggling to pay for care: a lot didn’t. Some families told us why they felt like this, and in some cases would welcome those type of conversations. Families also weren’t sure if the service would support them, if they did raise money concerns. It also needs to be said that some families would feel confident in talking to staff about money matters.
“Embarrassment and I was recommended by many professionals to apply for Disability Living Allowance but it was declined.”
“Some of the staff are really not approachable.”
“We never really talk about how we are doing about affording things and I feel if we did more of this we probably would share ideas that may be of benefit to a lot of families who may be shy to disclose they are struggling and this can be done when maybe talking about weaning.”
5.4.3 Recommendations for patient empowerment
5.4.3.1 Help with household money and debt
Make sure staff are aware that they can refer families for money and debt advice to Citizens Advice Doncaster (a referral link is at the end of this report) and record this on SystmOne.
5.4.3.2 Helping families with their digital needs
- Ask families about their digital needs and barriers.
- Refer families to Citizens Advice Doncaster digital support programme (a link is at the end of this report).
5.5 Staff awareness and guidance
This theme is around identifying the social and economic needs of families and giving holistic care so that they can be fully supported. Research has shown that those living in England’s most deprived areas tend to receive the worst quality healthcare, for example with longer waits and worse experiences accessing appointments (O’Dowd, 2020). Families will have different needs depending on individual, demographic, systemic and social needs and countless other factors.
5.5.1 What works
5.5.1.1 There are some clear examples how services support families experiencing poverty
Staff told us of a range of ways their service identified families who may be experiencing poverty. This then led to action being taken to support families. Many great examples were cited, here are just a few.
“We do this as part of our initial assessment as a health visitor and some of it get disclosed.”
“We are used to these conversations; we used to difficult conversations. It is more evident for us when we get into families houses as we get to see how they are living, and this sometimes leads us to be able to ask more questions.”
“Above and beyond to support families helping fill out forms supporting them with food parcels et cetera.”
“Previously supporting families health visitors, referrals to services, referrals to charity, home contacts, contacts in local family hub.”
“We try to source support for families in need such as with the Safer Sleep Scheme and through referring to Family Hubs et cetera.”
“Access to baby equipment and clothes for families.”
“Apply to charity or funds for necessary and needed equipment. Apply for healthy start vouchers or maternity grants. Loan out breast pumps free of charge. Give out food vouchers. Give out Tippee cups and tooth brush packs. Deliver Christmas presents to families in need. Signpost to relevant services who may be able to help further with housing, finances or employment. Signpost to local family hubs for extra support, completing forms, use of washing facilities if required et cetera.”
5.5.1.2 Some staff said the service had a way of identifying families who are experiencing poverty
Most of the staff responding to the survey said the service had a way of identifying families who are experiencing poverty. A consistent number of methods were cited, and these are show in the quotes below.
“We use risk assessments and discussions in meetings with patients to see if there is and any poverty.”
“Face to Face discussions, promotional guides.”
5.5.1.3 Staff would adjust their offer to meet about cultural or religious preferences
Staff said they felt confident they would adjust their work to meet traditions and religion and practices and support around faiths and religions, so that services could be provided respectfully.
“I think cultural differences if events happen then we would discuss and offer evidence-based information. Like infant feeding there are some differences which are discussed like offering tea as well as feeds. think if they had mentioned it, it is not like a routine thing that we ask about religion, unless it is just coming up in conversation.”
5.5.2 Barriers and challenges
5.5.2.1 The response to supporting families experiencing poverty is mixed and not consistent
Whilst the above paragraph shows structured ways to support families, with staff citing examples of where the service supports families experiencing poverty, but this can be dependent upon judgements of other individual staff or verbal screening. The response to the staff survey is also mixed: around half the staff think there is a way their service can identify someone in poverty, whereas the other half don’t think there is. This means the support families receive may depend upon the member of staff the person sees, rather than a consistent offer being made.
5.5.2.2 Staff confidence how well the service supports families experiencing poverty
Whilst a number of staff said their service did support families in poverty well or very well, there was also a number who were unsure if this was the case. They or their colleagues may be unaware of what is available or how they can help someone experiencing poverty. This means that families may be losing out to support that they need or are entitled to.
“The biggest thing is where to direct parents for support with finances when they have unwell children and need time off work. How do they claim benefits when having to wait 13 weeks if they leave a job? Can support with filling in Disability Living Allowance form but has parents living in limbo for months without knowing when they will receive benefits.”
“We need a comprehensive guide to what is available and where we can refer families to especially those that do not meet criteria for Universal Credit or Benefits”
5.5.2.3 Having information of what is available for families
Many staff told us that it would be helpful to have one source of information of what is available, in terms of services or in the community, for families to access. This was a strong feeling from both the face-to-face meetings and survey results.
“Foods banks offering support with baby equipment.”
“It would be good to have a bank of information somewhere including contact details of what services are out there to help families, as often we know what support is needed but it is not always easy to find out where we can access these resources or support.”
“Ensure I am up to-date with services available to support. Services often lose funding so are no longer available which can be crucial for families.”
“A good understanding of services locally that can support families in need.”
5.5.3 Recommendations for staff awareness and guidance
5.5.3.1 Making staff aware of financial support available
- Communicate with staff the nationally publicised help that is available for families which is published on the trust website (a link is at the end of this report):
- help with transport costs
- NHS Low Income Scheme
- help with health costs for families on Universal Credit
- help when you need to pay for NHS care (prescriptions, dental care, eye care wigs and fabric supports)
- personal health budgets
- Make sure this is communicated to families and their peer support.
5.5.3.2 Staff engaging in financial conversations with families
- Open up financial conversations routinely as part of someone’s care.
- Provide a basic level of training for staff, to empower them to have financial conversations.
- Get information from charities and foodbanks on what is available in Doncaster and how families can access them. The Council and voluntary, community and social enterprises (VCSE) can help with doing this. Make sure staff have an easy reference in one place on what is available.
5.5.3.3 Learning of what works already in the service
Use the examples colleagues reference for supporting families, such as financial screening, and spread this to all colleagues. For example, in team meetings.
5.5.3.4 Access to benefits and debt advice
Refer families to Citizens Advice Doncaster for an income or benefits check, a link is provided at the end of this report.
5.5.3.5 Access to other support
- Work with the council and voluntary and community sector to create a list of information of support available to families (such as access to white goods).
- Make that list accessible to staff.
- Communicate to staff via team meetings, email, et cetera.
5.6 Travel
Healthwatch UK (2019) showed that travel is a key issue for families, with 9 out of 10 families consulted saying a convenient way of getting to and from health services is important to them. Difficulties with transport were also identified as a common reason that families will miss appointments. There is a phenomenon known as the poverty premium, where those with less money end up having to pay more for essential items, which further perpetuates the cycle of poverty. For some families (who do not have access to a car) public transport and taxis are more expensive than it would be to drive.
5.6.1 What works
5.6.1.1 Offering home visits
A number of staff told us that their service offers home visits to families as a way of supporting families or families who need additional help due to their income. This helps reduce the financial burden on families to get to clinics or appointments elsewhere.
5.6.1.2 Families value community based activity
A number of families told us that they really value having a service to attend in their community, which is closer to home. This helps reduce the financial burden on families to get to clinics or appointments elsewhere.
“There is a few first friend session in our area so not too far to travel for families.”
“There are lots of location to attend group session for mothers and babies.”
5.6.2 Barriers and challenges
5.6.2.1 Knowledge of travel cost re-imbursement
There are instances where families can claim back their travel costs for appointments. A number of staff said they didn’t know who was entitled to, or how to. This means they won’t be able to advise those that are entitled to do so. We were also told by a person that they missed an appointment due to the cost of travel. A lot of families told us that help with travel expenses would be a good idea. The trust is also looking to implement a travel fund where families can’t afford to attend appointments, and would include families who don’t meet the national criteria for travel re-imbursements.
“Did it a while ago but not sure if this is still something that is still available?”
“Parents cannot often fork the middle out in the first place, so you know, although it is reimbursed, it is that initial layout of money that a lot of our families have not got. So, you know it can work, but it does not always do as well. But there is another, but there are other funding streams available, but like I say, it would be my place that we would look at to help us navigate that, you know, where we get that information.”
“I would not know how to refer a parent to access this support for travel at this present time.”
5.6.2.2 Opportunities to provider services closer to families’ homes
Whilst a lot of the support is based upon home visits, there is some support and sessions that are delivered through other venues (for example, family hubs). Staff have told us that there may be opportunities to look at other venues and ways of delivering these services.
“First friends’ groups are well attended. I would like to see more outreach venues where Family Hubs are not present.”
“Health bus to travel around the villages for outreach support.”
5.6.2.3 Cost of travel can stop families benefiting from the service
Families told us that they themselves or families they know do not get to some of the sessions due to the cost of travel. In some cases, as the sessions may be too far for them to walk with their children to attend. Other families who can attend really value the service, as it is free. A lot of staff also told us that the cost of travel can be a barrier to families accessing the service.
“If you can get to the location a lot of the things they offer are free. The only obstacle would be travel.”
“I know some families who don’t come because they would have to walk far to attend.”
“Home visits help because no travel cost.”
“If more information can be shared about help with travel cost I think it would be great, I know some mothers on mat leave who don’t attend groups because of the cost of travel but then this might be the few opportunities for them to leave the house and have outside interaction.”
5.6.3 Recommendations for staff awareness and guidance
5.6.3.1 Promote Healthcare Travel Cost Scheme
- Promote the claiming back of travel costs and make this normal in staff roles.
- As a trust, develop a process to claim back travel costs that isn’t stigmatising and is easy to use.
- Advertise it to patients, ensure staff know about it, and how it works.
- Look to introduce pre-loaded travel cards or similar for families who don’t have the money up front.
5.6.3.2 Volunteer drivers
- Look to create a pool of volunteer drivers to help families attend appointments.
- Identify families who would benefit from such a scheme.
- Trial and test, before learning and rollout.
5.6.3.3 Re-imbursing travel costs for families on low incomes
Where families have to attend clinics, and are at risk of was not brought (WNB) due to the affordability of travel, use the process being developed as part of the 2025 and 2026 investment fund
5.6.3.4 Home visits
Identify families for home visits, where cost and affordability of travel is a problem.
5.6.3.5 Community appointments
Look to hold appointments in community settings, which are closer to where families live and help avoid unnecessary travel.
5.6.3.6 Digital appointments
Look at there, clinically, an appointment can be undertaken digitally that will reduce the travel need of the person and staff alike.
6 References
- O’Dowd, A (2020) Poverty status is linked to worse quality of care
- Literacy Trust (2012) Adult Literacy
- Sheehy-Skeffington and Rea (2017) How poverty affects people’s decision-making processes
- Healthwatch UK (2019) There and back, People’s experiences of patient transport
- Disability Living Allowance (DLA) for adults
- Help with health cost
- Doncaster digital support
- Doncaster health professionals referral form
Page last reviewed: August 13, 2025
Next review due: August 13, 2026
Problem with this page?
Please tell us about any problems you have found with this web page.
Report a problem