Poverty proofing Doncaster and Rotherham neurorehabilitation 2026

1 Poverty proofing delivery partner model

Children North East are working in partnership with Rotherham, Doncaster and South Humber (RDaSH) NHS Trust to fulfil its ambitious promise to “poverty proof” all of its services by December 2025. 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 that contribute to overall health outcomes experienced by those living in poverty.

A locally trained team (LTT) of people 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 patients 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 patients 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 and Rotherham neurorehabilitation

The Neurorehabilitation Outreach team provides an integrated rehabilitation service for adults in Doncaster and Rotherham:

• inpatient assessment
• neurorehabilitation inpatient unit
• community services
• outpatient consultation
• rehabilitation

Doncaster neurorehabilitation service and the Rotherham neurorehabilitation service operate from Tickhill Road site and Park Rehabilitation Centre respectively.

Park Rehabilitation Centre is based on Badsley Moor Lane and for physiotherapy (musculoskeletal) and orthopaedics (knee replacement) occupational therapy and speech and language. Park Rehabilitation Centre has a surface level car park situated next to the building. There are accessible blue badge spaces next to the entrance to the building. Parking is free at Park Rehabilitation Centre.

The Neurorehabilitation team also provide neuro psychological support. The neuropsychology service offers clinical neuropsychology and clinical psychology support to patients accessing neurorehabilitation.

The service is available for patients over 16 years old registered with a Doncaster GP. It is suitable for those with a confirmed or in-progress diagnosis involving a neurologist’s input.

They help by:

Assessment and intervention focus on cognitive difficulties and behavioural changes, including:

• formal testing and informal assessment of cognitive issues
• providing cognitive rehabilitation strategies and advice on managing cognitive changes
• offering therapeutic input to help patients and families cope with behavioural or functional alterations
• interventions targeting mood difficulties and aiding adjustment to living with a neurological condition’s long-term impact

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

28 staff completed a three-hour training session. 34 staff were consulted with via a survey.

4.2 Stage 2: scoping

Time was spent by members of the locally trained team gathering information about the setting and how it works. This stage included conversations with staff and management, observing interactions and reviewing key areas such as the website and communications.

4.3 Stage 3: patient and community consultations

We spoke to 7 people in total. In order to truly represent the patients in these services, it would have been ideal to have more patient input.

4.4 Stage 4: feedback session

A feedback session will be offered, where we will discuss our findings and collaboratively consider various changes that could be implemented. These findings will be fed into the bigger piece of work across the whole trust. This report is based on our findings.

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 Doncaster and Rotherham neurorehabilitation were:

• health-related costs
• navigating and negotiating appointments
• staff awareness and guidance
• travel

5.1 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.

5.1.1 What works

5.1.1.1 Health-related costs

During consultations, all patients reported that they are able to afford their healthcare-related costs and have not missed any appointments due to financial struggles. Having no healthcare-related costs reduces financial stress and allows patients to focus on their well-being rather than worrying about medical bills. This makes preventative care more possible as patients are less likely to delay or avoid appointments because of financial concerns.

Patient:

“I do not incur any costs.”

5.1.2 Barriers and challenges

5.1.2.1 Money concerns

It was evident from discussions which took place during the training that some staff felt conversations about money often presided over supporting patients with any health-care related costs. Some staff felt worried that financial savings mattered more than their effort or patient care. This has the potential to increase stress on colleagues as they feel pressured to do less with more.
Staff:

“We are hounded by leadership on our spending.”

“Tight rules around spending means we have barriers in place about how we can support patients.”

5.1.2.2 Improving care

In contradiction to the “what works well” section above, colleagues have expressed that some patients could have a better quality of life if they were able to purchase critical items (for example, leg lifters, specialist cutlery and crockery). Some patients do not have the means to do this and, while their direct healthcare costs are covered, the things which might make a difference to life cannot be accessed.

Staff:

“Some patients can’t afford specialist things.”

5.1.3 Recommendations for health related costs

5.1.3.1 Money and food waste

• Put patient needs at the forefront of budgeting.
• Leadership to consider how conversations around money and savings can lead to misinformation being given to staff around what can be done to support patients.
• To continue to promote Citizens Advice service at the trust, each patient can have their own one-to-one appointment with a trained advisor (staff can book these for patients via the intranet). There is lots of structure support available which does not come at a cost the service.

5.1.3.2 Improving care

Where patients could have an improved quality of life and, or treatment cycle but are currently lacking the resources to do so, colleagues should make a referral into Citizens Advice, or consider other tertiary services or charities which might be able to offer support.

5.2 Navigating and negotiating appointments

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.”

5.2.1 What works

5.2.1.1 Accommodating patients with multiple appointments

Given the nature of the services, patients will often have appointments with different professionals on different days. This results in multiple trips to site and multiple days off work for the service user and, or their family. In order to accommodate these patients and make their schedules easier, colleagues will often try to book as many appointments on the same day or even combine clinic appointments. Staff are clearly aware of the difficulties patients face and are dedicated to doing as much as they can to support.

Staff:

“We always try to accommodate patients, even if it takes a bit of juggling around.”

“Sometimes home visits can be arranged as a solution.”

5.2.2 Barriers and challenges

5.2.2.1 Food availability

In some instances, staff have reported that patients do not have the relevant resources at home to complete important clinical assessments. A good example of this would be when patients do not have any food at home to be able to complete a swallow assessment.

Staff:

“I have been to patient’s houses before, and they haven’t had any food in the house. I’ve had to nip out and get some basics so that they were able to have a meal, and we could complete a swallow assessment.”

5.2.3 Recommendations for navigating and negotiating appointments

5.2.3.1 Food availability

• The trust should consider a trust wide approach to food poverty by creating internal emergency food banks or cupboards. Staff would be able to access these without having to purchase items out of their own money.
• Colleagues at the trust should continue to make referrals to Citizens Advice. Patients can receive emergency food parcels from local food banks by contacting their local rep or their local Citizens Advice office.

Page last reviewed: February 06, 2026
Next review due: February 06, 2027

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