Poverty proofing Doncaster therapy hub 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 therapy hub

2.1 Therapy hub

This services provides accessible, community-based therapy services for individuals who need support to maintain independence and improve their quality of life.

The therapy hub supports patients through physiotherapists and occupational therapists.

Occupational therapists help you manage everyday tasks like washing, dressing, and cooking. They show you ways to make these tasks easier and can suggest changes to your home to keep you safe and comfortable.

Physiotherapists help you improve movement and build strength. They teach exercises that support balance and flexibility, and they guide your recovery after an injury or illness.

We cannot take referrals for people who are already getting care from specialist services. If you need this type of help, please contact the specialist service for the right support with:

• neurological disorders
• stroke rehabilitation
• respiratory conditions
• falls

Self-referrals can be made through the single point of access service.

• Phone

  • 03000 218 996
  • 0800 804 8999

• Email

  doncaster.spa@nhs.net

2.2 Reablement

The service is provided 24 hours a day, 7 days a week, the service aims to offer an alternative to hospital admission, facilitate earlier hospital discharges and promote optimum independence for patients within their usual place of residence.

The Reablement team offers services to adults with physical rehabilitation who are registered with a Doncaster GP.

Patients following an assessment will start a programme of planned rehabilitation, which, would be better delivered in their own home environment, allowing the patient to achieve maximum independence.

The Reablement team accepts adults with physical rehabilitation needs through the single point of access (SPA).

This service does not accept referrals for patients who require specialist community stroke rehabilitation or neurorehabilitation.

2.3 Specialist falls

The specialist falls service provides comprehensive, multidisciplinary fall assessment and rehabilitation to fallers.

Treatment is provided by a specialist multidisciplinary workforce and targets fallers who require tailored assessment and rehabilitation interventions to address their specific needs.

Our service is person-centred to enable patients who have fallen to live as independently as possible in the community.

The team will work with the patient and carer where appropriate to develop a rehabilitation program to meet the patient’s needs with realistic goals and timescales.

The tailored rehabilitation program is aimed at promoting patient self-management, independence, and physical and psychological function regarding falls.

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

20 staff completed a three-hour training session. 29 staff were consulted with via a survey, and 1 participated in a verbal consultation.

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 11 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 therapy hub 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, patients reported incurring very few health-related costs. 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:

“No cost for the service.”

Staff did acknowledge that they can often make recommendations to patients, which would come at a cost to them. The recommendations are not a mandatory part of a person’s care plan, but they can help to make daily tasks easier.

Staff:

“I advised a relative about getting a shoehorn for their family member as a gift once.”

“Suggested a cream applicator for patient who was struggling to apply cream to their lower legs.”

Patients were comfortable with the additional suggestions, and did not feel it had an impact on their financial wellbeing.

5.1.2 Barriers and challenges

5.1.2.1 Inconsistent recommendations

It was evident from discussions which took place during the training that not all patients are receiving the same advice or guidance when it comes to financial support. A good example of this is that not all patients are made aware of the prescription prepayment certificate which is available to patients. Some colleagues are aware of the scheme and will mention to a handful of patients, and other colleagues do not mention it to patients at all. There is a variation into how this advice is given and, it could be assumed, that the approach is the same for other financial support schemes.

Staff:

“We do suggest about the prescription prepayment certificate where we realise a patient may have high prescription charges.”

“I mention the prescription prepayment certificate but not to everyone, as not everyone needs it.”

5.1.3 Recommendations for health related costs

5.1.3.1 Inconsistent recommendations

• Leadership to ensure all staff are aware of what is available to support patients.
• To implement a list of key items of financial support which should be mentioned to all patients. All colleagues to ensure the offering is consistent across the board.
• 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.

5.2 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 visit before 8am so that they don’t miss their appointments and, or patient transport.

Staff:

“How we support in such cases in that sometimes patient may need to be ready for as early as 8am to use patient transport so we will try our best to visit them if they have a morning call before 8am so that they don’t miss their appointments.”

5.2.2 Barriers and challenges

5.2.2.1 No set times for visits

One particular element of the consultations which stood out, was around those patients who receive home visits. Both staff and patients concurred that the time slots for visits were either morning, afternoon or evening, but not specific beyond this. While this suits the staff as they are able to carry out their visits and manage expectations, it does not necessarily suit the patient.

The impact on the patient can be:

• Waiting for hours without knowing when someone will arrive
• Anxiety about missing the visit if they step away briefly
• Fear that they have been forgotten about
• Feeling unable to relax or plan anything else for that day
• Ensures carers and families can feel like “their house is their own”

This uncertainty can be especially stressful for elderly patients, carers and those who are unwell.

Staff:

“We don’t have set times for the visit we do for patient we advise them of a period morning, afternoon, teatime or evening. This is to ensure that we set the expectation for the patient.”

5.2.3 Recommendations for navigating and negotiating appointments

5.2.3.1 Improve slots for patient visits

Services which deliver home-visits under the current morning, afternoon and evening regime should look at how they might be able to be more specific for the sake of the patients. Patients would value dedicated time slots to be able to plan their days. Even a 2-hour window gives patients control while allowing flexibility.

Page last reviewed: February 10, 2026
Next review due: February 10, 2027

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