Cost of living: People are increasingly avoiding NHS appointments and prescriptions
With spiraling costs of living, we have warned people are making changes to how they use health and social care services, which can have an adverse impact on their health and wellbeing.
The impact the cost of living crisis is having on many people’s ability to heat their homes and eat well has been widely reported. However, our new data suggests people are increasingly avoiding booking/attending NHS appointments or taking up prescriptions and over-the-counter medications because of the costs.
About the national poll
Healthwatch England, our national health and social care champion, conducted a poll with 2000 adults in England between October and December 2022 to assess the impact of the cost of living on their health and wellbeing and whether it has affected how they use health and social care services.
They found that more people avoided getting prescription medicines, and booking NHS appointments, including dental treatment, due to the fear of extra costs in December than in October.
The national findings shed further light on the crisis and reflect local trends, where 62% of people revealed they are struggling across North Yorkshire, with many revealing a major impact on their health, well-being and finances.
People are avoiding vital care due to the fear of extra costs
The number of people who avoided an NHS appointment due to the cost of travel doubled to almost one in 10, 11%, in December, up from 6% in October.
The poll also found:
- Over one in ten (11%) have avoided booking an NHS appointment because they couldn’t afford the associated costs, such as accessing the Internet or the cost of a phone call; up from 7% in October;
- 15% of respondents avoided going to a dentist because of the cost of checks ups or treatment, an up from 12% in October;
- And one in ten (10%) people have also avoided taking up one or more NHS prescriptions because of the cost, up from 6% in October;
- One in ten (10%) avoided buying over the counter medication they normally rely on, up from 7% in October.
Cost of living affects people's health
More than a third of the respondents, 39%, said that the changes they have made to keep up with the rising cost of living – include the actions mention above as well as not turning on the heating and cutting back on food - have negatively affected their mental health, while 35% said their physical health had got worse in the last two months.
Women are disproportionally affected by costs of living
The findings also suggest women are disproportionally affected by spiralling costs compared to men and more have taken action to cut back on:
- Heating, which 42% of women have not turned on when they usually would, compared to 33% of men;
- Food, which 27% of women say they have bought less of, because of the increased cost, compared to 20% of men; and
- Energy costs in general, with 33% of women saying they have turned off or avoided using essential appliances to save energy costs, compared to 25% of men.
Our response
"It is clear that the impact of the cost of living crisis on people’s health and well-being is beginning to hit home. We are very worried that people are increasingly avoiding getting prescription medicines, booking NHS appointments, and travelling to their appointments because of the extra costs. The steps people are taking to cope with the cost of living can have serious implications on their physical and mental health. This is likely to place a further burden on the already stretched NHS."
Louise Ansari, National Director of Healthwatch England
"As costs continue to rise, so do many people’s financial anxieties. Not only are they worried about rising household bills and inflation, but also being able to afford to get to appointments. This is extremely worrying – especially for the most vulnerable in society. Our NHS, carers, North Yorkshire County Council, borough and district councils, support organisations, volunteers and charities continue to work hard to help those most in need, but more needs to be done at a national level – particularly as Winter pressures set in.
Ashley Green, Chief Executive Officer, Healthwatch North Yorkshire
Tangible actions set out by Healthwatch England - and we agree
Healthwatch England have set out immediate actions the government working with health and care services can take to support people in the cost of living crisis and save money:
Prescriptions:
- GPs should offer people over the counter medications on prescription where they consider patients’ ability to pay is affected by significant social vulnerability; (although this has always been an option, NHS policy since 2018 has discouraged this to save money, but this approach should be reconsidered in the context of cost of living challenges);
- Primary care staff should make sure patients on lots of medication, as well as repeat or long-term prescriptions, are aware of the annual prescription option.
Travel:
- NHS services should ensure people are aware of access to patient transport services or travel reimbursement schemes
- NHS trusts should follow current car parking guidance and actively promote the offer of free parking for Blue Badge holders, people who attend hospitals at least three times a month and parents of sick children staying overnight.
- NHS England should support NHS trusts to further consider reducing the costs of parking charges and provide concessions to visitors and carers of people who are gravely ill or have extended stays in hospital.
Dental care:
- NHS dentists should follow NICE guidance to offer dental check-ups based on patient’s individual risk factors. This will help free up NHS slots for more people who currently can’t find an NHS dentist and are forced to go private.
Remote bookings and appointments:
- NHS England should work with OfCom and telecommunications companies to ensure that hospital and GP phone numbers are part of a freephone service, so cost is never a barrier to phoning a health service.
Benefits
- The Institute for Fiscal Studies has estimated that even with inflation uprating, working-age benefits will be 6% below pre-pandemic levels in real terms next year. The government should ensure benefits, including Statutory Sick Pay (SSP), keep pace with inflation in real terms, and senior health leaders should advocate for the importance of this to ensure that cost is never a barrier to managing health.
- The government should consider extending the amount of time statutory sick pay can be paid to people who can’t work. It should take into account the impact that longer waiting lists for elective care will have on some people’s ability to work, and ensuring these people aren’t left without pay despite contributing throughout their lives to the NHS through taxation.
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We have previously recommended the Department of Health and Social Care and NHS England should commission a national helpline to improve access to health and care benefits, including Statutory Sick Pay, Universal Credit, Employment and Support Allowance (ESA), Healthcare Travel Costs Scheme, Carer’s Allowance, and Personal Independence Payments (PIP). Health and care workers could signpost people to this helpline when someone mentions concerns about costs. Signposting can also be done proactively, with NHS teams using data from across integrated care systems to target, for example, people with caring responsibilities to ensure they are aware of the benefits they are entitled to.
