Providing legal advice in a GP practice: how can it make a difference to health and wellbeing?
| ISRCTN | ISRCTN17079789 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN17079789 |
| Secondary identifying numbers | TLEF-2016-000666 |
- Submission date
- 06/06/2016
- Registration date
- 23/02/2017
- Last edited
- 15/08/2022
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Other
Plain English summary of protocol
Background and study aims
The circumstances in which people are born, live and work have a significant impact on their health. Recent major changes in Employment and Support Allowance (ESA), Personal Independence Payments (PIP), and the current agenda for social welfare reform in housing benefits and tax credits, have come at a time of recession and financial difficulty for those individuals most reliant on the social welfare system. In these circumstances, the poorest and most vulnerable in society turn to free legal and welfare advice services for help. But these advice services are similarly affected by cuts in local authority funding and the recent loss of free legal aid (financial assistance for those who cannot afford legal fees). Vulnerable patient groups with complex social and legal problems are now faced with few places to seek advice, and there is considerable potential for these problems to overspill into General Practice. Some GPs practices have chosen to pay for free advice services to help patients attending their surgeries with welfare problems, such as housing, unemployment or debt. Advice services have been able to show financial benefit to their users, but there is not much evidence of impact on an their health and their visits to see the doctor. The aim of this study is to find out whether a free legal advice centre located with a GP practice affect health related quality of life, mental wellbeing or health-related behaviour of those who use the service.
Who can participate?
Adults who are a new client at the UCL Legal Clinic during the study period.
What does the study involve?
New clients of the UCL Legal Clinic (a free face-to-face legal and welfare advice centre) are asked to complete a number of questionnaires about their wellbeing before their first free legal advice session. The questionnaires ask about quality of life, mental wellbeing, frequency of GP visits, smoking and alcohol consumption. Three and six months later, participants are asked to repeat the questionnaires to see if there has been any change. The questionnaires take 5-10 minutes to complete in total and can be done in person, by post or over the telephone.
What are the possible benefits and risks of participating?
Participants will be offered a £15 high street voucher in return for their participation when they complete follow-up questionnaires. Those participating in a full-length interview will be offered a high street voucher to the value of £20 in return for their effort and valuable contribution to the study. There are no notable risks involved with participating in this study.
Where is the study run from?
Sir Ludwig Guttmann Health & Wellbeing Centre (UK)
When is the study starting and how long is it expected to run for?
September 2016 to December 2017
Who is funding the study?
1. University College London (UK)
2. Legal Education Foundation (UK)
Who is the main contact?
1. Ms Sarah Beardon
sarah.beardon@ucl.ac.uk
2. Dr Matthew Appelby
matthew.appleby@ucl.ac.uk
Contact information
Public
University College London
Bidborough House
38-50 Bidborough Street
London
WC1H 9BT
United Kingdom
 ORCID ID |
0000-0001-8716-6211 |
|---|---|
| Phone | +44 20 3108 8393 |
| sarah.beardon@ucl.ac.uk |
Scientific
University College London
Bidborough House
38-50 Bidborough Street
London
WC1H 9BT
United Kingdom
| Phone | +44 7990 514984 |
|---|---|
| matthew.appleby@ucl.ac.uk |
Study information
| Study design | Single-centre longitudinal observational study |
|---|---|
| Primary study design | Observational |
| Secondary study design | Longitudinal study |
| Study setting(s) | GP practice |
| Study type | Quality of life |
| Participant information sheet | Not available in web format, please use contact details to request a participant information sheet |
| Scientific title | The Value of Health-Justice Partnerships: Exploring the health impact of free legal advice in a primary care setting |
| Study objectives | Primary aim: To investigate how the provision of free legal advice in a primary care setting affects, or is associated with, the health related quality of life for those who use the service Secondary aims: 1. To investigate the burden of ill health (both mental and physical) among those seeking legal advice. 2. To explore the ways in which ill health (both mental and physical) may be related to having a civil legal problem 3. To quantify whether changes in health status (both mental and physical) can be detected following the receipt of legal advice 4. To explore how health-related behaviours (such as smoking and drinking) may be related to having a civil legal problem 5. To quantify whether changes in health-related behaviours (smoking and drinking) can be detected following the receipt of legal advice 6. To explore whether the receipt of legal advice in a primary care setting is related to GP consultation rate. 7. To explore clients’ perspectives on tackling legal problems in primary care settings 8. To explore the perspectives of GP practice staff on the value of the co-located legal advice service to professional practice |
| Ethics approval(s) | London Chelsea NHS Research Ethics Committee, 30/12/2016 |
| Health condition(s) or problem(s) studied | Social welfare problems attending general practice |
| Intervention | This study will recruit clients attending their first legal advice appointment. Participants will complete health and wellbeing questionnaires before their first free legal advice session (baseline) and this will be repeated 3 and 6 months later. The questionnaires will ask about health related quality of life, GP consultation rates, mental wellbeing and health behaviours. Participants will also be asked if they would like to take part in one-to-one interviews exploring the links between legal and health problems. Interviews will also be undertaken with staff of the GP practice addressing impact of legal problems on health and the acceptability of co-located legal advice clinics in primary care settings. |
| Intervention type | Other |
| Primary outcome measure | 1. Health related quality of life is measured using the EQ5D at baseline 3 and 6 months 2. Recipient’s GP consultation rate is measured through self-report and validated by GP records where available at baseline 3 and 6 months |
| Secondary outcome measures | 1. Mental wellbeing is measured using the Short Warwick-Edinburgh Mental Well-Being Scale at baseline 3 and 6 months 2. Tobacco and alcohol consumption is measured by Quantity-Frequency indices at baseline 3 and 6 months 3. Description of health problems of those seeking legal advice is recorded in client case records at baseline 4. Client perspectives on tackling legal problems in primary care settings are gathered through qualitative semi-structured interviews between 3 and 6 months after recruitment 5. Stakeholders perspectives on tackling legal problems in primary care settings are gathered through qualitative semi-structured interviews from study commencement until 1 year later |
| Overall study start date | 01/09/2016 |
| Completion date | 31/12/2017 |
Eligibility
| Participant type(s) | Other |
|---|---|
| Age group | Adult |
| Lower age limit | 18 Years |
| Sex | Both |
| Target number of participants | 165 |
| Total final enrolment | 100 |
| Key inclusion criteria | 1. Aged 18 years and over 2. New clients of the UCL Legal Clinic 3. Have had at least one free advice session during the research study period 4. Fluency of English allowing provision of fully informed consent 5. Having the capacity to consent to the research. |
| Key exclusion criteria | 1. Clients of the UCL Legal Advice Clinic who do not have sufficient fluency in English that allows them to provide fully informed consent 2. Insufficient capacity to consent to research |
| Date of first enrolment | 25/01/2017 |
| Date of final enrolment | 31/10/2017 |
Locations
Countries of recruitment
- England
- United Kingdom
Study participating centre
East Village
Olympic Park
Stratford
London
E20 1AS
United Kingdom
Sponsor information
University/education
Joint Research Office (part of the Research Support Centre)
1st Floor Maple House (Suite B)
149 Tottenham Court Road
London
WC1E 6BT
England
United Kingdom
| Website | www.ucl.ac.uk/jro |
|---|---|
"ROR" |
https://ror.org/02jx3x895 |
Funders
Funder type
University/education
Government organisation / Universities (academic only)
- Alternative name(s)
- University College London in United Kingdom, Collegium Universitatis Londinensis, UCL
- Location
- United Kingdom
No information available
Results and Publications
| Intention to publish date | 31/12/2020 |
|---|---|
| Individual participant data (IPD) Intention to share | Yes |
| IPD sharing plan summary | Available on request |
| Publication and dissemination plan | Results will be submitted to peer-reviewed journals for publication. Study findings will also be disseminated through newsletters, the Centre for Access to Justice website, meetings and public lectures. |
| IPD sharing plan | Anonymised data will be made available where possible following publication in journals. For information about research data availability, please contact Sarah Beardon: sarah.beardon@ucl.ac.uk. |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Basic results | 03/07/2019 | 03/07/2019 | No | No | |
| Funder report results | Study results start on page 15 | 01/07/2021 | 15/08/2022 | No | No |
Additional files
- ISRCTN17079789_Basic_results_03Jul19.pdf
- uploaded 03/07/2019
Editorial Notes
15/08/2022: A funder report link has been added.
08/06/2020: The intention to publish date was changed from 31/12/2019 to 31/12/2020.
03/07/2019: The following changes were made to the trial record:
1. The total final enrolment was added.
2. The basic results of this trial have been uploaded as an additional file.
24/06/2019: The intention to publish date has been changed from 31/12/2018 to 31/12/2019.
