Condition category
Not Applicable
Date applied
06/06/2016
Date assigned
23/02/2017
Last edited
07/02/2017
Prospective/Retrospective
Retrospectively registered
Overall trial status
Ongoing
Recruitment status
Recruiting

Plain English Summary

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

Trial website

Contact information

Type

Public

Primary contact

Ms Sarah Beardon

ORCID ID

http://orcid.org/0000-0001-8716-6211

Contact details

University College London
Bidborough House
38-50 Bidborough Street
London
WC1H 9BT
United Kingdom
+44 20 3108 8393
sarah.beardon@ucl.ac.uk

Type

Scientific

Additional contact

Dr Matthew Appelby

ORCID ID

Contact details

University College London
Bidborough House
38-50 Bidborough Street
London
WC1H 9BT
United Kingdom
+44 7990 514984
matthew.appleby@ucl.ac.uk

Additional identifiers

EudraCT number

ClinicalTrials.gov number

Protocol/serial number

TLEF-2016-000666

Study information

Scientific title

The Value of Health-Justice Partnerships: Exploring the health impact of free legal advice in a primary care setting

Acronym

Study hypothesis

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

London Chelsea NHS Research Ethics Committee, 30/12/2016

Study design

Single-centre longitudinal observational study

Primary study design

Observational

Secondary study design

Longitudinal study

Trial setting

GP practices

Trial type

Quality of life

Patient information sheet

Not available in web format, please use contact details to request a participant information sheet

Condition

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

Phase

Drug names

Primary outcome measures

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 trial start date

01/09/2016

Overall trial end date

31/12/2017

Reason abandoned

Eligibility

Participant 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.

Participant type

Other

Age group

Adult

Gender

Both

Target number of participants

165

Participant 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

Recruitment start date

25/01/2017

Recruitment end date

31/10/2017

Locations

Countries of recruitment

United Kingdom

Trial participating centre

Sir Ludwig Guttmann Health & Wellbeing Centre
40 Liberty Bridge Road East Village Olympic Park Stratford
London
E20 1AS
United Kingdom

Sponsor information

Organisation

University College London

Sponsor details

Joint Research Office (part of the Research Support Centre)
1st Floor Maple House (Suite B)
149 Tottenham Court Road
London
WC1E 6BT
United Kingdom

Sponsor type

University/education

Website

www.ucl.ac.uk/jro

Funders

Funder type

University/education

Funder name

University College London

Alternative name(s)

UCL

Funding Body Type

private sector organisation

Funding Body Subtype

academic

Location

United Kingdom

Funder name

Legal Education Foundation

Alternative name(s)

Funding Body Type

Funding Body Subtype

Location

Results and Publications

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.

Intention to publish date

31/12/2018

Participant level data

Available on request

Results - basic reporting

Publication summary

Publication citations

Additional files

Editorial Notes