Cost of living: People are avoiding NHS appointments and prescriptions

News - 10 January 2023

New data from Healthwatch England shows a worrying increase in the number of people avoiding vital care. We're calling for urgent action from government and health and care services to ensure rising costs are not a barrier to healthcare.

A man sitting on an adapted bike for disabled cyclists

With spiralling 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, 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 research poll

Healthwatch England conducted a tracker poll with 2000 adults in England between October and December 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.

Healthwatch have 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.

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 that in December:

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.

Healthwatch have set out tangible actions

These are the immediate actions the government need to take to support people accessing health and social care services during the cost-of-living crisis:

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.
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.

Find out more about the Healthwatch poll