Deepening poverty: why the health innovation response must recognise the integral role of the VCSE

“The findings of the ‘UK Poverty 2026’ report from the Joseph Rowntree Foundation are unsurprising yet shocking”, states Ways to Wellness Chief Executive Sandra Mitchell-Phillips.

“In the wake of years of austerity, followed by the economic impact of a global pandemic and an ongoing cost-of-living crisis, it reveals that poverty is rising dramatically in headline terms. But the rate at which it is deepening should be of real concern to all of us working in health and care.

“More people are now living in deep poverty than at any point in recent history, with destitution having doubled in less than a decade. Food insecurity has also surged, and people already managing poor health are disproportionately affected.

“For those of us working to minimise health inequalities and their impacts, this is not simply an abstract matter of policy. As the lived reality of the people we see in our work at Ways to Wellness every day, it has profound implications for the future of UK healthcare, especially in the midst of the 10-year plan from the NHS.”

Poverty is no longer the backdrop to health inequality. It is an accelerant.

“The foundation’s report makes clear that nearly half of people who are in poverty are not just living marginally below the poverty line. The depth of poverty being experienced by a record high 6.8 million individuals – which amounts to just under 10% of the UK population – affects every aspect of their lives: how and what they eat, how they sleep, how and whether they heat their homes, whether they can travel to work, attend medical appointments or maintain community connections. It impacts on their opportunity to manage health conditions, including chronic conditions and mental health issues. In short, health risk intensifies as poverty does.

“In the North East of England where Ways to Wellness was founded because of its disproportionately high levels of health inequality, we continue to see the starkest examples of this. We see higher rates of long-term conditions, higher economic inactivity due to ill health, and lower healthy life expectancy.

“If poverty continues to deepen, those inequalities won’t be maintained. They’ll compound.”

The success of health system improvements goes hand in hand with reform of living conditions

“We know the NHS is under extraordinary pressure, with every system leader being asked to make tougher and tougher decisions to deliver on prevention, reduce demand, improve productivity, and tackle inequalities. But the uncomfortable reality is that much of the rise in healthcare demand we are seeing is structurally driven.

“When someone with diabetes can’t afford food to buy the types of food that supports the management of their condition, it isn’t that they’re unwilling to comply with treatment. When someone with Chronic Obstructive Pulmonary Disease (COPD) can’t adequately heat their home, it’s not a clinical failure. And when someone with debilitating pain and associated anxiety is navigating debt, uncertainty around their benefit entitlement, and food insecurity, that is not simply a prescribing challenge.

“Poverty at its current depths is a multiplier. Healthcare innovation that fails to factor in income insecurity will always be running to catch up. Quite simply, we need to think about health in broader terms.”

The opportunity – and responsibility – for the VCSE sector

“What strikes me most about the report is how clearly it outlines situations in which statutory systems struggle to reach people early; precisely the circumstances many Voluntary, Community and Social Enterprise (VCSE) organisations are set up to support people with, namely financial distress, benefit complexity, housing insecurity, fuel poverty, food insecurity, and social isolation. These are the spaces in which the VCSE can demonstrate the deepest relationships and greatest agility.

“At Ways to Wellness, we see every day how social prescribing uncovers the financial and social stressors that sit beneath chronic conditions. We see how relational, person-centred support can help people stabilise their health. And this report suggests we’ve reached the point at which we need to go further.

“It is not enough for the healthcare system to see the VCSE sector only in terms of service delivery. The VCSE is well-placed to test, learn, and evidence new models that integrate income, housing and health support in a systematic way, and must therefore be acknowledged as a vital strategic partner in health transformation.

“Welfare information is no longer peripheral to healthcare. Embedding financial support and guidance within primary care, mental health services, and long-term condition pathways is not a ‘nice to have’ we can afford to take or leave. It is preventative health infrastructure that responds directly to the 10-year plan.

“If we can demonstrate resulting reductions in the presentation of crises, and show improvements in both adherence to medication, and mental wellbeing, then income support becomes part of system reform – not just an add-on.”

Let’s square the circle

“Currently, it’s a vicious circle in which financial insecurity drives anxiety. Anxiety then reduces people’s capacity to navigate complex systems, and reduced capacity worsens financial insecurity. We need integrated pathways that address both of these issues simultaneously, not sequentially.

“In regions like the North East, older housing stock and rising energy costs create predictable winter pressures. Warm home referrals, housing-health partnerships, and targeted environmental interventions should be part of respiratory strategy, rather than being left to chance.

“Child poverty remains stubbornly high, and the lifelong health consequences of early disadvantage are well documented. Embedding financial navigation and practical family support into maternity and early years pathways could be one of the most powerful long-term health interventions available to us.

“Destitution has doubled since 2017. If we are serious about prevention, we must intervene before people hit crisis point, not once they are already there. That requires shared data, early warning indicators, and cross-sector collaboration – all of which are key to the Ways to Wellness way of working.”

Great need presents the region with great opportunity

“The North East has historically faced structural labour market challenges. We have higher levels of economic inactivity linked to ill health, and we rely more heavily on public services. That makes our citizens more vulnerable when poverty deepens. But it also makes us uniquely positioned to lead the change.

“Integrated Care Systems (ICSs) here understand inequality not as an abstract concept but as an operational day-to-day reality. Our VCSE sector is strong and collaborative. Our communities are resilient. Our cross-sector connectivity is mature. If there is a place in which poverty-health integration models can be developed, tested and scaled, it is here.”

A shift in mindset

“The Joseph Rowntree Foundation report reframes poverty as structural, persistent and intensifying. For health leaders, the implication is clear: income security, housing stability and financial resilience are not peripheral social issues. They are foundational health determinants.

“If we continue to innovate only within clinical pathways, we will struggle to bend the curve on demand. But if we integrate poverty-aware practice into system reform, and treat income maximisation, housing security and social connection as preventative health interventions, we have an opportunity not only to reduce inequalities for individuals, but to relieve pressure on the healthcare system itself.

“The VCSE sector must be central to that ambition. Not as a safety net, but as a test-and-learn partner in building a health system that recognises the realities of the lives people are living.

“Deepening poverty demands deeper integration. The time to act is now.”