I quite enjoying giving presentations but I fall apart a bit if I have to rush. Tthe problem is that I am always over-ambitious about how much I can cover in a limited amount of time. And that’s before itineraries slip or event organisers haven’t quite factored in that people take a while to get from one room to another and get seated.

Earlier in October, with my colleague Paul McGee, I led a workshop called Breaking the Cycle: No Work, No Money, Poor Health. We were at the Health Equity Network’s annual conference in Newcastle, hosted by Sir Michael Marmot. Fitting as we were there to explore two specific ‘Marmot principles’ being worked into commissioning to combat unequal health outcomes: Creating fair employment and good work for all, and ensuring a healthy standard of living for all.

When I saw the themes and the call for workshop ideas, I had a ‘hold my jacket’ moment. Even before these principles were principles that commissioners had taken to their hearts, Clean Slate was creating the means to deliver both. 

MORE THAN BETTER OFF

For twenty years, we have been breaking down barriers for people with long-term health conditions, disabilities, and histories blocking their way to employment. This has not just been about delivering employment support to people from vulnerable communities, it has also been about recruiting, training and employing them to become part of the solution within our own service. This creates a virtuous cycle that in turn feeds a bigger mechanism of positive change.

Employment is just one strand of how we improve the standard of living for people in hardship. Let’s find all the ways they might boost their incomes and cut their costs. Let’s add to that helping them work down debt, including through smoother access pathways to formal advice. And while we’re here, why don’t we also create ways for people to build a savings buffer against future financial setbacks? 

Our goal is to help people become ‘more than better off’. Our theory of change, mapped out in our 20 Year Review publication, explains how informing people on how to get on top of their finances, including finding work when they’re ready, doesn’t just boost their budget’s bottom line. It puts them in control. It clears everyday barriers to longer term challenges. It starts them thinking about the future and enables them to take more care of their health.

DOWNWARD SPIRAL TO VIRTUOUS CIRCLE

Everyone at the conference had bought into the concept of the downward spiral. How no job means no money means poorer health. They needed no reminding that some groups of people in poverty die many years younger than their wealthier counterparts.

So what if we wedge a poker into the machine grinding people down? At Clean Slate, we take a money first approach. This engages even the most reticent consumers who are (literally) sick of feeling trapped in hardship. It’s a ‘nothing to lose’ offer: Try it out. Maybe find some quick wins. Clear the day-to-day pre-occupations about where the next meal or rent money will come from. Get some headspace to think about longer term opportunities, including work. And, in order to hold down a job, a little self-care. Who knows, maybe they’ll be one of the winners enjoying average financial gains of almost £1,500 in one year alone, (source: Clean Slate 2025-26 impact data, based on six weeks of money coaching).

It’s a compelling response to the Marmot principles around standards of living and fair employment. The fact that we employ people who know what it’s like to struggle within the service that tackles hardship and prepares people for employment only speeds up the rate at which the virtuous circle begins to spin.

NOT MY PROBLEM… YET

I worried about the amount of sway our small, money guidance and employment outfit might have when it comes to speaking to health professionals. I’ve made similar presentations to homelessness organisations in the past, showing how we can work upstream to identify people on the first steps towards housing crisis. It came to nothing because they don’t work with people until they’re actually homeless.

For health workers, though, they are there at the start and end of each person’s health journey. They can see how financial hardship limits the outcomes. They can be the bridge to a money-first intervention. But how can Clean Slate and its Quids in! Money Guidance programme help?

A few years back, we ran a programme called Nobody in the Dark. We teamed up with 25 or more local community projects around the country. They had no prior experience of delivering money guidance but they each had great engagement with people in hardship in their local areas. We provided them with training on how to engage people in conversations about money, keeping it light touch and simple. We shared access to our money health-check toolkit to help review their budgets and identify steps towards improved financial wellbeing. It worked and we counted the numbers, measuring the distance travelled by around 1,800 collective participants.

COMMUNITY PARTNERS

We have embraced this approach to build partnerships with organisations who engage people in hardship and recognise they are stakeholders in the financial wellbeing of participants. Partners like health services who can host one of our digital information stands, our CashPointers, and take people through a money health-check and refer them into our money coaching programme of support.

Over thirty people signed up, with most of those wanting to learn more about how we might work together to help lift their clients out of poverty and hardship.

So while I had been too ambitious about the content we could cram into one hour, the concept landed. The moment that really broke my heart was when there was a knock at the door and one of the conference organisers told me we had four minutes left. We were halfway through a recording of one our managers as she told her story, coming from among the ranks of our clients, joining our peer worker programme and repeatedly exceeding her own expectations from one promotion to another. I had to pause the video, mid-radiant smile, to move us on.

There’s never a good place to end a great conversation. But there are some excellent places to start breaking the cycle of no job, no money, poor health.

Image: Oleksandr P/Pexels