One family’s tale – welfare support from St Christopher’s Hospice to support Richard and Rana:
Second in our series of case studies on caring for those with no recourse to public funds.
The role performed by family carers supporting a loved one to die well is extremely challenging. That is not accounting for the circumstances that an increasing number of people are finding themselves in the UK where they have no recourse to public funds (NRPF), generally as a result of unresolved immigration status. It is almost impossible to imagine the challenges for people in this position, with no access to welfare benefits, insecure housing and the very real risk of deportation.
There are 1.4 million people in the UK who find themselves with NRPF, outside the system and subsequently denied many benefits. The number of people with NRPF is growing, with Citizens Advice reporting a doubling of referrals since COVID-19.
In pursuit of its mission to provide world class palliative and end of life care to everyone who needs it, whenever or wherever that may be, St Christopher’s Hospice decided to act. In January 2021 it launched a guide, Do You See Us?, designed to help identify and support one of society’s most vulnerable groups.
People with NRPF face a wide range of challenges in addition to their own health issues or those of someone they are caring for. Here, we assess the role welfare officers can play in addressing some of the main problems facing people with NRPF.
Dee Behan, Welfare Officer at St Christopher’s, first met Rana and Richard in 2016. Their life had, in the space of a very short period been turned upside down. The couple had been living overseas for many years in Rana’s home country. Richard was working there, and the couple enjoyed a prosperous life in a nice family home with their two children.
Richard developed a serious heart condition and became too unwell to work, so the couple returned to the UK. Initially living in the Home Counties, Rana was told by immigration that her immigration status was settled, and the couple were awarded Employment and Support Allowance.
When Richard’s condition deteriorated the family moved within the catchment area of St Christopher’s and crucially their benefits were reviewed with the introduction of the new Universal Credit.
This is where Dee comes in.
“Richard was referred to the hospice for his clinical needs and it is standard practice for the clinical team to ask if patients have any welfare issues. Past experiences can mean people with NRPF are naturally distrustful of organisations and therefore may initially hold back details. Rana was able to articulate well and advocate for the family.”
Dee’s immediate priority was to establish Rana’s immigration status and the family’s benefit entitlement. It became clear when the family had moved their application for Universal Credit was refused on the grounds Rana had no recourse to public funds.
Rana approached her local MP, who, despite contacting the Home Office, failed to make any progress with her case.
Rana’s immigration status remains unresolved because she does not have the means to pay for the legal fees and there is very limited free immigration advice available.
Dee says: “We have been trying to obtain free immigration advice for many years.” The main issue for Rana is what happens when Richard is not around, as she is totally dependent on his benefits to survive; without this she is destitute. Should Richard die or enter nursing care, Rana would be left without any benefits. The only option for Rana then would be to present to social services, who would make an assessment for financial support and adequate housing. The continual worry of her status being unresolved is exhausting for Rana and leaves her feeling trapped.
The family have had an incredibly difficult time coping with Richard’s illness, which has been exacerbated by Rana’s unresolved immigration status. Their life changed overnight because of his illness.
Dee says: “I have a very good relationship with the family, having supported them for so long. I have always done what I promised I would. I have also managed their expectations and never given them false hope, being as reliable as I can be.”
Dee continues to be frustrated in her search for quality, free or affordable immigration advice and has even contemplated undertaking training in this complex subject.
“If Rana had her immigration status finalised, the family would have sufficient benefits to meet their circumstances and our welfare team would not be involved. Richard would still be accessing the medical care, but they wouldn’t have the continual threat of Rana’s immigration status which is responsible for their very real financial problems and housing insecurity.”
St Christopher’s social work team has also provided emotional support to the family, while Dee has accessed much needed grants for the family through a number of other agencies.
Dee advises leaving no stone unturned in the pursuit of ways in which you can help clients in this situation. “We are always looking to identify other areas of support outside the benefit system to support people with NRPF,” she adds. “Whether that’s applying for grants or searching for any other form of funds, like a forgotten pension or a previous employment benevolent fund.”
Dee states good practice when encountering a case like Rana and Richard’s would be:
- Identify immigration status at the start and seek out free or affordable quality legal advice where possible
- Be prepared for it to take time to gain the trust of people with NRPF
- Maintain professional boundaries, recognising our own limitations with what immigration assistance we are regulated to provide
- Manage people’s expectations and deliver on the commitments you have made
- Explore means of financial support outside the benefit system, e.g. charitable grant, unclaimed pensions etc
St Christopher’s NRPF toolkit provides practical information on ways to identify people in this situation, further case studies and an invaluable guide to the physical, emotional, spiritual and social needs to identify, assess and attend to. You can download the NRPF toolkit and watch the launch webinar which includes an interview with Marie.