Evaluation of the Tenovus Money Advice Service (ETMAS)

1. Description of the programme
2. The study
3. Key findings
4. Points to consider

• Description of the programme
• The study
• Key findings
• Points to consider
• Full report

Description of the programme

[This is an extract from the Executive Summary of the evaluation report. Further amendments may be made to this Summary, pending review by the Evidence Hub partner]

A cancer diagnosis is not limited to the physical and emotional effects of the illness and its treatment; fears of the impact of loss of income and personal costs have also been found to add to the burden of cancer (Stump et al., 2013). As such, effort should be made towards reducing financial concerns and their impacts by offering timely financial discussions as part of cancer patients’ early care (Tran & Zyfar, 2018). A strategy to improve financial capability has been implemented across the UK; working with financial services and debt advisors across various sectors to identify effective models of support for differing populations is central to this. This implies improving people’s ability to manage money well, both day to day and through significant life events, along with supporting their ability to handle periods of financial difficulty. The focus of the strategy and related funding is on developing people’s financial skills and knowledge, and improving their attitudes and motivation (Money Advice Service, 2018).

The Tenovus Cancer Care Money Advice Service (TMAS) aims to embed financial capability for people with cancer, on a low income or in financial difficulty, at an early stage in their diagnosis. TMAS is structured around delivering three one hour one-to-one sessions with clients; the focus of the planned sessions was derived from the Money Advice Service Adult Outcomes Framework and sought to address skills and knowledge, attitudes towards money, motivation to take action, and the accessibility of financial services, i.e., factors that influence people’s behaviour around money as per the MAS ethos. This may involve establishing a client’s numeracy skills; looking at basic money management skills, such as budgeting, income maximisation, and understanding of priority and non-priority debts; giving basic debt advice, and taking action where required (for example, referring clients to specialist debt advisors); and providing information about, and signposting/referring to, appropriate financial products and services, such as those provided by Credit Unions.

The study

The research question guiding the evaluation of TMAS was:

• ‘For people who have received a cancer diagnosis within the last six months and are in financial difficulty (or on a low income), can access to financial capability advice, training and support, through Tenovus Money Advice Service, mitigate the financial impact of their cancer diagnosis?’

The aim of the evaluation was to review the TMAS process around adoption and implementation and aimed to capture the wider experiences and impressions of clients and collaborators, as well as providers, relating to programme promotion, referral pathway, access, engagement, and delivery. The evaluation questions developed were:

• What are the demographic characteristics of the clients served by TMAS?
• To what extent does TMAS meet client needs?
• What are the referral agents’ experiences and impression of TMAS?
• What are the experiences and impressions of the programme delivery by TMAS/TCC staff?
• What type of activities take place?
• To what extent are the activities delivered as intended?
• What resources and plans are in place to ensure TMAS sustainability?

Key findings

Initial findings indicate that TMAS clients were grateful for the service and benefitted from the debt advice provided;

• Though quantitative data was difficult to acquire, interview data provided a rich detail that provided context to the positive impact the service had on the ability and financial wellbeing of clients;
• External stakeholders saw debt advice as a meaningful and necessary service for the group of clients targeted, although referral agents were not always aware of the uniqueness of debt advice relative to other financial advice such as benefits advice;
• Internal stakeholders felt TMAS had made a positive difference to clients, as well as facilitating other TCC services. It was felt by TCC staff that TMAS positively affected capacity and the quality of TCC overall service delivery, as well as job satisfaction;
• The fact that the demands on the service were exceeding the initial resources made available was recognised;
• The inclusive nature of TCC as an organisation is such that the TMAS was not being delivered as a unique debt advice intervention;
• TCC and TMAS advisors have multiple strengths which they draw on in their roles, hence the boundaries relating to the TMAS inclusion criteria, as well as the protocol of work to be undertaken for the specific TMAS service, were often extended in order for the advisors to work to the TCC ethos of providing a ‘holistic service’;
• There appears to have been flexibility in regards to those who were able to access the service as well as the exact nature of the service delivered;
• The client outcomes appear positive in regards to addressing debt issues; however, due to the nature of the client group (i.e., many are dealing with terminal cancer), the planned activities do not appear to have been delivered as intended in regards to building capacity for those supported to better manage finances;
• In addition to logistical impact from accessing the service, clients reported psychological benefits;
• As expressed by external and internal stakeholders, at the time of the evaluation interviews there was uncertainty about continued project funding and therefore concerns as to the sustainability of the service were noted.

Points to consider

• Methodological limitations:
  • Significantly less quantitative data was available for analysis than anticipated. This limited the SCHE ET’s knowledge and understanding and as such a true mixed methods approach was not undertaken.
  • TCC ET struggled to engage clients for interviews, with service users being too ill to follow up, or in some cases having passed away. TCC ET were unable to provide SCHE ET with a complete set of transcripts; thus it was not possible to triangulate the findings reported by TCC with the quantitative data. SCHE ET were only able to secure a limited number of nurse interviews.

Full report

Evaluation of the Tenovus Money Advice Service (ETMAS) - full report