Publicly-funded advice services in Scotland: review report

Chapter 6: How is advice delivered?

Chapter Summary

The publicly-funded advice landscape in Scotland is diverse, with a range of UK-wide, national and local organisations offering advice on a range of topics via a multitude of different channels to people in Scotland. In this chapter we explore:

• service design;
• channels of delivery; and
• barriers to advice provision.

We find that increased collaboration will enable advice providers to reach people in new ways and remove barriers to accessing advice.

Introduction

In this chapter we discuss the ways in which advice is currently delivered. As described earlier in this report, much of the literature refers to advice provision in the broadest sense, while other research is specific to a certain type of advice (with a dominance of money advice amongst the literature examined). This chapter reflects delivery across the breadth of the advice landscape in relation to welfare, money and consumer advice. We note where examples given are specific to one type of advice.

Advice service design

The literature indicates that advices services tend to be delivered in three different ways:

Client group specific services	Services that specifically target a group of users sharing a specific characteristic
Single issue services	These are services that are most likely to be required by people in or facing poverty, and/or experiencing a change of life circumstances. For example advice concerned with welfare benefits, debt advice, housing, childcare and routes to employment.
Community based services	Services that provide a wide range of advice but are targeted to a particular community/locality. Key providers might include a Law Clinic or Citizens Advice Bureaux operating in local areas. Other examples include advice services offered to all residents in a particular area, all tenants of a particular housing association, or all patients of a particular GP practice.

There is a clear focus in the literature on services taking a person-centred approach to advice provision, and emphasis that it is rare for advice to be required on one topic in isolation. That said, it is not possible from the sample of survey respondents or from the range of literature to quantify the prevalence of advice service design. For example, in their Debt Advice in Scotland report, (Dryburgh 2011) Citizens Advice Scotland refers to dealing with the client's whole situation, not just their debts. This is in recognition that clients frequently encounter multiple problems which are both causes and effects of their debts. Examples given include unfair dismissal, relationship issues, benefit problems and homelessness. They note that Citizens Advice Bureaux often provide a range of advice to one client, rather than dealing with a problem in isolation. Likewise, in their Annual Report, the Health and Social Care Alliance Scotland (H. S. C. A. Scotland 2015) also highlight the benefits of person-centred service design and the need to involve those accessing services in meaningful dialogue.

In its Advice, Support and Poverty report (Gibbons & Foster 2014), the Centre for Economic and Social Inclusion advocates for tailoring information, advice and support services to the needs of people at specific life points (as the Money Advice Service has done), and for embedding services which groups of people in poverty are most likely to use in relation to major life events. For example, in health and welfare to work services. It also emphasises the need to focus local provision on those advice issues which are of greatest importance to people in poverty: welfare benefits, debt, housing, childcare, employment, careers guidance and support services for young people in poverty.

The Scottish Legal Aid Board, in its Annual Report 2014-15 (Scottish Legal Aid Board 2015), makes reference to the launch of the funders framework ^[9] . This sets out the key elements that public funders should take into account of when reviewing their current funding arrangements with advice and representation services, or when funding new projects. It focuses on the best outcome for the client facing a problem and value for money for the public purse by minimising duplication and overlap, and encouraging referrals and collaboration. It also advocates a more strategic approach between funders and providers.

It is, however, important to note that by having advice available to all does not mean that everyone who needs advice will be able or willing to access available advice. For example, the literature highlights that people are reluctant to access advice services due to a perceived stigma attached (this is particularly prevalent in relation to money and debt advice) (Farnish 2015; Littler 2015; Salter 2014; West Lothian Council n.d.; NHS Health Scotland 2016).

Our survey responses confirmed what is described in the literature, with many of the providers describing their service as "holistic", and aiming to support an individual with all the inter-linked issues they are experiencing.

"The national helpline takes a holistic approach as callers come to us with a situational experience, e.g. a caller who has just separated from her husband would be unconsciously looking for advice on family law… benefits… employment rights… money… child maintenance… [and] childcare". (Survey respondent)

"National helpline services… provide a dedicated holistic helpline service that is dedicated to providing comprehensive advice in one intervention that can lead to action and prevention of use of public services, reaching out to those who may be isolated, mistrust services and cannot or prefer not to go to an advice centre". (Survey respondent)

"To be able to offer a holistic service delivering advice to the most disadvantaged in the community... We have a team of specialist advisers each extremely knowledgeable in their own field who can work together with an individual to address multiple issues at the same time". (Survey respondent)

Location of advice services

Geographical spread of advice services

Some organisations have no specific geographical target area for their work, and focus their work instead on particular client groups (for example, Age Scotland and One Parent Families Scotland). In addition to these national services, there are a number of client specific advice services operating in defined locations. This includes services such as the Action Group that offers advice and support for people with learning disabilities and their families within specific locations in Edinburgh.

National services	include advice services operated by national charities such as Citizens Advice Scotland, the Stepchange Debt Charity, Macmillan, Shelter and Advice Direct Scotland.
Locally-focused services	include services provided by organisations like the Granton Information Centre, The Action Group and in some instances local projects operated by larger charities that also operate nationally, for example One Parent Families Scotland.

The Scottish Government database of advice-related grants includes 55 services that operate nationally and 91 that operate in a specific geographical region. It also details 23 awards made to advice providers offering advice to tenants of particular housing associations.

It is impossible to gain a complete picture of the geographical spread of publicly-funded advice services in Scotland from the literature, however what is clear is that, as noted earlier in this report, there are a wide range of advice providers across the country, delivering both nationally or locally depending on their remit. Some organisations have publicly available data about their reach, but for other organisations this is less clear.
The Citizens Advice Scotland report Debt Advice in Scotland (Dryburgh 2011), for example, gives a comprehensive overview of its debt advice clients by geography ^[10] , and by numbers of households. It also shows that the Local Authorities in which clients were helped with the highest number of new referrals were Fife, East Renfrewshire, and the Highlands, followed by Edinburgh, Glasgow, North and South Lanarkshire, Dumfries and Galloway, Midlothian, Falkirk, and East Renfrewshire.

However, an evaluation of Money Advice Services Across Scottish Local Authorities by the Improvement Service and Money Advice Service (2013) highlights that there is little consistency of data collection, with different Local Authorities using different IT systems. It is likely that similar inconsistences also apply to other advice services operated or commissioned by Local Authorities. Figure 6.1 shows the geographic spread of advice providers who responded to our survey.

Figure 6.1 Geographical spread of survey respondents

Clearly the findings emerging from the survey cannot and do not provide a complete map of advice provision across Scotland. However, the data provided does suggest a greater range of local services being available in the more central and populated areas of Scotland.

Advice settings

The literature supports the location of advice services in settings that remove access barriers and enable advice providers to address unmet need. For example, prior research has demonstrated the benefits (to the individual and involved organisations) associated with advice service provision in both acute and primary care settings within the NHS in Scotland and the rest of the UK (Littler 2015; Parsonage 2013; Hopkins 2014; Withington 2011; London Health Inequalities Network 2013). A recent internal scanning exercise conducted by NHS Scotland has sought to establish the extent of current collaborations and the findings will be available in 2017.

Users of the Financial Inclusion Service at the Royal Hospital for Sick Kids report that the location (in the hospital) of the advice service is an important factor that enables them to access the advice on offer. This is echoed by the advice worker who reported that the services gets to families it would not otherwise reach (Hopkins 2014).

A review of advice provision in the Keppoch medical practice ( NHS Greater Glasgow & Clyde), provides a further example of where locating advice in a health setting has had tangible benefits for patients (Littler 2015). The approach involved the provision of welfare advice to patients with several pathways for referring patients for support – referring patients to CAB drop-in sessions; formal referrals to CAB through a referral form. Additionally, in Possilpark, SLAB provided funding for two money advice workers to be based in the health centre to enable more cohesion between NHS and money advice, facilitating access for patients and removing stigma. Whilst the project was not without challenges, including the time constraints of patient consultations, how openly the patient is willing to discuss their financial situation, and how confident the GP feels in asking about what is often considered to be a very sensitive topic, the project enabled important lessons to be learned.

Channels of delivery

The literature sets out examples of the range of different channels through which advice is provided currently. The main channels of delivery across advice services are:

• face-to-face (located in offices and shop fronts, or delivered through outreach);
• written forms of correspondence including email and letter; and
• web-based advice.

The most common method of delivering advice is still currently from office or shop-based premises, with some organisations having developed outreach services at settings such as youth clubs, as well as home visit services and mobile advice services. Recently there has been an increase in electronic means of delivering advice, including telephone, internet and other digital technology (The Scottish Government 2009). For example:

• Citizens Advice Scotland notes the benefit of its capacity to provide face-to-face advice, and whilst the service also provides advice by telephone, email or letter, their evidence shows that clients prefer face-to-face support with debt problems (Dryburgh 2011, p.7).
• In their annual report for 2014/2015, Shelter (Shelter 2015) reports that people access their advice on the phone, online and in person. The advice that they offer is available to help people avoid homelessness either by finding a home or helping them to keep a home. Additionally, they offer advice to help people improve their home. The advice offered can relate to consumer (fuel), money (debt) and income maximisation (welfare) as well as general housing advice, for example legalities related to tenancy agreements (rights). Shelter reports that in the year 2014/2015 it answered 116,339 calls to its helpline, that over 4 million people sought advice on its webpages and that nearly 70,000 people received help through face to face advice and support services.
• Action on Hearing Loss, a charity providing support to people who are deaf or hearing impaired reports a mix of delivery methods. They report 28,000 calls to their information line, a 37% increase in email requests for information (9,000) and 50,000 unique downloads of information resources from their website. As well as remote channels the charity also offers face to face support to people with complex and multi-sensory impairments, reporting 40,000 interventions to support 13,000 people in communities across the UK (Action on Hearing Loss 2015, p. 12).

The literature makes the case for diverse routes to advice. Information extracted from the funding awards made by Scottish Government reflects this. Information extracted from the funding awards made by Scottish Government suggests that a large number (119) of the advice services funded by Scottish Government offer face-to-face provision. Web or email-based support is offered by 94 of the advice services in receipt of Scottish Government funding, and a telephone helpline is offered by 102 advice services. Of the organisations funded by Scottish Government, 79 reported offering advice through one channel only and 96 offered advice using a variety of channels. These included online portals and face-to-face provision. (Ellison & Whyley 2012; Parkinson & Buttrick 2015). The literature also highlights that collaboration can support multi-channel provision and enable advice providers reach a wider customer base (Social Value Lab 2014).

Respondents to our survey of publicly-funded advice providers also report that they deliver advice using multiple channels. Most (95%) survey respondents provide advice using a mixed methods approach. Only two (5%) use a single method of delivery, reporting that they rely solely on in-person contact. Figure 6.2 shows the number of organisations providing advice through each of the channels listed, and as noted above qualitative responses to the survey show that within this, organisations are usually offering advice through a mix of these channels.

Figure 6.2: Advice channels provided by survey respondents

As shown in Figure 6.2, based on responses to the survey, telephone is the most common channel for advice overall. Advice providers working in specific local locations were more likely to report that they offer a face-to-face service and national advice providers were more likely to report that they offer an online chat service. Survey respondents noted the importance of outreach elements of face-to-face provision noting it was an important part of engaging with people with complex needs. They described face-to-face forms of advice as including meetings in organisation's premises, home visits and in public settings such as cafes. Nearly three-quarters (73%, 32) of survey respondents reported delivering advice in this way.

"the majority of advice takes place face-to-face as this tends to be the best method for giving advice and explaining things for people with learning disabilities (and other support needs)". Survey respondent

Why do service users select particular channels for advice?

The literature suggests that an individual's personal preference will lead them to select the channel for advice, but that channel selection is also influenced by the first type of advice they happen to access. The Money Advice Trust carried out a study to inform the development of channel strategy for the debt advice sector (Ellison & Whyley 2012). This highlights that channel preference can often be simply a matter of personal comfort, skills and experience, but that it is also heavily influenced by whichever provider the client, often in crisis, first comes into contact with and the first channel of advice that they access. It notes little public awareness or understanding of advice providers and so provider choice is largely shaped by providers' internet presence or brand visibility, and recommendations from family and friends.

Ellison & Whyley (2012) highlight that remote channels can offer important advantages related to anonymity, accessibility and convenience; but whilst the overall picture given is of a relatively high degree of openness to remote channels (even amongst those using face-to-face services), an over-use of face-to-face channels is reported. They attribute this to the dominance of the Citizen's Advice brand and its focus on face-to-face delivery models, as well as a funding bias towards face-to-face models of delivery.

Ellison & Whyley (2012) note that vulnerable clients are more likely to use face-to-face support, but even in these more complex cases demonstrates evidence of some willingness to access advice through other channels. This is echoed by a review of the experiences of men seeking money and debt advice (Goode & Waring 2011). It suggests that face-to-face interactions are effective when individuals have complex advice needs as it allows for the advisor to get the 'whole picture', and therefore enables the provision of holistic advice and signposting, thus empowering individuals to take action using alternative routes.

Use of digital and 'new technologies'

The literature supports the assertion that face-to face support is important for clients with complex needs; however, it also suggests that there is an over-emphasis on face-to-face support. The Money Advice Trust's research on Debt Advice Channel Strategy (Ellison & Whyley 2012), for example, notes the importance for the future of channel and service strategy being driven by evidence of what works, and by the consumer, rather than being shaped by the existing sector structure or specific funding models. It observes that this implies that in the right context, remote channels can deliver as effective a debt advice service as face-to-face, and that there should be a gradual shift away from face-to-face channels, largely towards telephone services, and online advice as this model of delivery, and trust in it, grows.

A range of other methods of delivering advice were also cited by advice providers, including using remote channels (including use of new technology): 95% (42) of responding organisations said they deliver advice by telephone, 77% (34) by email, 64% (28) via website content and 23% (10) via online chat. One organisation noted "the clear preference of an increasing number of people is to access advice online and by telephone". Respondents also advised that written correspondence is a common form of delivering advice, with 73% (32) of respondents reporting that they deliver advice in this way.

Some respondents recognise the potential to use new technology to deliver advice in a more efficient way, enabling their service to reach more people, and examples were given of services using social media and video conferencing to deliver advice.

"Our flexible, multi-channel service can deliver against the preventative agenda, dealing with volume, and encourage citizens to seek advice and information at the earliest possible stage. We already reach a younger demographic than traditional agencies". Survey respondent

"New technology will allow us to offer a webchat service and will enable us to offer a client portal to all our information and advice". Survey respondent

"Using new technology and social media to widen the scope for clients to access our service and to reach new kinds of audience". Survey respondent

"Our advice helpline funded by the Big Lottery provides welfare rights and benefits advice by our specialist welfare advisors who are based in Glasgow. This is an accredited helpline". Survey respondent

"[Our] unique holistic Scotland wide helpline and online advice and information means we can reach those in rural areas and places where there are limited services… We offer family support services that enable us to warmly refer single parents to our advice services and partners". Survey respondent

"Our service delivery model is based on an effective and well established triage system… Central to this approach is the integrated delivery of our national and local digital, telephone and face to face services across the country, developed to improve housing outcomes and prevent homelessness". Survey respondent

There are many examples of the current ways in which telephone and online technology are being used to deliver advice in the literature. For example:

• The Money Advice Trust's National Debtline has a service called My Money Steps, which is an interactive online advice service that provides users with a personalised action plan, setting out practical steps to help them deal with their debts and manage their finances in future.

• The Scottish Legal Aid Board, in its Annual Report 2014-15 (Scottish Legal Aid Board 2015), makes reference to its contribution to the Digital Strategy for Justice which promotes a "digital first" approach to policy development across legal aid and the justice system which includes a justice digital portal which is a one-stop-shop for the public on justice issues.
• In its annual report (Shelter 2015, p.13) Shelter highlights that it has begun a process of developing its website so that users can access tailored support using online channels. They are also exploring greater use of mobile technologies to support advice giving in clients' homes, and have launched an online chat facility that is staffed by Shelter volunteers.
• The Energy Savings Trust reports that homeowners increasingly opt to source information regarding fuel economy and improved energy savings from online sources (Energy Savings Trust 2016).

What enables/determines channel shift?

A key message from the literature, and one that is supported by the primary research, is that whilst a mixed economy of advice provision is required, a larger number of people requiring advice could be directed to use more cost-effective delivery channels such as telephone and online sources of information. The literature suggests that to achieve this aim will require a more co-ordinated approach in raising awareness of rights to advice and a change in the way messages about advice are relayed to the public.

The literature suggests that there are a number of reasons for and ways of effecting channel shift. The Money Advice Trust (Ellison & Whyley 2012) highlights that key factors in effecting channel shift ( i.e. encouraging people to access advice through an alternative mode) rest on factors such as the skill and professionalism of the adviser, and the integrity and reputation of the advice provider. They also contend that channel use appears to be reactive, shaped more by supply-side factors such as availability/accessibility of advice, and providers' demand-management strategies and business models, than by demand-side factors. The Money Advice Trust emphasise that there is significant potential to increase the use of online channels, but notes that there is less appetite for a stand-alone channel than one linked to personalised phone and email advice where required.

Similarly, research by Money Advice Scotland found that there is a need to improve access to money advice provision for specific target groups, especially the most vulnerable clients. This report suggested there could be some scope for 'channel shifting' to target resources at the clients in most need. This could include encouraging more able clients to access advice via the telephone, online or with assisted self-help, thereby freeing up front line advisers to deliver face-to-face intensive support to more vulnerable clients.

In their longitudinal review of the impact of advice services, Atfield et al (2016) note that the majority of the subjects seeking debt advice were able to act independently on the advice that they received, noting that only a small group of participants who had complex needs needed on-going, tailored support if they were to successfully tackle their financial situation. They go on to note that in these complex cases the need for advice is not limited to money or debt advice. Rather, that the causes and experiences of debt need to be contextualised with reference to other issues and to achieve this holistic approach collaboration is required between different agencies (Atfield et al. 2016).

Partnership working and collaboration

The Christie Commission called for greater collaboration and integration between public organisations (Christie 2011), and the literature we examined suggests that the extent of collaboration in the advice sector is growing.

Research undertaken by the Baring Foundation in 2013 emphasises the importance of the need to refer clients effectively and efficiently to those advice providers best able to help them in order to prevent referral fatigue (cited in Gibbons & Foster 2014). It also emphasises the necessity for people with multiple needs to get all their problems resolved so that they do not simply come back when their secondary problems develop to crisis point – referring to this as revolving door demand.

The literature refers to the benefits of advice providers collaborating to maximise economies of scale and play to organisational strengths (Farnish 2015; The Scottish Government 2014; Low 2015; F. in C. Scotland 2015; The Scottish Government 2011; Christie 2011). Other examples of effective collaboration from the literature include:

• Macmillan Cancer Support (Macmillan 2015), which has a longstanding partnership with npower to assist people living with cancer to reduce their energy bills when their income drops; working in partnership with Citizens Advice and Local Authorities to help people in their communities (including through a pilot project in Dundee); and working with public library services.
• Citizens Advice Scotland (funded by Glasgow City Council) worked with NHS Greater Glasgow & Clyde to fund an advice worker to be based in the Royal Hospital for Sick Children 4 days a week. The project was created as a result of a needs assessment conducted by the Health Board and it is aligned to wider strategic objectives of the board to 'build clear pathways between health services and financial inclusion support organisations' (Hopkins 2014)
• The Scottish Legal Aid Board funds two money advice workers to work within a Health Centre in Possilpark (Littler 2015).
• Money Advice Scotland (Money Advice Scotland 2015) has contacted every member of the Scottish Federation of Housing Associations to identify whether they are involved in money advice, and whether they need support with training, financial capability or standards work.

The need for effective collaboration to facilitate appropriate referrals is identified as a key way in which "to simplify the 'customer journey' and ensure, via an effective triage system, that need is properly identified and acted upon efficiently" (Burfeind et al. 2013, p7).

Quality of advice provision

The issue of quality appears frequently in the literature. There is widespread agreement about the need for high quality advice to be provided, but also recognition that at the moment there remain inconsistencies in quality levels. There is also agreement across the literature that the best way to address this variation in levels of quality is to quality assure providers of advice.

In order to address this, SLAB, for example, recommends that the Scottish Government should continue to support organisations to use the Scottish National Standards for Advice and Information Providers, and explore whether the Consumer Quality Mark should be centrally supported (Scottish Legal Aid Board 2014). The Scottish National Standards for Advice and Information Providers is a quality assurance framework for agencies involved in debt counselling, housing information and advice, income maximisation, money advice and welfare benefits advice services. They include standards to ensure that services are effectively managed as well as competences for advisers and good practice guidance (The Scottish Government 2009). The standards are owned and accredited by Scottish Government with the accreditation process managed by SLAB. Blake Stevenson recently undertook work on behalf of SLAB to update the competences and support the development of a peer review scheme for Types 2 and 3 advice in Housing, Debt and Welfare Benefits. The standards and associated review and accreditation processes are designed to encourage continuous improvement among advice providers.

Other examples of advice standards include:

• Macmillan Cancer Support (Macmillan 2015) has developed the Macmillan Quality in Information and Support Services standard to ensure that the information and support they provide is of a high standard.
• Volunteer Scotland is working with selected advice providers to encourage them to embrace the UK Quality Standard for volunteer programmes ("Investing in Volunteers") as some providers' delivery is highly dependent on Volunteers.

There may, however, be some challenges/barriers to providers working towards some of the available quality standards. The Improvement Service, for example, found that local authority money advice services need additional support and resources to achieve accreditation under the Scottish National Standards of Information and Advice Providers (Burfeind et al. 2013).

Barriers to accessing advice

Our review of the literature suggests that there were three distinct types of barrier that may prevent timely access to advice services – individual, structural and cultural barriers, as shown in the table below.

Individual	These are barriers specific to the person seeking support. They may be a result of health condition or disability; caring commitments, confidence or self-esteem; or lack of English language skills.
Structural	Structural barriers relate to the channels of advice provision. These could involve overly bureaucratic procedures that hinder a referral to the service, inappropriate channels of delivery, or a lack of provision that results in long waiting times.
Cultural	The person seeking support may not be familiar with the service or may not trust the providers.

Prior research has shown that past negative experiences, access needs, and a lack of knowledge about the availability of advice can all prevent people accessing advice (Gillespie & Dobbie 2009), it is therefore imperative that the design of advice services promotes quality of advice provision, ensures inclusion and are properly targeted at those in need.

Home-visiting is one example of steps taken to remove individual barriers: "People with mental and/or physical ill health described the way different conditions including chronic anxiety, agoraphobia or poor mobility can lead to difficulties leaving the house. Some learning difficulties can affect an individual's ability to orientate themselves in unfamiliar environments so that a home-visiting service is essential. In rural areas, poor transport links and the high cost of travel are barriers to accessing advice which can be addressed by advisers travelling to the client, through outreach or home-visiting services" (Gillespie 2007).

Providing advice in a new setting is also cited as an example of removing a structural barrier. As Gillespie (2007) notes, "the service filled a gap because there was previously no such service in the locality and some said they were not likely to go into the city centre for advice". The co-location of advice services in NHS settings is another example of advice being taken to the people in need of advice, as are the collaborations between organisations such as Money Advice Scotland and CEMVO.

The manner that the advice service is provided is also noted as removing a cultural barrier. For example, recipients of advice note the positive impact of non-judgemental advice (Salter 2014; Financial Inclusion Taskforce 2010; Rahim & Arthur 2012; Green 2009; Mitton 2008) and advice being given in an informal manner (Gillespie 2007), thus making the recipients of advice more comfortable and more likely to engage.

Other barriers cited by survey respondents include:

• communication issues - for example, with people whose first language is not English and with people who have learning disabilities or have sensory impairments);
• the stigma associated with the issue which an individual needs advice with. For example, a debt advice service commented that " other barriers include the stigma of debt as people still feel ashamed to ask for help". Similarly, an agency that helps people access benefits said " families will often delay claiming benefits they are entitled as they have a fear regarding how they will be viewed in the community or by society as a whole if they are seen to claim benefits";
• difficulties in accessing face-to-face services, particularly in rural areas, for example the cost of transport or childcare; and,
• physical and mental health issues.

Conclusion

This chapter has highlighted that the majority of providers take a mixed channel approach to delivery and channel selection seems to be dictated by personal preference.

While face-to-face support is critical in engaging those hardest-to-reach clients, it may be offered too frequently to clients who could be actively encouraged and supported to access advice through alternative, more cost-efficient routes. Channel shift can be successful where people are encouraged and supported to use other means to access advice. For example, advice provision through digital media is growing but there is potential for more to happen in this area. Current providers seem to be actively pursuing alternative and more cost-effective routes of delivery – in response to cuts to funding.

Collaboration/partnership working is happening, but there is potential for significantly more collaboration to take place. Co-locating advice providers within other organisations, such as health centres or libraries has proven to be effective.
Furthermore, while quality standards are in place, they are not applied by all providers, and cost may prohibit their application for some organisations.

Finally, there are some key barriers to accessing advice, including structural, cultural and individual barriers. Awareness of services is a particular barrier identified by providers. At present, however, not enough is known about the reach of advice services. Improvements in data collection could improve knowledge relating to the reach of services.