Background Around one in five people in the UK lives in poverty and increasing numbers of low-income households struggle to afford essentials such as food, rent and energy. Emerging evidence suggests that prescriptions are another essential that many can no longer afford. England is the only UK country to charge for prescriptions, despite evidence that abolishing these charges could result in cost savings to the NHS. The aim of this study was to explore the impact of the ongoing cost of living crisis on people’s health, wellbeing and use of health services, including prescriptions.

Methods An exploratory qualitative design utilising semi-structured interviews was employed. A recruitment poster was distributed at venues in North East England where people on low incomes gather, as well as being shared via social media and relevant networks. Interviews with 12 participants (8 men and 4 women of various ages and ethnicities) took place in person or online, and the transcripts were analysed thematically using the OSOP (one sheet of paper) method.

Results Analysis produced two major themes – effects of the cost of living crisis and potential or actual solutions to mitigate these effects – and a number of sub-themes. All participants felt the crisis had affected them negatively, in ways that included difficulties meeting basic needs such as heating their homes, increased social isolation, and mental health impacts such as loss of sleep. There were reports of people delaying help-seeking for health concerns due to the costs of transport and parking, as well as being unable to afford to take time off work to attend appointments. Some participants noted increases in the costs of over-the-counter medicines, resulting in increased use of prescriptions. Solutions were suggested at individual, local and national levels. While participants employed coping strategies such as taking on extra work, buying cheaper food and using less electricity, most felt that large-scale efforts by government were needed. Suggestions included increasing wages, removing prescription charges, and fundamental restructuring of the health service to improve equity.

Conclusion This study found that the cost of living crisis has had a detrimental impact on people living in North East England, a region characterised by high levels of socioeconomic deprivation and poor health. Action is needed at national level to address the causes of the crisis and mitigate the effects on physical and mental health, in order to avoid widening health inequalities further.