Table 1

HEADS guide for poverty questions and cues to look for in family and social history, adapted from the Accountable Health Communities Social Needs Screening Tool7 and HEADSSS6

HEADS questions	Poverty cues
Draw family tree Home: Who lives at home with you?	Chronic physical or mental health problems, >3 young children, single parent Housing concerns: pests, leaks mould, cold, overcrowding
Employment/education Do you work? How is your child doing at school?	Unemployment/low income, asylum seekers, travellers Developmental delay, poor school attainment
Activities: Do you have any hobbies?	Lack of money for hobbies or transport Social isolation
Diet What did you eat yesterday? In the last year, have you worried that your food would run out before you got money to buy more?	Lack of (healthy) food, unable to afford fresh fruit and vegetables Parents missing meals to feed children Free school meals Foodbank use
Safeguarding Have you ever had a social worker? Has anyone, including family and friends, physically hurt or threatened you?	Reasons for social worker could give insight into current and previous vulnerabilities Physical, verbal, emotional or sexual abuse warrants further investigation and referral as per local pathways.