Coronavirus (COVID-19): supporting people at higher risk - qualitative research

Findings from interviews with representatives of 16 local authorities across Scotland, exploring how they have been supporting people at higher risk during COVID-19.


Support for all

All of the LAs that participated in this research strongly believe that the helplines are there to support everyone who may be in need due to Covid, particularly those without a support network; they focus on need and not on specific categories (i.e. shielded, non-shielded) or on demographics. This is summed up by one urban authority describing the role of the helplines: '[For] anyone in need of support due to COVID-19 who didn't have a support network in place'.

The local authorities are providing 'support for all' (at least initially), regardless of circumstance - 'we don't turn anyone away'. They are not asking for any evidence of need beyond asking callers whether they have a shielding letter and whether they have existing support available. The aim of the telephone helpline was to provide support for those with no other support, so this reflects the LAs' attempts to ascertain who falls into this category. If it became clear over time that some callers might be able to support themselves more or reach out to other networks, then some difficult conversations would be undertaken by the LAs with clients at that stage. However, initial contacts for support are always supported where reasonable and many LAs noted that the only difference between the support for shielding and non-shielding people was the SG-supported food box and the priority shopping slots, otherwise everyone can receive the same service.

This approach reflects the focus of the LAs on need and not on specific categories (i.e. shielded, non-shielded) or on specific demographics. If someone called up in need they would be supported. One urban authority described this as 'humanitarian aid'. The LAs we interviewed tend not to be systematically collecting demographic data on callers and, when asked, often did not want to estimate the demographic profile of callers except in broad terms, due largely to the limitations of management information. The next paragraphs rely on these broad descriptions.

Shielding callers

LAs reported that they receive a lot of calls from people who are shielding looking for help in understanding and applying government advice to their specific circumstances. They also receive a lot of calls from people (particularly people aged 85+ and those with a variety of medical conditions, including some with dementia) who think they are or should be on the shielding list, and do not understand why they are not. These calls were more frequent in the early stages of the crisis.

The helpline target group, existing users of local services and people with new vulnerabilities

A range of callers within the original target group for the helpline also call. These callers are often older, are disabled or have underlying health conditions but are not on the shielding list, and lack support networks.

LAs noted that the helpline also acts as a route to support for those they already know and who have been using local services before. These callers may call frequently and ask for a range of support. Some LAs receive repeat calls from particular individuals, which are sometimes weekly or daily.

However, those who call extend well beyond these groups and include people with a range of new vulnerabilities. A lot of callers are isolated either socially or (particularly in rural and island communities) geographically. One rural authority noted they receive calls from men in their 40s and 50s who live alone in remote places and coped before, but are now struggling or needing reassurance that support is available if needed. Some LAs noted increasing numbers of calls about wellbeing, isolation, and befriending services. Others are calling because of financial difficulties that have arisen because of Covid – such as loss of income – that have left them struggling for food or to pay bills.

Many of these people were not known to the LAs before this crisis and LAs reported that the range of people calling for help is much broader than usual. Interviewees noted that these people often find it difficult to ask for help – 'some are clearly reluctant and embarrassed to ask for help'. The helpline was described by one LA as picking up those whose 'vulnerability is less easily identified'.

One factor which was reportedly causing people who were previously coping to need help is enforced reductions in the social infrastructure that would normally have supported them in crisis, such as wider family who could provide food or accommodation, churches and lunch clubs.

Marginalised groups

LAs also gave an anecdotal sense of the contact they receive from marginalised groups (e.g. homeless people, people with problem substance use, gypsies and travellers, and people recently released from prison). LAs reported only being aware of a small number of these marginalised groups calling, but they are getting some of these callers, usually relating to homelessness or problem substance use. There were even fewer reports of calls from gypsies and travellers or people released from prison. Some LAs point out that they have specialist teams for these marginalised groups and people who are known to these teams will already have been contacted directly about their needs and the support available during the crisis – this may be one reason for the scarcity of contact from these groups.

Change over time

Some LAs also note a change in caller groups over time: for example, one mixed urban/rural authority reports that, across their community food projects and requests for help, initially it was often young, single men calling, but there are more couples and families as the crisis continues and needs change. This authority undertook targeted communication to those individuals with a higher risk profile and, although results are from a small sample, found that around half of the responses came from a group who were disabled, with financial difficulties and living in a higher deprivation area as measured by the SIMD.

Other LAs talked about it initially being people with medical risks and older people getting in contact, whilst over time the profile has included more families and other groups, providing a wider caller base.



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