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.

Overall reflections on support provided for people not shielding but at risk

Reflections were highly positive, with the LAs we spoke with confident that support is reaching the right people and has made an impact on alleviating distress, need, and worry. As one LA phrased it, it has allowed people 'dignity and normality' in a difficult time..

LAs recognise that they may not have reached everybody who is at risk but say they have made extensive attempts to do so, both through promotion of support available and outreach. One LA was using posters to reach those who may not be on social media and another arranged for postcards to be distributed to older people at supermarket tills explaining the shopping support available. One LA mentioned the importance of the national advertising campaign around the National Assistance Helpline, which reached more people than their local resources would have allowed.

Successes and learning

When reflecting on what had been most successful during this whole experience for LAs there were many reflections on how fast the response had been. Work had necessarily had to be at pace and under intense pressure – 'we were chasing our tails a bit', 'a crazy time', 'in the beginning we were flying by the seat of our pants'. A number of complex systems and processes have been established quickly - 'we spun up a new system very quickly', 'We started up from scratch, up and running in a week', 'Some of the things that could take three or four years in a council were done in a couple of weeks because the will was there to do it'. Since then, there had been considerable efforts to 'mature the service over time'. These comments suggest there has been learning about how such fast working can be managed and what this can achieve, if everyone is pulling in the same direction. There was clear interest from the LAs we spoke to in seeing whether and how they can take these ways of working forward into the future.

Going along with this was pride in staff being able to adapt and change to the ongoing circumstances. Interviewees mentioned staff being flexible, going 'above and beyond', and improving processes over time (e.g. frequent guidance updates, daily briefings with call handlers, setting up steering groups, meetings with food consortiums). They have had to be agile in responding to customer requests, partner working, and changes at SG level as well. Staff have been redeployed from across the council to deal with this demand. A number of LAs reported more cross-council working.

Some LAs say they have learned more about their local populations (for example about mental health) and the challenges and reality of life for many people in their area through the crisis. This could help them to better understand need and where they can offer support going forward. Some populations they had not engaged with previously have come forward in this crisis and this is helpful for them to think through service provision and planning in future.

As evidence of the success of their working, LAs referred to positive feedback from partners and the public. Many used the word 'grateful' to describe the response from the public, who are often relieved to find support and help. One LA noted that there are 'pats on the back and some grumps', which illustrates that they have not got things right every time for everyone, but that overall their work is achieving its aim of supporting those in need.

Things that could have gone better and concerns going forward

Many LAs wished they had had more time to plan at the beginning – for example, developing guidance and referral processes, establishing data collection systems for easier reporting, clarifying expectations with partners – whilst recognising it often wasn't possible due to the pace of change and newness of the situation.

Most LAs we spoke to are concerned about sustainability going forward, both in terms of their own resources and the re-emergence of business as usual demands, with one LA saying: 'the challenge is how long are we going to have to do this for?'. They are also concerned about their partners' ability to continue to deliver, particularly the third sector, and whether the model in place will be sustainable going forward without increased or renewed funding and staff in place.

Some LAs are concerned about the development of a reliance on the support currently offered during the crisis and how they can move people away from this as support is wound down. This concern ranged across the working population through to older people, who may all be having to depend on a variety of formal and informal support mechanisms.



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