Disability and Carers Benefits Expert Advisory Group - COVID-19 advice: letter to Chair

Jim McCormick

Chair: Disability and Carers Benefits Expert Advisory Group c/o Scottish Government

16 October 2020

Dear Jim,

COVID-19

Thank you for your letter of 26 June outlining the Group’s concerns and recommendations regarding the impacts of COVID-19 on disabled people and carers in Scotland. There is little doubt that the outbreak has had a tremendous impact on everyone in Scotland, and I agree that the wellbeing of disabled people and carers must be a key focus of our efforts to address these impacts. This is clear in this year’s Programme for Government, which shows how over the last year we have continued to put clients at the heart of our approach and points the way to the further investments we are making in the people of Scotland.

Your letter contained contextual information on the wider experience of disabled people and carers during the height of the pandemic. As you note in your letter, much has changed since April, when the majority of data referred to in your advice was gathered.

We are in regular contact with groups directly representing disabled people and carers, and this engagement was stepped up from spring so that people’s experience on the ground could inform the Scottish Government response. I was provided with ongoing feedback from groups on which many members of DACBEAG are represented, such as the Carer Benefits Advisory Group and the Ill Health and Disability Stakeholder Reference Group. This is in addition to surveys and research reports on the pandemic. Your advice note was also sent to Social Renewal Advisory Board. I can assure you that all parts of Government worked and continue to work at pace to seek resolution to the unprecedented and large scale challenges resulting from the global pandemic, as it impacts on the lives of disabled people and carers in Scotland.

You raise a large number of issues. Many of these are in respect of issues outwith social security, however I will address the key points you highlighted before responding directly to the recommendations which do sit within the remit of DACBEAG.

Advice support

You mention that claimants are impacted by advice services not being able to provide the same level of support. I agree this is an important issue and I recognise that independent advice services play a critical role in helping people to understand and exercise their rights and to seek solutions in a range of areas such as money, debt and social security entitlements.

We provide funding for welfare advice to Citizens Advice Scotland, One Parent Families Scotland, Child Poverty Action Group, and Advice Direct Scotland. This funding covers both direct advice to people seeking assistance, as well as training, support and second-tier advice given to other advice agencies across Scotland. As part of our first Benefit Take-up Strategy, we also paid a total of £600,000 to 21 third sector organisations to help them prepare their services to advise and support people looking to access Scottish benefits, and this funding has been flexed to allow those organisations to continue to deliver support through the emergency period.

It is also clear that there is an important role for local authorities in the provision of welfare advice, and the Scottish Government has committed over £300 million of additional funding for COVID-19 measures on top of the £11.4 billion local government finance settlement in 2020-21. It is right and proper that local authorities have the discretion to put appropriate welfare rights services in place, to meet local needs.

The pandemic has undoubtedly made it more difficult for welfare advice providers to offer face to face services, but all providers receiving Scottish Government funding have put in place alternative measures using phone or online methods. The Scottish Government also made additional emergency funding available for advice providers, including a grant of

£100,000 to Citizens Advice Scotland to help it set up its new, national phone line – a long term goal accelerated as a result of the pandemic.

In addition to this, we set up a £500,000 fund to support local carers centres throughout Scotland to transition to remote working. This meant that support and advice has been available to carers through the pandemic both over the phone and online. Face to face support has now resumed.

Access to food

You discuss the difficulties many disabled people are having accessing appropriate food. I can assure you that tackling food insecurity has been, and continues to be, a priority for this Government.

We have been taking a ‘cash first’ approach, more than doubling the Scottish Welfare Fund budget and encouraging local authorities to provide support as cash transfers where appropriate. We have committed over £110 million directly to support people struggling to access food during the pandemic. In addition to our original £70m Food Fund announced in March, we have now committed to supporting local authorities with a further £27.6 million over the summer months, and have provided a further £15m for an extension of the shielding programme. The Supporting Communities and Wellbeing Funds have further bolstered this support, investing £5.2m and £2.6m respectively in food related projects. These investments continue to provide support for a range of needs, including for those experiencing financial or physical barriers to food.

We also know that supermarkets have been unable to offer online delivery slots for all those who wish to use them and we continue to work alongside our UK Government colleagues to engage with retailers on the range of challenges facing consumers as a result of COVID-19. Following Scottish led discussions 100,000 priority delivery slots from Iceland supermarket

have been made available for those who are at risk. This is a new offer and is in addition to slots allocated to the shielded group. Slots were allocated to local authorities, Age Scotland and RNIB in June.

To help make sure everyone is aware of the range of support available, we have prepared guidance for individuals, including information on gift cards to enable others to shop on their behalf, food boxes and prepared meal delivery options. Anyone that is still struggling to access food and cannot get the help they need from family, friends or neighbours, is encouraged to call the National Assistance Helpline. The free helpline number is 0800 111 4000, or can be contacted via a textphone on 0800 111 4114. Callers will be put through to speak to someone at their local authority who will be able to advise what types of help are available.

Social care support

You highlight that social care support changed in some instances. I agree that social care support is critical to the COVID-19 emergency response. Our focus remains on supporting people to ensure the continued safety, dignity and human rights of those who already receive support, whether or not they have the virus.

We have always made clear that social care services must be maintained with as little interruption as possible during the COVID-19 emergency. Whilst many social care services have continued to operate, we know that some people’s support has changed during the lockdown and that this will be for various reasons. For example, this may be due to family members who are not at work being able to provide more support, some people not feeling comfortable about carers coming into their homes at this time, and staff absences or changes.

Health and Social Care Partnerships are planning what steps need to be taken to begin the recovery of some key social care services. This will include understanding whether and how people’s needs have changed during the lockdown, to make sure their support is still right for them. Some supports and services, for example day care services, are likely to look and feel quite different for now due to things like social distancing and use of PPE where needed.

We will be working together with Health and Social Care Partnerships and other partners to develop shared principles for this to ensure services and supports are resumed safely for people and staff. Ministers wrote to partners on 3 August to confirm that registered building- based adult day services and dedicated overnight respite can also reopen, subject to risk assessment in line with existing guidance and agreement with the Care Inspectorate and local Health Protection Team. On the 31 August, we published comprehensive guidance to support the safe re-opening of adult day centre services. Guidance on re-opening of school age childcare services was published in July.

The Scottish Government has made additional funding available to local authorities to increase the capacity of support social care and ensure fair working conditions for these key workers.

While our immediate focus is on protecting life and protecting people from the virus, it is right that in the fullness of time we must use our learning from the pandemic to continue working together with our partners to enhance and accelerate the reform of adult social care. This should include a conversation with the people of Scotland about how social care support is

organised, regulated and funded and, as we have seen with our reform work to date, have at its heart the involvement of those who use or provide social care support.

Access to health services

You explain that some disabled people reported being worried about receiving equal access to treatment in the event they contracted COVID-19. This is an issue we are taking very seriously.

We produced ethical and clinical advice that aims to support clinicians with decision making throughout this COVID-19 pandemic. The guidance aims to ensure that people in Scotland who may catch COVID-19 will get access to the treatment and care that they need.

We have worked closely and extensively with our stakeholders including Inclusion Scotland, Scottish Care, SCLD, EHRC, SHRC, the Scottish Academy of Medical Royal Colleges and many others to ensure that this guidance is helpful to clinicians and in developing an Equality Impact Assessment (EQIA) of this guidance, to ensure it best meets our equality and human rights requirements.

We are grateful to these organisations for their thoughtful and constructive advice and support which has resulted in much stronger guidance documents.

Personal Protective Equipment (PPE)

You note that some support services and unpaid carers reported having difficulty obtaining appropriate PPE. The supply of PPE is primarily the responsibility of social care providers themselves, whether in the public, private, or third sectors. However, given the immense pressure on normal supply chains due to COVID-19, the Scottish Government has been committed to providing top-up and emergency provision from the national stock to ensure that staff have what they need.

We have had two routes to support normal supply chains for PPE for social care providers since March. These are the NHS National Services Scotland (NSS) Social Care PPE Triage helpline and deliveries of PPE to local hubs for onward distribution or collection by social care providers. In addition to this, we provided a one-off direct delivery of at least one week’s supplies of aprons, fluid resistant surgical masks and gloves to all care homes in Scotland to enhance their supplies. Since these routes were launched, more than 86 million pieces of PPE for social care have been delivered to more than 1,000 locations across Scotland.

The local PPE Hubs are now supporting the whole social care sector, and also unpaid carers and social care Personal Assistants, with their PPE needs where their normal routes have failed.

We worked with the national carer organisations (NCOs) to set up a dedicated route for unpaid carers to access PPE and were the first of the UK nations to do so. We published advice on the Scottish Government website for carers providing personal care which covers situations where PPE should be used and how to access it. Feedback has been positive to date and we continue to liaise with the NCOs and local carer services to ensure the process is working well.

Increased demand on carers

You highlight that many unpaid carers have had to take on extra caring responsibilities as a result of the lockdown, and that some groups face particular barriers and challenges. I recognise this has been an especially challenging time for unpaid carers.

We set out many of the steps we have taken to support carers in our response to the Life Leaving Lockdown report submitted by Oxfam and the National Carer Organisations (NCOs), so I will not go into great detail here. Suffice to say we are taking this issue very seriously and taking significant steps to ensure unpaid carers are listened to and well supported.

Equalities

Across Government we are alert to the need to invest in identifying and addressing the needs of people with protected characteristics. The Carers (Scotland) Act 2016 includes duties for local authorities to take account of the impact of having one or more protected characteristic when identifying carers’ personal outcomes and needs for support and in providing carer information and advice services. We fund MECOPP (Minority Ethnic Carers of People Project) and other NCOs to support local carer organisations, which often deliver these duties on behalf of authorities.

As part of our immediate response to the pandemic, the Scottish Government has provided more than £500,000 to organisations working specifically with minority ethnic communities across Scotland. Also, in June 2020 we established the Expert Reference Group on COVID- 19 and Ethnicity to help provide a clearer picture of the impact on minority ethnic communities. The Group have now put forward initial advice and recommendations on data, evidence, risk and systemic issues and the Government is actively considering how to take the recommendations forward. You may want to note that our recently published Programme for Government contains a number of actions in relation to minority ethnic communities.

This is part of our wider work to advance race equality, backed by over £2.6 million in the last year. We were also very pleased to have Judith Robertson, the Chair of the Scottish Human Rights Commission, facilitate our 2019 Carers Parliament event. More widely, as you will be aware, we work closely with groups supporting and reporting on carers with protected characteristics to help us understand and respond to how the pandemic is felt across all communities. We have very much valued the input of groups such as Engender, Inclusion Scotland and MECOPP through, for example, the Carer Benefits Advisory Group and in wider discussions. We want to ensure that everyone in our society has equal access to support and services and that the systems we put in place do not act as a barrier to achieving that.

Connectivity

You mention that a number of disabled people report facing barriers to accessing online support. The Connecting Scotland programme is supporting low income individuals across Scotland that are clinically at risk to COVID-19. The initiative was successfully trialled with Glasgow Disability Alliance and Govan Housing Association, and is being delivered by the Scottish Government in partnership with local authorities, Healthcare Improvement Scotland, The Scottish Council for Voluntary Organisations and the digital and IT sectors led by Scotland.

The initial phase of the Connecting Scotland programme committed £20 million to provide devices, an internet connection, training and support for digitally excluded, low income individuals across Scotland clinically at risk to COVID-19, and we have subsequently moved on to work with low income households with children, and young people leaving care.

The Programme for Government 2020-2021 sets out how we are now committing an additional £23 million to help even more digitally excluded people and households with a digital and data safety net, providing them with a device and extending our previous offer of unlimited data and support and training from one year to two for everyone the programme has helped. This will bring the total number of households we have helped to get confidently online up to 50,000 by the end of 2021.

Additionally, we have provided Family Fund with £2.98 million to deliver grants for families on low incomes raising disabled or seriously ill children and young people for items including tablets/computers and gaming in order to improve digital access for those young people and their families and enable them to access on-line and digital support.

We also fund the ILF (Independent Living Fund) Transition Fund for 16 to 25 year old young people living with a disability to support their independence, which can include the purchase of IT equipment. Improving digital access for those young people and their families will support them to access on-line and digital support.

I hope the above gives you some reassurance that the we are putting in significant effort and investment to address the concerns you have raised. I know I have not addressed all of your comments fully, but suggest if you would like to discuss anything in further detail my officials would be pleased to refer you to the relevant parts of Scottish Government.

Recommendations

I now turn to your recommendations.

Recommendation 1: The increased payment of CAS is welcome, however, more must be done to provide financial support to carers who are not eligible for CAS due to the overlapping benefit rules.

Recommendation 3: The Scottish Government should explore how it can support disabled people to cope with the financial impacts of COVID-19. To do this, it should consider how it can use its social security and other available powers to either increase the incomes of disabled people or reduce their costs.

As set out above, direct financial support is only one aspect of the support we have put in place for disabled people and carers in our COVID-19 response. I have very carefully considered how social security can play a part in mitigating the impact of the pandemic.

Since the arrival of the pandemic, as well as delivering the Coronavirus Carer’s Allowance Supplement, we have made changes through regulation and guidance to protect access to existing benefits, implemented an interim advocacy service to ensure independent support is available to those who need it, begun processing new Best Start Grant applications, and delivered a suite of improvements and fixes to the Agency’s live running systems.

Our main priority however must remain maintaining live running within Social Security Scotland, to continue to pay the much needed benefits that we have already implemented, including any increased demands on those services, and to deliver new benefits within our revised programme. Making changes to benefit levels or eligibility over and above what we would have already committed to would put added pressure onto our delivery programme and Social Security Scotland front line services.

For the remainder of 2020, we have a packed delivery programme. We have just launched Job Start Payment and will launch a further two new benefits - Child Winter Heating Assistance and Scottish Child Payment - we will also make improvements to the Agency’s existing processes to ensure they are as efficient as possible so the Agency can respond effectively to the anticipated increase in claims for benefits. While the pandemic has unfortunately meant the delivery timetable for disability benefits has had to be delayed, delivering the Child Winter Heating Assistance on schedule for winter 2020 will make a tangible difference for severely disabled children in Scotland, without impacting on Social Security Scotland’s wider delivery. Similarly, significant work, under incredible pressures, has meant that we are now aiming for the Scottish Child Payment, which has been rightly been hailed as a game‑changer by leading anti‑poverty charities, to be open for applications for under 6s in November 2020 and for first payments to be made to eligible families from the end of February 2021.

All staff resources are currently allocated, and given the already full delivery programme to launch a further two new benefits before the end of the year, any additional requests would mean further delays to planned benefit delivery.

Turning to unpaid carers, the Coronavirus Carer’s Allowance Supplement delivered in June provides a further £230.10 to around 83,000 carers. Combined with the increase we have made to Carer’s Allowance through our Carer’s Allowance Supplement, this means eligible carers in Scotland will be £690.30 better off than equivalent carers in other parts of the UK this year. Your advice referenced taking a similar approach to increasing payments for disabled people, however, as you know, there is no equivalent existing mechanism in place within Social Security Scotland to provide for such an increase in payment to those in receipt of disability benefits.

You highlighted the situation of carers with underlying entitlement to Carer’s Allowance. As well as having intensive caring roles, people in receipt of Carer’s Allowance are on some of the lowest incomes. Carers who are not eligible for Carer’s Allowance due to the overlapping benefit rules are generally on higher incomes than those who receive Carer’s Allowance. This difference is often significant, as receipt of the State Pension is by far the most common overlapping benefit.

There are other practical issues to be considered in respect of carers, and these apply also to disability benefits. Both of these are being delivered by DWP on behalf of the Scottish Government, while we develop the infrastructure for a safe and secure transition of cases to Social Security Scotland. Extending eligibility for Carer’s Allowance, or increasing the level of disability benefits, would depend on making new agreements with DWP.

Like us, DWP have prioritised front line services, and their capacity to take on work over and above the measures they have already announced is extremely limited. It is particularly important that they are able to meet demand for disability benefits and Carer’s Allowance, and indeed the increased demand for Universal Credit, which will benefit many disabled people and carers.

Disabled people and carers can also benefit from a number of other forms of support, including more than doubling the Scottish Welfare Fund which provides a safety net to people on low incomes who require financial support. The £50m Hardship Fund has been established for allocation to local authorities to deliver payments to any claimants who present with a hardship need. This can be accessed by low-income families and people in receipt of benefits.

Discretionary Housing Payments (DHPs) remain available for those people who are eligible and who require housing support. Local authorities can add further funds if they need to do so and will have freedom and flexibility on how they deploy the funds. A further £8m was allocated to DHPs to support people financially affected by COVID-19 to sustain their tenancies. The UK Government also raised the Local Housing Allowance rates to the 30th percentile to support tenants in the private rented sector.

Finally, as discussed above, we are providing increased funding for advice services to provide support to people affected by poverty and welfare reforms, helping everyone in Scotland who is struggling financially at this time.

Recommendation 2: Consistent robust equalities impacts analysis must be carried out when developing social security policy responses to COVID-19.

In line with our principle of dignity and respect, quality equality impact assessments must sit at the heart of social security policy. Indeed, in the very early period of the pandemic in Scotland, I highlighted to my officials that full and proper consideration of equalities in responding to the pandemic was an even higher priority than in non-crisis times.

As explained above, there are a number of reasons why the Coronavirus Carer’s Allowance Supplement was not paid to carers with underlying entitlement to Carer’s Allowance.

However, I accept that it would have been right and proper to set this out clearly in the equalities impact assessment for the Coronavirus (Scotland) (no. 2) Act 2020. It is not enough to impact assess, it is also necessary to communicate the thinking in respect of equalities so that policies are well understood and can be effectively scrutinised. My officials will consider if more can be done in communicating the approach to and results of equalities impact assessing.

I am unable to comment on the impact assessments carried out by the UK Government on changes to reserved benefits. You will however have noted in the published equalities impact assessment on the Act that the indirect positive impact on disabled people of the Coronavirus Carer’s Allowance Supplement was part of considerations in making the payment.

Recommendation 4: The Scottish Government should consider how the DWP might be persuaded to make changes to the administration of disability benefits where this would improve access.

The DWP have put in place measures to assist with continued access to disability benefits during the pandemic. It has suspended face to face assessments for a period of time due to the current situation. They have put in place alternative arrangements including conducting assessments over the phone and carrying out paper based assessments. It is not clear how long these contingency measures will be in place for but we are engaging closely with DWP as they refine their plans.