Coronavirus (COVID-19): supporting people at higher risk - survey of third sector organisations

11. Reaching everyone in need

Almost half of respondents (out of the 518 who answered this question) think that not everyone in need has been reached.  47% selected ‘No, I think there are some groups our services could provide for who have been missed’, while 28% selected ‘Yes, I think we have reached everyone in need that our services provide for’ and a quarter (25%) selected ‘I don’t know’. This suggest that, though respondents feel those who have been reached have been well-served overall, they do not feel everyone in need has been reached.

Those who answered ‘no’ or ‘I don’t know’ were asked to reflect on their answers in an open question, providing insight into their reasons for their answer.  There were a large number of responses, covering a range of pertinent issues.  Many of these intersect and should not be seen as standalone areas of need.

A strong theme emerging from this question was that of digital exclusion.  Many responses focused on the fact that the Covid-19 response – in terms of information, but also in terms of support due to face-to-face restrictions – had been very digital.  This requires the technology and the means to pay for technology and internet connection, but also the skills and confidence to access online information and services.  For example, one response reflected that:

‘Most of the support we were able to give was online or over [the] phone. I suspect that if people did not have access to internet/gadgets then they would not have been able to easily access support.’

Responses about this issue noted a range of demographics as potentially being negatively impacted by this, including older people, those with limited means, those with mental health problems, those living in rural areas, those with limited or poor reception and those with disabilities:

‘Many people, especially elderly are digitally excluded due to the lack of essential technology or skills.’

‘People with no or patchy digital connections are struggling too - gap is there for several reasons incl costs, broadband coverage, limited confidence/skills.’

Though some responses acknowledged the difficulities of responding in ways other than digital when face-to-face work became dangerous, everyone was keen to note that this will have meant some groups were not well-served and that future planning should include how to provide information and services to those who do not have (easy) access to the internet:

‘Accessing digital in general for those who cannot afford it or who live in a poor reception area have put them at a disadvantage and work needs to be done to engage with all of these people before a second spike occurs.’

The responses did not provide suggestions for how to address this issue, but raised it as an important point to think through in future.

The organisations also reflected on their provision to other specific groups or demographics they felt had been potentially under-served. Some responses felt this was wider than their own provision and should be looked at in the round of the Covid-19 response.  These potentially under-served groups include: older people; disabled people; unpaid carers and those who have lost professional care support; those who are isolated (geographically and/or socially); those with mental health issues; those with physical health issues or long-term health conditions; rural and island communities; those living in poverty or with limited means; and those with English as a second language and/or who are asylum seekers or refugees.  To a lesser extent there were also mentions of those experiencing domestic abuse; children, young people, and families; ethnic minority communities; gypsy and traveller communities; those with problem substance use; and those with dementia.  

The range of groups mentioned here will reflect the respondents to the survey and their own particular knowledge and expertise, but, particularly when coupled with concerns about digital exclusion, suggest areas of potential exclusion to tackle.

Another smaller group of responses to this question focused on organisational failures and resourcing.  There were a few negative comments about Health and Social Care Partnerships (HSCPs), for example, and local authorities:

‘The HSCP are often poor at carrying out their statutory obligation to put people in touch with independent support organisations for [condition] therefore we are bound to have missed people (as we are an independent support project for [a condition]).’

‘Lack of leadership at the top, and H&SCP stumbling through week to week.’

‘There is no doubt that there are some people who have been missed. Had we had more support and collaboration from our local authority and TSI we could have delivered to more people who couldn't collect or who we couldn't deliver to.’

Part of the issue here was considered to be a lack of communication between organisations – some were relying on schools, social work teams, and other agencies for contact information and, if this was not received, people in need could be missed.  It was also noted in some responses that GDPR made sharing of information between organisations difficult:

‘GDPR prevented front line services referring people to the community services involved in helping the communities.’

‘Due to GDPR information isn't shared within local 3rd sector from local authorities but am sure housing associations and the council have done their best to ensure everyone has been contacted and asked if they require any assistance.’

Others noted that their services work on a confidential basis – i.e. they do not keep records of clients’ names, addresses, and so on.  Hence, in a crisis they were unable to directly find and support them.  Some organisations were reassessing this in light of the pandemic:

‘I feel the biggest issue with supporting the more vulnerable is the confidentiality issue. We are a community council who work under complete confidentiality and we are unable to compile a list of the people who are most at risk and in need especially at this very difficult time. There needs to be a way that all the organisations can share this information to make sure that we are not missing any vulnerable people.  I will be bringing this up with the council and other organisations to see what can be done.’

Some of these responses also noted that resources are strapped and limited funding means there are limitations on what organisations can achieve.  Some noted that, without further funding, the support they can provide will cease over the next few months.

Beyond this there were also a number of responses that stated that it is impossible to know whether everyone has been reached – with some feeling the real impact of Covid-19 is in the future.  A great deal of responses noted that all need cannot be met and that it is inevitable that some groups are missed.  A large number of these responses felt that some people are ‘too proud’ to ask for help or would see there being stigma in accessing support.  The quotes below illustrate the many comments along these lines:

‘There are always some people/groups that either don't ask for the help they need or just go unnoticed.’

‘With the best will in the world, there will always be gaps in the system.’

‘There are many people who are proud and reluctant to seek /accept help. Often they can be invisible until they reach crisis point and then need advanced services and support.’

Although these quotes point out that it is inevitable not to meet all need, they also raise issues that may have potential responses: destigmatising asking for help when in crisis; and communicating clearly about what support is available and how it can be accessed.  Concern about people not knowing how to access support came up in a small number of other responses too and was clearly a worry for some third sector organisations in how they can reach out to these people: ‘not everyone knows what to do or where to go for help.’