REVOLVING DOORS AND NATIONAL EXPERT CITIZENS GROUP (NECG) – SUPPLEMENTARY EVIDENCE (PSR0112)
National Expert Citizens Group (NECG) & Revolving Doors Lived Experience
Theme: COVID-19 and its impact on public services for people with multiple needs
Introduction
Revolving Doors Agency is a national charity that aims to change systems and improve services for people ‘in the revolving door’ – people who come into repeat contact with the criminal justice system due to multiple unmet needs such as mental ill-health, substance misuse, homelessness, poverty and other traumatic life events. Our forums provide a space for lived experience insight, they are designed to be solution focussed, power shifting, and the members all have recent experience of the criminal justice system,
These notes were captured as part of a focus group on the impact of COVID-19 on public services for people in the revolving door. The evidence from this focus group is intended to inform the House of Lords Public Services Committee’s and their inquiry into the impact of Coronavirus on public services.
The group participants were drawn from the National Expert Citizens’ Group (NECG), which is the lived experience representative group for people using services in the National Lottery Community Fund’s Fulfilling Lives programme. Fulfilling Lives aims to create system change to improve services for people who have experienced multiple disadvantage (two or more of; homelessness, substance/alcohol dependency, mental health issues and contact with the criminal justice system).
The NECG aims to ensure lived experience shapes system change and creates services that are; co-produced, accessible and designed for people who have experienced multiple disadvantage.
All the quotes provided below are from NECG members.
Questions and discussion
The views on how public services are meeting the needs of people in the revolving door, with multiple needs, appears to be shifting. In previous focus groups we heard that services were changing their engagement approaches to reach more people, and now it seems that some are falling through the cracks. Whereas there are still some significant benefits to the way in which services have cut red tape and referral processes, there now seems to be growing frustration at how difficult it can be for people to access services when they are not already know, or in, services.
Some still held the view that services were doing well, but issues are coming to the surface that perhaps were not present in earlier parts of the lockdown.
“the fact that everyone is using different forms of communication means that people
aren’t falling through the cracks… don’t get me wrong it’s not perfect… I have pancreatitis. I had a flare up. I phone up and I just need stronger pain meds. They said no. They told me to go to hospital, then they told me I could have done this over the phone. I don’t blame the NHS I just think it’s poorly trained 111 staff. It was just poor, like, the staff not having the full training at their disposal. They have to go via a rule book. I knew that all I needed was stronger pain meds, but they didn’t have the power to override
“people who I know, who have come to the end of their tether who are trying to engage with drug and alcohol services. They’ve reached rock bottom and they’re trying to engage and their reaching out for help. People who have been seeking or crying out for help, they aren’t getting int services. People who are deep in addiction, during the past 6 months I dread to think what has happened if you hit rock bottom. Waiting hours on the end of phones, cos they wasn’t in the loop already, It was like a 6 month waiting list. They wasn’t on the waiting list, but they were told to wait 6 months. Not impressed with services at all in that way.”
“My mother has a long-term health condition… that primary care has met. I have mental health, They’ve been fantastic. They have talked over the phone and I haven’t had any problem with that.
“It’s a bit of a mixed bag for me. I suffer from mental health issues, severe anxiety and depression. I have certain triggers with addiction. I tried to step through my GP to try and get help or counselling. I had no help whatsoever, I got told to ring Mind. They were of no use whatsoever. Told they’d give you a 15-minute call, a triage call. It was only being part of the Fulfilling Lives team in Blackpool that I got regular phone calls. I got regular appointments, that was good.”
“getting anyone to ring you back, if you’re not known or not already on the list then you’re not really seen it. It’s just unbelievable that you could leave people in unsafe situations. If you’re with an abusive partner, and you’re in the house. You’re trying to do it over the phone, you’ve got no privacy. A friend in Liverpool was in a bad place, got nowhere to go. She was asking what to do. She’d been through Women’s Aid, they had nowhere to put her, she was left in that situation and I think she’s still in it now. My support came through Fulfilling Lives, but it was an NHS counsellor that did the services, but getting it through the NHS was a no-go.”
“Social care, that was really difficult, you didn’t hear for weeks, they just phone the police. That was quite bad. But there were others that kept in touch, They got me a laptop to keep me in touch with everyone.”
A good one, Women’s Aid was one, because of the extremely large amounts of new referrals coming in. With Women’s Aid you’re supposed to have contact on a weekly basis but because of the amount of new referrals coming in, they can’t see everyone, but those of us that were already on the books have been helped.”
For some it was ongoing failings in the system that appeared to cause frustration, in one example set out below, someone was struggling with ongoing issues in relation to benefit payments, especially when people were on ESA – which was disproportionately people with disabilities.
“I’ve had a mixed bag. Some things like the council, I got social services, I got a rail on my stairs that is fantastic. I have gone back and forward on housing benefit with the council. Most benefits if there’s a bank holiday they pay it early, Birmingham Council pay it about 4 days late. It’s already hard enough to relate to your landlord about arrears. On Universal Credit it seems some people have got the sun and the earth but not for people on ESA and working credit tax – most people are disabled.”
For others the issues were not just about accessing services but about accessing the technology that was now needed to be part of that services. Many people reflected that they had either struggled to use the tech, or to get access to it. Others knew that they were the luck ones, in that they had the means to access services digitally, or even enough phone credit to make calls.
“There’s been a heavier reliance of charities to get the technology – we can’t get all people tablets.”
“Some have been really great and supplied equipment to get online and keep in contact, and others have been non-existant. A good one, Women’s Aid was one, because of the extremely large amounts of new referrals coming in. With Women’s Aid supposed to have contact on a weekly basis but because of the amount of new referrals coming in, those of us that were already on the books.
“Some have been really great and supplied equipment to get online and keep in contact, and others have been non-existant.”
“I felt like through Fulfilling Lives people got engaged with, I struggle with anxiety and sometimes seeing people out of lockdown was a struggle. I get anxious seeing people out of lockdown. Seeing someone face to face on a video chat was a real help.”
“I struggled to get out and about, sort of meetings, or social occasions, I’d arrange it and then have a minor meltdown. Whereas on a digital platform you can say you’re not OK and re-arrange.”
In one instance, someone asked what support was being given to those people who did key worker roles, but needed mental health support themselves.
“I know a porter who was wheeling out people, no mental health support, no bereavement support. The person who has to stack that body, they are the person with the least help. The government hasn’t given them the mental health they need.”
The NECG members we spoke to did see improvements in services, but these were often hampered by clogged up services, long waiting lists, or simple difficulty in knowing how to access services if you are not being supported already. The experiences seem to be varied and will likely be different from place to place. But it seems that many are struggling, or seeing struggles, in how people can get access to services. In better news, the availability of longer prescriptions continues to be of benefit.
“Some have been able to deal with the backlog. You’ve not had to travel. You’ve not had to deal with the reception areas. Some services have probably improved because of that. But like others have said, when you’re not on the books, then you can’t get help. Because of lockdown that’s affected your mental health in a bad way. If you’re not on the books but you’ve experienced a breakdown because a loved on has died, or because they’ve been isolated. The fact that there have been a lot of people that have just not been dealt with because they just add people into a workload, but it’s probably just been in the paperwork, or something that has come from the top, like we’re not going to add people to the caseload, which makes sense, but it means that a lot of people are probably not getting support and experiencing trauma.
“A lot of services have improved. Taking away that red tape, the waiting lists, the constant contact on the phone. In some ways it has improved. But others are like you’ll have to wait till Covid is over.”
“Pharmacies have improved because of deliveries, getting stuff out on time. They’re giving you a weeks’ worth, that seem to be better. Longer wait for NHS services. There doesn’t seem to be a clear publicised strategy for how they are going to deal with people on waiting lists… what about the people that die or committed suicide because they didn’t get help?”
“My GP, you can’t make a routine appointment, you need to call at 8am and see if you get through”
“Definite mixed bag there – improved in some aspects, a lot of guys in entrenched homelessness were moved into accommodation and shows that govt can do something if they want. The support workers knew exactly who they were, have a discussion see if they want to engage. What happens to those guys, after lockdown, as they are coming out, who knows.”
“It’s a real serious problem, if you’re not in the system You have to go through initial assessment, the paperwork, if you can’t get through that first hurdle and that initial assessment. If you can’t get through that it’s massive, you just can’t engage, you’re crying out for help. I’d normally go to CGL – the addiction service in Brum – you can phone ‘em up and there’s no answer, there’s an email, but no answer. Services improved on one front, in terms of homeless, but trying to engage if you was actually in accommodation, that would be a knockback.”
“A bit of an improvement in drug services, with more people in our area getting phone contact and their medication, y’know, not having to turn up for the scripts. My local pharmacy has been amazing… I just ring them up and they say what do you need… they would give me a week or 10 days till I could get my GP appointment.”
“Housing benefit, that is like difficult to get any contact with. Same with the job centre, you’d just get letters, and I’m dyslexic, with no support here, it’s quite difficult to know what’s going on week to week and month to month. That has got worse since lockdown, the job centre are not always the greatest people for communicating anyway, but they have got a lot worse.”
“Some heave really stepped up to the plate and others have just said ‘oh, we’ll deal with you after’ and then you’ve got a backlog.”
“It’s scary when you’ve got a private landlord and they call up and say you’ve not paid for 6 weeks, you call and they give you a name and a number. You get into that situation. It took 12 weeks to sort that out [housing benefit]. They left me 12 weeks. But if we hadn’t been in lockdown, I could have sat in the office and demanded to be seen. But now I’m waiting on them to call, that’s a massive negative, I’m waiting for them to do the phone calls.”
“The services I think have worsened. But I think it’s because everything has been done over the phone. It’s not the same as talking to someone over the phone. It’s not as easy to relax and have a conversation.”
The impact of charities on people’s lives seems significant for most. Almost everyone had experience of essential support that was provided by charities. In many cases this was about survival, like foodbanks. But even these charities are struggling with demand and have longer waiting lists. These services are not immune to the same stresses that public services are experiencing. They are also experiencing the same difficulties in how people are best supported, for some phone calls or video calls work, but for others they don’t and the desire for face to face support is palpable.
“Food banks and food shares, if they were withdrawn, even the guys taken off the streets they were still accessing the food banks, their money didn’t go up, they still had the same financial situation. Without food banks, without the volunteers ant food shares things would have been awful, I’d class them as the heroes”
“I’ve had a lot of help with the foodbanks, and the vouchers from the schools. When my kids are at home 24/7 they eat an awful lot, so that’s been a huge help. Access to laptops, gave me the change to do all the other stuff, I also struggle with childcare, it means that I can be included. If it was withdrawn, I’d be stuck in the house all day. It would have a huge effect on my mental health, the kids going hungry.”
“If you live on your own and you’ve not had people to visit you then you can’t really connect with people. You can over the phone, but not seeing someone face to face… just that emotional contact, I know it’s not physical but you can see if people are smiling or agreeing with a comment. Those that haven’t had it [digital contact] then that would be terrible.”
“18 months ago I got pancreatitis from heavy drinking and since then I’ve stopped drinking. I tried to use the local rehab services, like local recovery services. Because they didn’t agree with my recover process like not changing my social circle and not stopping going to pubs… When we went into lockdown I thought shit was going to hit the fan. I get three phone calls a day… without expert citizens [the charity] throughout lockdown the risk of me picking up a drink again would have been greatly increased. Them alone have helped me a lot. If the contact that I’ve had was not there during lockdown then I think, I wouldn’t say definitely that I’d have picked up a drink, but the risk would have been greatly increased.”
“It would be terrible if it was withdrawn and we didn’t have tech. Remember a lot of people don’t have phones or laptops, or broadband. Then people haven’t had that call, they haven’t been able to engage. We struggled at the start to get used to the tech.”
“If it was all of a sudden to change and to stop. I don’t know. I was homeless for 10 years. I think the numbers [of homelessness] would increase.”
“For me personally I am quite settled. I am looking for employment [if support was removed]. I think numbers would increase, homelessness and addiction, I think numbers would increase dramatically.”
“Most of my interaction has been with Mind, they have been fantastic., You can have social drop in on Sunday there is a course on mindfulness. I know they they’ve supported people with tech and that.
“People who are leaving hotels, the council are way behind with services. So, the charities are having to help supply people with the technology, and help people get into the digital realm.”
“I’ve had counselling through this time. It’s helped me cope with bereavement. If mind’s floating support hadn’t been there, if something had happened… it would take weeks for someone to realise that something was going wrong. You know to be frank, checking that they’re not dead in their home.”
Clearly digital and phone based support is a theme that runs throughout this feedback. Some have had good experiences with it, some have enjoyed it less. However, most noted that getting access to the right technology was the hardest aspect of engaging. The participants also noted that for many access to digital services was still very unlikely, for reasons of poverty or homelessness, or even where the need to attain the money for drugs might outweigh the desire to access services (in some cases leading to the sale of hardware like tablets, laptops or smart phones).
“I struggled big time… I had someone helping me, and even then I struggled. I had someone helping me. Since I’ve got to use it, it’s’ been a brilliant tool. I’m working on the phone now, so I’ve only got a tiny screen. Hopefully everyone could get broadband and a relatively new phone, but I struggled big time. I’ve never facetimed or Skyped.”
“To begin with I only had a phone, it’s quite difficult but it’s still accessible. Once I had a laptop it was so much easier.”
“[without help with technology] I would have been completely isolated, just at home, not getting involved. The less I do the worse my mental health gets. The first few weeks when I didn’t do them I was a wreck so yeah, it’s been great.”
“The digital services, I don’t have a clue about tech. It’s far better to be able to see people than just talking to a phone. It was down to Shelter that I got the phone.”
I was having major difficulties with everybody saying, have a zoom meeting, I had an older phone, I was on pay as you go, had no broadband, I had basic amenities at home. Now I’ve got broadband. Without that I think my mental health would have been 1000 times worse. I’ve have had no physical contact. I have had a lot of help through, they [local charity] didn’t have to, but they called me up when I was upset that I couldn’t engage. Within two days she was at the front door with a tablet and said try that and let me know if you have any issues.
“I do struggle with tech cos of dyslexia – I have to have coloured filters so I can read and it doesn’t turn int a jumble. They are helping me an awful lot. If they didn’t have that I think I’d be in the local mental health facility, cos I wouldn’t cope well at all. I am pretty isolated and live alone anyway, it has massively improved my mental health and my life.”
“I prefer getting up and going out of the house. I find you lose some of the connection and motivation going online. I am lucky that I have broadband and a desktop computer. I hate zoom. Things like this are needed, and they can’t stop because of Covid… I’d go 75% personal, 25% zoom.”
“I love being able to going into the office but I can’t see a time now when zoom wouldn’t be part of the daily tasks.”
“I started off on the first 3 months of lockdown I had to use my phone. Someone provided me a laptop. I am slightly confused by all the different mechanisms. Without being accessing digitally I wouldn’t have been able to work from home.”
The participants had some clear asks about the changes needed ahead. Broadly these can be summarised as:
“A little less red tape, more accessibility, flexibility and maybe a bit more confidentiality as well. Not having to jump through all these hoops and tick boxes.
“The tech poverty, broadband should be considered an essential service. The government should be getting people phones.”
“I’d like to see services continuing to use all forms of communication to contact people.”
“I’d like to see a lot more, we don’t have enough safe space for women in services. You go in as a women, or a woman with children, you sit in a predominantly male populated waiting area. Guaranteed most people are men. You’re a vulnerable woman in a room full of men. You may be the only woman there for an hour and a half. I was sent into a waiting room and my ex-husband, in a waiting room. He was violent during our marriage, I was sat in the room, four feet away from the man who put me in intensive care. They didn’t ask him to leave the room, they asked me to leave. In probation and A&E, it’s like you’re tutted at and told it’s too difficult to deal with. You just end up not getting treated and not getting spoken to. There needs to be a lot more help for women accessing services to feel safe, The woman I’ve spoken to, we don’t feel safe, it’s as simple as that.”
“One of the hardest things about engaging as a woman, you’re worried about who they are going to share that information. You’re worried about losing your children. You probably don’t tell people wate you need to because of you recovery.”
“When I first went into service, I was terrified about losing my kids. You were scared about what other services that service was contacting. You were not sure, it’s a scary place to be when you’re a mum with kids.”
“You’re waiting 3 months for a referral and by that time you could have died, OD’d, you could have moved town to get services. If we meet the criteria, then DEAL WITH US. Not just waiting and waiting to get help.”
“There needs to be s strategy for mental health. People need more help now than ever. When you add Covid and the impact on that, the waiting lists are already sky-high”
“I’d also like to see a lot more services employ someone with lived experience as a go between. I am not silly enough to think that these 5 month waiting lists are going to go away… but if you’re on a 5 month waiting list and no one has been in touch with you then keep in touch with services.”
A massive one is the homelessness. The government have proved that they can Put a rooF over the head of 99% of people on the streets. They can continue to step up, they can fund it. They’ve got the nouse to do it now. By doing that it’s a win-win situation for everyone. The justice system is helped…. You’ll always get the odd person that doesn’t wanna come in, but 99% want a roof over their head.
“people still don’t have the ability to back pay their rent. You’re going to end up with a whole bunch of people who will be evicted. I went without food for 2 weeks to afford a fridge., The complaints council needs to be held to account over their actions.”
“Fully fund charities, places like Anawim, Mind, Shelter, who are doing a public service but they’re not getting paid”
4 September 2020