SCOPE – WRITTEN EVIDENCE (PSR0091)
Public services: lessons learned from Coronavirus
Summary of recommendations
1. The Government should give disabled people clarity on when non-COVID related health care will resume, as we move into the next phase of the Government’s recovery strategy
2. The Department for Health and Social Care should review the risk and impact of future waves of infection to assess if Care Act easements are still required. Parliament should look to exercise its power to end the Care Act easements at the earliest opportunity, as per the provisions within the in the Coronavirus Act.
3. The Government must ensure the supply of suitable and sufficient personal protective equipment (PPE) to social care staff and personal assistants, so that staff and care users to be suitably equipped to cope with impacts of any future waves of infection or lockdowns.
4. The Department for Education must provide a clear plan about when local authorities “reasonable endeavours” will be rescinded and full rights for disabled children’s ECHPs re-instated. The Department must also publish specific guidance about expectations and support for disabled children returning to school in September.
5. The Government must urgently uprate and backdate legacy benefits in line with Universal Credit to remove disparities between different groups of disabled people.
6. The Government should also use the Welfare Green Paper as an opportunity to build on the positive temporary changes seen during the crisis, to make permanent improvements to the welfare system. In particular, making permanent the end to sanctions and conditionality alongside undertaking an evaluation of the success of remote assessments.
7. In addition, the five-week wait in Universal Credit should be removed and a new component for Universal Credit developed to replace the disability premiums in the legacy benefit system.
8. Emergency funding for frontline charities and volunteers supporting the response to the coronavirus crisis, especially where they are alleviating pressure on the health service or providing support to people suffering from the economic and social impact of coronavirus
9. A ‘stabilisation fund’ for all charities to help them stay afloat, pay staff and continue operating during the course of the pandemic
10. Confirmation that charities should be eligible for similar business interruption measures announced by the chancellor for businesses.
Introduction
Coronavirus has created an unprecedented demand on our public services, and the impact has been particularly acute for disabled people and their families. The crisis has exacerbated existing barriers disabled people face in using public services, exposed new issues and highlighted where things can change quickly to create more inclusive conditions for everyone.
A huge amount has changed for disabled people over the last two months. We have seen reductions to the provisions of care for disabled adults and children ([1]), challenges providing health care unrelated to COVID ([2]) and temporary shifts in the welfare system.
Disabled people have been left feeling increasingly forgotten as a result of the crisis; Scope research in April found that 28 per cent of disabled people felt this way ([3]).
In light of the crisis, Scope has had to adapt the type of support we offer so we can meet the changing nature of demand for our services. Throughout the crisis we have been speaking with disabled people and their families, through our helpline, online community, services, social media, research panel and research polling to understand what lessons can be learnt from the crisis. The inequalities disabled people already face using public services must not be allowed to worsen as a result of the pandemic.
Scope welcomes the opportunity to respond to the committee’s call for evidence about the impact this has had on disabled people and disability charities during this time.
- Communication and information
1.1. Understandably, a lot of health care capacity during the crisis has been driven towards treating people who become seriously unwell with Covid-19. This has however come at the cost of delayed treatment for other conditions ([4]), leaving many disabled people anxious that they will be unable to access medical services when they need them the most.
1.2. During the outbreak, many disabled people have feared their condition or illness deteriorating and requiring hospitalisation. We found that 63 per cent of disabled people were concerned they would not get the hospital treatment they need if they became ill with coronavirus ([5]).
1.3. We have also heard from many disabled people worried because they have had medical and surgical appointments cancelled or postponed due to the crisis ([6]).
1.4. “I have had so many medical appointments cancelled it’s been really difficult. Including my mental health ones, so a stressful time.”
1.5. 
There is also increasing uncertainty about the impact of halting healthcare that is unrelated to COVID, particularly as we enter the second phase of the Government’s recovery strategy.
“I have had so many medical appointments cancelled it’s been really difficult. Including my mental health ones, so a stressful time.”
- Rights
Social Care
2.1. Social care is a lifeline for many disabled people. However, provisions of the Coronavirus Act have allowed local authorities to apply to temporarily suspend key duties to meet the needs of disabled people and carers during the crisis ([7]). The Act has also allowed health bodies to delay carrying out an assessment for eligibility for NHS continuing care.
2.2. Local authorities using easements only have to provide care “if they consider it necessary” for the purposes of avoiding a breach of the Human Rights Act ([8]). However, this does not provide the same level of safeguards as the Care Act and can be difficult for disabled people to challenge.
2.3. Currently, just one local authority has been granted an easement from the Department for Health and Social Care. However, there is a risk that more local authorities will request easements in the event of a second wave, or if Parliament decides not to end easements in September or October as it has the power to do.
2.4. This poses a risk that some disabled people could find their social care needs unidentified or unmet during the outbreak. Care assessments for those who have new or changing care needs in this time could also be delayed. Further uptake of easements by more local authorities could therefore leave some disabled people with only basic support, or even none at all, at a point where they may need it most.
2.5. Additionally, the Parliamentary and Health Service Ombudsman paused new and ongoing investigations from the start of lockdown in March until 1 June. This removed a key safeguard for people wanting to raise complaints about care during a time when rights were being perceived by many disabled people as being eroded.
2.6. 
Throughout the pandemic, we have also heard persistent concerns from disabled people who are worried that frontline public service workers are unable to get hold of the correct personal protective equipment (PPE) when delivering their care. This has left some disabled people feeling unnecessarily at risk of catching Coronavirus because they require help from social care workers or Personal Assistants.
“There isn’t really much support. As an employer of Personal Assistants, I’d have to provide them with an apron, a mask, maybe a visor – there was a list of things I was told I’d have to provide if I got sick. But how do I actually get them?”
Education
2.7. Before the outbreak, schools and other institutions had an ‘absolute duty’ to admit a child where they are named in a child’s Education, Health and Care Plan (ECHP). The Secretary of State for Education implemented powers set out in the Coronavirus Act to temporarily replace the ‘absolute duty’ with a ‘reasonable endeavours’ provision ([9]).
2.8. With 76 per cent of families of disabled children having the vital care and support they relied on pre-crisis stopped altogether, some parents of disabled children are deeply concerned that some local authorities may decide not to provide all elements of their child’s EHCP, so long as they have made ‘reasonable endeavours’ to do so ([10]).
2.9. The Secretary of State also applied changes to the timelines for EHCP applications set out in the Act. Before the outbreak local authorities have struggled since EHCPs were introduced, to abide by the 20-week limit set out in legislation ([11]).
2.10. During the outbreak where it is not “reasonably practicable” or is “impractical” to meet that time limit because of the transmission of coronavirus, the limit will not be applied. Instead, local authorities will have to complete the process as soon as reasonably practicable or within any other time limit. These new time scales will also be applied to any annual review or reassessment of a disabled child or young person’s EHCPs during the outbreak.
2.11. 
Though these changes may be modified on a case-by-case basis, two thirds of families of disabled going through the assessment process have seen it delayed as a result of the crisis, while nearly half found their child’s annual review had lapsed or been put on hold ([12]).
- Benefits
3.1. At the beginning of the pandemic, the chancellor announced £350 billion of emergency measures to support people affected by coronavirus. From this, the Department for Work and Pensions (DWP) implemented a suite of measures that could be “quickly and effectively operationalised, to benefit those facing the most financial disruption during the pandemic” ([13]).
3.2. As a result, in addition to the planned annual increase, Universal Credit claimants saw their standard allowance increase by just over £1,000 for 2020/21. This equates to an additional £20 a week. This increase, however, has not been applied to Employment and Support Allowance (ESA), a legacy benefit that many disabled people continue to rely on.
3.3. On average, disabled people face extra costs of £583 a month, even taking into account benefits such as Personal Independence Payment (PIP) which are designed to help meet these costs ([14]).
3.4. Disabled claimants in the Work-Related Activity Group of ESA have already been subject to significant financial losses in recent years, as a result of the four-year benefit freeze and removal of the work-related activity component.
3.5. While Scope acknowledges there are technical differences between administrative systems for Universal Credit and legacy benefits, we do not believe it is acceptable that the uplift has not been extended to a benefit specifically designed to support people with a disability or health condition.
3.6. The Government should urgently increase ESA payments in line with Universal Credit and backdate the increase to April 2020 as recommended by the Work and Pensions Select Committee, to avoid disabled people in receipt of legacy benefits from being further disadvantaged ([15]).
3.7. The DWP has made some welcome changes to the benefits process during this time, including removing conditionality and sanctions for claimants and suspending reviews and reassessments across all benefits to provide consistent financial support during the outbreak. These changes represent significant shifts in disabled people’s interactions with the benefit system.
3.8. Scope has long called for an end to conditionality and sanctioning. There is evidence that conditionality does not lead to disabled people moving into employment. The National Audit Office found that sanctions “reduced claimant’s time in employment” and “may have discouraged some claimants from working” ([16]).
3.9. This is supported by Government figures, which found that just eight per cent of ESA claimants on the Work Programme found work 12 months into their claim ([17]). The loss of income from being sanctioned can present another barrier for disabled people moving into employment, as disabled people have a lower level of financial resilience, with an average of £108,000 fewer savings and assets than non-disabled people ([18]).
3.10. The loss of income through sanctions can also make it difficult for disabled people to afford costs related to preparing and looking for work, such as education or training, travel, childcare or formal work attire for interviews.
3.11. Scope runs a range of employment programmes for disabled people focusing on voluntary support. The voluntary support we provide is integral to the success of our employment programmes and evidence that a voluntary approach would be a much more effective way of supporting disabled people into work in the welfare system than the current system of sanctions and conditionality ([19]).
3.12. Face-to-face assessments were also suspended for an initial period of three months due to the outbreak and replaced with paper or telephone assessments. Scope have long been calling for changes to the assessment process, to adequately address the different needs of disabled claimants. We have heard from disabled people during the crisis who do not feel a telephone assessment is appropriate for them.
3.13. The DWP should use the suspension of face-to-face assessments as an opportunity to evaluate the success of remote assessments. They should look to implement remote assessments permanently, alongside face-to-face assessments, giving claimants the opportunity to participate in an assessment which works best for them.
3.14. 
We also want to see the DWP address pre-existing issues with the welfare system which can cause financial insecurity for some disabled people, that have been highlighted due to the crisis. This includes removing the five-week wait in Universal Credit by making the advance payment a claimant can apply for non-repayable and developing a new component for Universal Credit to replace the disability premiums in the legacy benefit system.
- Support for the charity sector
4.1. Public services are vital, but the third sector also plays a crucial part in supporting people before, during and beyond this crisis.
4.2. As the UK’s leading pan-disability charity, Scope has continued to provide practical information and emotional support throughout the crisis to the UK’s 13.3 million disabled people. The Government has set aside £750m for charities, however Scope will not benefit from this funding. Like many charities, we are deeply concerned about the impact of coronavirus on our ability to support and help disabled people during and after this crisis.
4.3. Our helpline has experienced an unprecedented demand, responding to over 2,000 calls in March from disabled people concerned about their wellbeing, with 80 per cent of calls being related to the pandemic.
4.4. We migrated many of our face-to-face services online or by phone, the majority of which are one to one so we can continue to provide tailored support for disabled people when they need it the most. We have also continued to produce new information and advice, to help disabled people navigate the crisis, including access to food and essentials.
4.5. However, as the demand for our services has increased, we have seen a dramatic decrease in our funding. Our income dropped 60 per cent due to a significant decrease in available funding streams as a result of the outbreak and lockdown restrictions. All our services and support are funded by public donations.
4.6. In line with government guidance, we closed all 207 of our shops for over three months and ceased all street fundraising and fundraising events over the same period. We have been urging those who can, to continue giving, but in the current emergency this will not be possible for everyone. We also furloughed 70 per cent of our staff from mid-March until mid-June.
4.7. The costs of delivering our existing services have risen substantially due to the pandemic, even before the spike in demand for support is considered. Unless government funding is forthcoming there is a big risk that our support for disabled people will be compromised.
4.8. 
Scope is a member of the Disability Charities Consortium (DCC), a coalition of charities who represent disabled people. The DCC has found that many disabled people’s charities have not received any emergency funding at all, despite millions of disabled people relying on them through the crisis. The DCC is urgently calling for more financial support from the Government.
About Scope
We’re Scope, the disability equality charity. We won’t stop until we achieve a society where all disabled people enjoy equality and fairness. At home. At school. At work. In our communities.
We’re a strong community of disabled and non-disabled people. We provide practical and emotional information and support when it’s needed most. We use our collective power to change attitudes and end injustice.
We campaign relentlessly to create a fairer society. And we won’t stop until we achieve a society where all disabled people enjoy equality and fairness.
June 2020