Flipped, turned upside down – Covid responses to multiple disadvantage
Since lockdown we have been asking people involved in our lived experience work how they have experienced the pandemic. We have held forums regionally and nationally, conducted interviews, surveys and focus groups. The unique approach by the National Expert Citizens Group (NECG) was not to dwell on the failings but seek out the positive changes for people experiencing multiple disadvantage. Today they have published their findings – read the report here.
The NECG membership noted some remarkable changes, brought about through adversity, that many had championed prior to the pandemic.
Services became more accessible
The NECG saw services become more flexible allowing people to make a choice about how, when and they were engaged, especially through the increased use of pre-existing tech; simple use of regular phone calls, or (less frequently) video calls. Services started to fast-track people into support, showing up mis-placed criteria, or mandatory courses as unnecessary hurdles to real support. Services were also forced to exit the office and meet people where they were at, making outreach the main mode of delivery. This cutting out of regular visits to services helped a great number of people, mainly because those office visits often caused fear and anxiety.
Perhaps the most striking finding was that these emergency approaches blew the myth of non-engagement out of the water. It quickly showed up the fact that often services were putting up unnecessary barriers; those self-imposed barriers made people ‘hard to reach’, not the behaviour of people in need of services.
This resulted in several innovations
There were some practical changes that this brought about which the NECG members thought should stick.
- Prescribing services were faster, and the prescriptions lasted for longer. Opioid substitute prescribing services (especially for methadone) moved from daily prescriptions consumed at the Pharmacist to meekly, fortnightly or sometimes monthly ‘take away’ prescriptions. The trust and responsibility placed in people to manage their intake and simplify their lives was welcomed by all. The risks associated with this approach were said to be well managed by drug.
- Residential rehab became a possibility. Previous barriers to residential rehab, such as mandated courses, were brushed aside allowing people to access residential rehab more easily and quicker.
- Probation contact became easier and more regular. The change to regular phone contact and doorstep visits were viewed as a positive change. People generally saw probation offices as ‘horrible’ places to visit and the outreach model was praised for reducing anxiety and improving their relationship with their probation officer.
The impact of Covid is far reaching and forever changing. The NECG have made some powerful recommendations for services, which we will take forward. The NECG recognises that these positive practices are fragile, and we have begun to hear anecdotal evidence that those new to an area or in need of a new referral to services are struggling to gain access and failing to be met. The challenge is not to be underestimated, and the landscape is shifting. But the importance of listening to lived experience and co-producing the solutions remains as important as it ever was.
The National Expert Citizens Group (NECG) is a representative group whose members have lived experience of using Fulfilling Lives services. The NECG uses its insight to collaborate with decision makers with the aim of improving systems and services.
The Fulfilling Lives programme supports people who are experiencing multiple disadvantage in 12 areas across England. Its aim is to improve the support available for people who experience multiple disadvantage. Multiple disadvantage is defined by Fulfilling Lives as people who experience two or more of the following: homelessness, a record of current or historical offending, substance misuse, and mental ill health.
Revolving Doors Agency coordinates, facilitates and administers the NECG forums, equipping its members with the skills and opportunities to affect systems change.
