Category Archives: Findings

Can you deliver? Food slots during lockdown

Paul Pearson shares early findings from interviews with participants living with disabilities and long-term health conditions in Scotland, exploring their experiences of accessing food during and after lockdown. Interviews revealed that access to supermarket delivery slots has been particularly challenging.

I have been working as a researcher on the ‘Scotland in Lockdown’ project over the past five months, a study that is aiming to understand and share the experiences of people from four different ‘at-risk’ groups in our society during the pandemic. My own research, as part of a wider team, has focused on the experiences of disabled people and those living with long-term health conditions. The issue of food insecurity has been highlighted consistently throughout the pandemic, not least through the work of Marcus Rashford on free school meals in England. Food insecurity has also emerged as a key issue in our study across all four areas, and this piece is part of a series on food access and security.

This contribution draws on the nineteen interviews I have carried out, and the following quotes are from several of the people who took part in the study. The issue of accessing supermarket delivery slots has proven to be a complex and barrier-filled environment that many of the people I spoke with have struggled to navigate. This issue has affected people of all ages, from all areas of the country, and from all walks of life.

Forgotten shielders: not on the ‘list’ but shielding still

In the early stages of lockdown, the Scottish Government (along with others in the UK) agreed a range of measures designed to support those asked to shield. These measures included access to priority online supermarket delivery slots; however, navigating this system proved very difficult for many of the people I interviewed. This experience was summed up by one participant who lives with MS and faced barriers when accessing a major supermarkets online delivery system:

“[…] the whole… system for the deliveries was just a nightmare.” (Participant living with MS)

This was the case not just for those officially shielding, but also those who themselves took the decision to shield due to being at additional risk because of pre-existing conditions. This was the case for the following participant whose long-term condition has resulted in them being virtually housebound:  

“I think what would have been really useful is some of the support that the shielders got. So, the biggest issue first was we rely on Tesco grocery deliveries, and suddenly that got impossible to get.” (Participant living ME/Chronic Fatigue Syndrome)

As I spoke to more people, a significant category of individuals emerged – those who took the decision to shield but did not receive an official ‘shielding letter’ advising them do to so. This group did not have guaranteed access to the same concessions as shielders, such as priority access to online delivery slots. This frustration was voiced by the same participant, who found their access to food services severely limited:

“[…] we fall between the cracks, really, because we’re housebound but not on the shielding list.” (Participant living with ME/Chronic Fatigue Syndrome)

This participant identifies a key problem that recurred throughout interviews. That is that lockdown for this group meant that some found themselves without the level of access to essentials that they had prior to the pandemic. This had the effect of thrusting people into an often-new system of food access that seemed, at times, to buckle. Furthermore, this system appeared to have little or no consideration built-in for the additional barriers that this group faced. Both, those shielding without a formal letter and those housebound, represent a collective group of what I would term ‘forgotten shielders’- a group whose needs appear to not have been met during lockdown.

Delivery issues don’t stop at the door

Once the supermarket food delivery systems were accessed, participants reported a mixed experience. Some found it worked for them, whilst others encountered a variety of problems. The inability of a major supermarket to provide a specific, and, in the case of the following participant, accessible time slot, was further raised as being a major issue:

“[…] it’ll be like an all day, eight ‘til four, or eight ‘til six slot, and that’s not great for me, because I tend to conk out unconscious, and the thing with these deliveries, they say, […] there has to be an adult to receive it.” (Participant living with MS)

One of the people I spoke to, who lives with a chronic debilitating illness, described a recent food delivery, highlighting how a ‘one size fits all’ delivery scheduling system can be inaccessible, dangerous, and the cause of extreme distress:

“[…] the other week I ordered shopping to be delivered, and obviously because I live up one flight of stairs, but the stairs are internal, so [I?] just like come in the front door and then it’s like a flight of stairs up to the rest of the house, and my health was so bad, like so bad, I could hardly get down the stairs. So, I said to the guy, I was like, could you like carry the stuff up the stairs? I can stand in another room or whatever, like…but like I’m disabled, I really can’t manage to carry the stuff up the stairs… I ended up like crawling up the stairs with the stuff that was supposed to be…that needed to go in the fridge, like the meat and stuff, and then I just sat on the floor in my kitchen and cried for half an hour, before I had the energy to put anything away. And like two days later, there’s still stuff like strewn all up the stairs and a friend came to visit, and he put a load of stuff away for me.” (Participant living with ME/Chronic Fatigue Syndrome)

Hearing from disabled people and those living with long-term health conditions has powerfully detailed how food delivery systems need to consider individual circumstances and needs. Current policies appear to neglect the individual needs of the person and assume that everyone is able to carry their shopping bags up the stairs, regardless of any impairment or health condition they may have. These issues suggest that the shielding provisions need to consider practical elements of people’s living conditions such as their type of housing. This offers an illustration of a form of discrimination called ‘ableism’. Situations such as those described above, illustrate how policies put in place to address food access can themselves create barriers to getting food. It should be noted that such examples are not failings of the individual delivery workers, themselves performing a job that may have placed them at additional risk throughout the pandemic, but of the system as a whole.

Getting food, but not what you need

The issue of having access to food, but not the food that you need, was also raised. For one participant living with Crohn’s disease, whose condition is triggered by eating gluten, a lack of gluten-free products meant they would sometimes go to bed hungry:

“A lot of the gluten free food was understocked, and, you know, that was probably the worst part of it I’d say, that was the most stressful part… the consequences for taking […] gluten far outweighed being a little bit hungry till morning.” (Participant living with Crohn’s Disease)

When delivery systems couldn’t be accessed, some people were forced to rely on support from informal sources. A person who took part in the study, who is registered blind, spoke of the loss of their additional support (home-helps), and described in detail their struggles to secure food. They highlighted a period when they were reliant on the generosity of a local bar and its workers:

“[…] the local bar sent me food, so that tided me over, and then somebody else in the pub took it on herself to a couple of weeks later, and she bought me food out of her own pocket, you know, so if it wasn’t for the support and the generosity, you know, people in the community, I would have been royally fucked, to be honest.” (Participant living with multiple health conditions and registered blind)

Accessing and using online food delivery services both during and post-lockdown has been extremely challenging for many of the official and ‘forgotten’ shielders. The issues and barriers  described by these people can be tackled, and it is encouraging to see the Scottish Government’s updated guidance, which states that the Government is exploring how to expand access to online delivery slots. However, to address the issues discussed in this piece, it would appear that a collaborative approach, which looks specifically at how to meet the needs of individuals, both official and ‘forgotten shielders’ alike, is needed. This should involve all stakeholders, including the major supermarkets, Government and, crucially, the people affected by this issue. This is particularly urgent given the resurgence of COVID-19 and the possibility of Scotland facing further public health restrictions as we approach winter.

Paul Pearson (@paulthepearson) is a Research Associate in the DHC stream on the Scotland in Lockdown Study. He is also a PhD student researching the lived experience of brain injury.

Mental health in Scottish prisons under pressure during lockdown

Marguerite Schinkel shares early findings from a prison survey disseminated across Scotland, exploring the difficulties experienced by prisoners as a result of the Covid-19 pandemic. This is a companion piece to an article written for Inside Time which will be published in November.

A recent study on the impact of lockdown conducted by the University of Glasgow included 87 survey responses from prisoners in all Scottish establishments except for HMP Addiewell and HMP Castle Huntly.

Asked ‘how has your life changed over lockdown’, many wrote about increased feelings of depression and anxiety. Respondents said these were caused by uncertain and changed routines, long hours of being locked up, few resources with which to pass the time (with libraries closed), not being able to see family and the sense of not being adequately protected from Covid-19. People complained about only being able to clean cells once a week, having to share with others, staff and prisoners not getting face masks in time or wearing them properly, problems with social distancing and a lack of care from staff. These findings built on concerns raised elsewhere.

Against this backdrop of poor mental health and descriptions of rising tensions, people found it difficult to access support. One person said they had been waiting since the start of lockdown for any kind of one to one contact with mental health services, despite serious issues. Another described how they had been advised to phone the Samaritans instead of looking for support within the prison but couldn’t afford to do so. This chimes with findings provided by Samaritans themselves (see RPsych in Scotland webinars, or download slides of Samaritans July 2020 presentation here). Yet another had turned to the chaplaincy team in the face of unavailable specialised services. Physical health was also an issue, with people not having their medical needs, such as diabetes, taken into account in the food they were given, or failing to get prescribed medication in time. Some explicitly linked the above problems to completed suicides, of which there have been a number during lockdown in Scotland.  The graph below shows that, overall, for most people life in prison is worse (in many cases much worse) during Covid-19, especially in relation to sources of support.

Graph: How are the following under Covid-19 compared to before?

Bar graph showing aspects of life that got better or worse for prisoners

Other respondents mentioned they had benefited from the lockdown in some ways. Some people who found the chaos of normal prison life difficult, especially being in big groups, found the lockdown regime easier, even describing it as a ‘reprieve’. Others had been able to stop taking drugs with fewer drugs entering the prison. Respondents commented positively on the introduction of virtual visits, which allowed some to see people who lived too far away to come visit in person and felt that mobile phones had made staying in touch with people outside easier. This should be read, though, against the total absence of visits at the start of the pandemic. There were also positive comments about the way that some staff had handled the situation and protocols being followed well.

These positive views ought to remind us that people are individuals and respond differently to the same situation, just as has been the case outside. Elsewhere, staff and family members have reported very negative impacts of prison restrictions, some of which might be easier to articulate for others.  Support should be in place for those who struggle and Scotland’s prisons have a duty of care to provide such support immediately to those most in need, lockdown or no lockdown.

Marguerite Schinkel (@margueritesch) is a Lecturer in Sociology at the University of Glasgow and co-lead of the Criminal Justice stream of the Scotland in Lockdown study.

Description of charts on this page

This graph shows responses to the survey question ‘how are the following compared to before?’ Bars indicate the proportion of respondents that responded either ‘Much worse’, ‘A bit worse’, ‘The same’, ‘A bit better’, or ‘Much better’.

It shows that, overall, for most people life in prison is worse (in many cases much worse) during Covid-19, especially in relation to life on the hall, contact with family and friends and access to support services.

Supporting Survivors of Domestic Abuse: Early findings from the Third Sector

April Shaw & the DASV research team share early findings from interviews with third sector practitioners supporting survivors of domestic abuse through lockdown. Practitioners have reported significant challenges during the pandemic, both in supporting survivors and maintaining their own well-being.

Scotland’s third sector has played an important and vital role in supporting survivors of domestic abuse and sexual violence through lockdown. We have spoken to staff from 17 third sector organisations throughout Scotland and the overwhelming response has been one of adaptability. Funding to deal specifically with Covid-19 was provided for some of the organisations but others have maintained their work within existing budgets while many remain in long-term insecure funding (see latest findings from the organisational survey).  All have had to adapt and innovate their practice while lockdown continues. Online support has been used to great effect for some while others have found it difficult to adjust due to unfamiliarity with digital technologies, lack of training in online working and lack of money to invest in new technologies.  

Moreover, the Covid-19 lockdown has shone a spotlight not only on financial, fuel and food poverty among survivors; it has also raised awareness of digital poverty. Helping survivors online is only possible if survivors can access online support safely. Some organisations reported that survivors at home with perpetrators could not easily maintain contact online or by phone – indeed some survivors have not been in contact and this has caused stress and worry for staff who were helping them. Many women reportedly do not want to access support remotely due to the unsuitability of their home environment (e.g. lack of privacy, poor reception/internet connection) or because they fear opening up difficult emotions without being in a safe space – either because they are worried that they won’t be able to cope alone with the distress or just that they are sceptical that online/phone support would be as effective. As one practitioner reported: In both scenarios, the human connection of inhabiting the same space seems to be important and a necessary factor for establishing rapport and trust”.  

Some organisations have been able, with help from external funding sources and from within local communities, to provide financial assistance for women and children. Food vouchers, food parcels, laptops for kids and help with smart phones has offered some relief but as waiting lists continue to grow, organisations have concerns that coming out of lockdown (and prolonging lockdown further) their services will be stretched even more.  

While partnership working has been good (e.g. sharing of resources, good practice and support) some have felt that statutory services have been slow to respond and adapt to the situation. In particular, survivors have been negatively affected by court trial delays, problems with bail restrictions and other case delays (echoing findings elsewhere). For example, it has taken longer to put Protective Orders in place. For some organisations, criminal justice delays have resulted in workers carrying larger caseloads and increased the backlog in cases, causing problems for staff and survivors alike.  

Issues around children are emerging as a distinct area of concern and stress. Mothers have justifiably been anxious about their children and schooling while delays in court proceedings have added further to their concerns. Child contact has been a huge problem for some, with perpetrators using contact as a means to manipulate survivors: e.g. by not taking children for contact visits or by suggesting they quarantine with their children. While courts were closed, any child contact arrangements that were not concluded left many women and children in limbo and anxious about their safety.  Furthermore, some organisations reported that government guidance has been confusing, particularly in relation to children accessing support from external agencies. Many workers and survivors thought there were no statutory services available while guidance on working with children is reported as ‘unclear’. Being unable to conduct face-to-face work with children has been particularly isolating for children and parents.   

Community diversity and inequalities present further challenges around Covid guidance. We heard these messages from DASV organisations working with BAME populations, where English is a second language (or not spoken at all) and with those working with homeless populations and people with learning difficulties. Ensuring these populations have access to appropriate information materials is paramount to their health and wellbeing.   

Maintaining staff well-being is another area that has raised some concerns (see early analysis of the organisational survey). Staff have endured the personal effects of lockdown, while also being anxious for the survivors and children they work with, particularly those they have been unable to keep contact with. Unable to meet face-to-face, some worry that their service falls short of client needs. Some organisations have by and large attempted to ameliorate staff anxieties with more regular check-ins, introducing well-being hours and generally supporting each other more often than pre-lockdown.  

Having adapted to lockdown with new processes and procedures, there is some optimism going forward (see our analysis of positives coming out of the survey). For example, online technologies have helped some organisations offer access to more services and support. Flexible working for staff (e.g. working from home) and new and creative ways of supporting groups and individuals online are also potential changes that may be adapted in future provision. Ensuring long-term funding for these third-sector groups is paramount to their survival and the important work they do with survivors of domestic abuse and sexual violence.  

April Shaw is a Research Associate in the DASV stream on the Scotland in Lockdown Study. She is also a PhD student looking at the lived experiences of older women in recovery from substance use.  

Funding lifelines but growing uncertainty: Early analysis of our survey of organisations (Part 3)

Sarah Armstrong shares findings from our survey of organisations. Funding in the third sector, already typified by instability and short lifecycles, has become even more unstable during the pandemic.

Previous blogs have shared early findings from our survey, including some positives of lockdown and some of the changes in service provision. This blog discusses the financial picture for third sector organisations and service providers. Emergency funding has been a lifeline for, and widely accessed by, many. However, this now has been spent, and organisations are facing a deeply uncertain period as we move into winter. Crisis support has offered both large and small lifelines to extremely isolated and vulnerable people but it is unclear how or if such support will be renewed.

This analysis is based on the nearly half of survey respondents (31 responses, representing 30 organisations) who answered at least some finance questions (as of 2 Oct, 63 responses). Abbreviations are used for the four sectors covered in the study: Refugees and asylum-seekers facing destitution (RAD); survivors of domestic abuse or sexual violence (DASV); criminal justice system affected (CJS); and those living with disability or long-term health condition (DHC).

Sources and stability of funding

“Generally speaking our funding is now much less stable than it was before, in common with many other charities.”  (CJS organisation)

“Hard to predict how stable or unstable funding will be in future but it is fair to say we are a very small charity and are always looking for funding.” (RAD organisation)

“We have to scrap around for every piece of funding opportunity.” (RAD organisation)

Three sources of funding were critical to the operation of services: Scottish Government, local authority/health and social care and charitable funding.

  • 68% of organisations receiving local authority funding depended on this source (defined as having 20% or more of all income from this source; average amount of budget covered by local authority funding was 33%)
  • 80% of organisations receiving Scottish Government funding were dependent on this (average amount of funding from this source was 38% of total budget)
  • 70% of organisations receiving charity funding were dependent on this (average amount of charity funding as portion of total budget was 40%)

Scottish Government funding was largely felt to be ‘stable’ (55% of respondents reporting this source of income) over at least the next year. However, the other sources of funding were reported by respondents to be ‘less stable’ or ‘unstable’: 74% of those receiving local authority funding rated this as ‘less stable’ or ‘unstable’ and 67% said this about charity funding.

Concerns about finances before, during and after the pandemic

“Funding an organisation like ours is always a struggle, it has simply become much more of a struggle over the past year or so.” (Community development organisation)

Nearly a quarter of respondents (23%) said that prior to the pandemic they had ‘high’ or ‘very high’ concerns about their funding, underlining the financial precarity of the sector. When asked about the state of their finances during the pandemic, these levels increased, nearly doubling so that 45% said they had ‘high’ or ‘very high’ concerns about funding. This figure rose again when asked to assess concerns about funding over the next year, to 66% of respondents.

Respondents rating funding as a ‘high’ or ‘very high’ concern at different points of the pandemic (n=31)

Chart showing respondents rating funding as high or very high concern

The pandemic seems to have intensified a feeling of funding instability that is part of the normal experience of service organisations. There is a concern not only about the increased costs of adapting to Covid-19 related lockdown (such as transitioning to online services) but wider economic instability and the impact of this on funding availability:

“The economy has taken a battering as well, which in turn may reduce the available income of charitable funders due to a downturn in their investment income. We are keeping a close eye on this.” (CJS organisation)

Emergency funding

Most respondents sought, and also received, emergency grants to support their work: of 28 applying for emergency or crisis funding, 86% were successful (24 organisations; four were unsuccessful). Two of the unsuccessful organisations were in the CJS area; the other two were a DHC organisation and a refugee and asylum seeker’s organisation.

The figure below shows successful emergency grant applications by sector. The number of DASV organisations (11) successfully applying for grants is the same as for all other sectors combined (and the one successful BAME women’s organisation also works to some extent with women in abusive situations). The second largest category receiving emergency funding was the RAD sector. This may not be surprising as many RAD and DASV organisations provide refuge accommodation, and the loss and need for safe housing has been on the Government radar from early in the pandemic.

Emergency funding by sector (n=22)

Chart showing respondents receiving emergency funding

Emergency and crisis funding has supported organisations in several clearly identified areas, underlining the primary areas of need:

  • emergency accommodation costs (including offsetting loss of housing benefit for some)
  • food provision
  • digital/technological inclusion for both staff and service users
  • wellbeing support

Comments from respondents detailing how emergency grants were used convey this:

food preparation, delivery, baby and mum provisions, travel expenses, unconditional cash grants up to £50, phone top ups (RAD organisation)

IT provision for staff working from home (DASV organisation)

buying food and laptops for the families (RAD organisation)

to support service users ensuring they have access to internet through the provision of dongles, tablets etc and provision of supermarket vouchers and tops ups for phones and utilities and wellbeing pack  (DASV organisation)

the costs of moving to home working  and remote delivery of support (DASV organisation)


Some noted that emergency funding was fairly accessible and generous early in the pandemic lockdown buffering the impact on organisations and their services:

“The pandemic has, bizarrely, created a short-term ‘windfall” in terms of availability of funding.” (CJS organisation)

We are now entering the seventh month of Covid-19 restrictions with furlough schemes ending, cases spiking and colder temperatures of the autumn and winter coming. The need for supplemental and more stable sources of income for frontline services will not be decreasing, and crisis funds have now been spent. Uncertainty about the future was a theme raised in comments and it is difficult to imagine maintaining even close to a similar level of services without another round of emergency funding or more stable support.

Some costs have been one-off, such as buying equipment, enabling staff to work from home, or for service users to keep in touch with services that are now online. Other costs have been for basic needs that will be ongoing – food, housing, mobile phone top-ups.

A final note related to emergency funding during the pandemic is the extent to which small amounts have been a lifeline for service users. One month of phone data, £50 in cash, a food delivery, a wellbeing pack – these have been common means of providing crisis support to clients. These direct forms of support often are carried out by the smaller organisations, and those working in domestic abuse or refugee/asylum areas.

Sarah Armstrong (@SarahAinGlasgow) is Professor of Criminology at the University of Glasgow and co-lead of the Scotland in Lockdown study.

Description of charts on this page

The first graph on this page shows respondents rating funding as a ‘high’ or ‘very high’ concern at different points of the pandemic

It shows that 66% of respondents have ranked funding as a ‘high’ or ‘very high’ concern over the next 12 months.

The second chart on this page shows emergency funding by sector. It shows that the number of domestic abuse and sexual violence service providers have applied for emergency funding the most, followed by the refugee and asylum service providers.

Less, more, gone and new: Early analysis of our survey of organisations (Part 2)

Ryan Casey shares more early findings from our survey of organisations. Service providers have faced a uniquely challenging time during lockdown, reporting increased demand from client groups for food parcels, equipment for digital inclusion, and social activities.

In a recent blog, Gareth Mulvey analysed what the first respondents to our survey, received between 28 July 2020 and 21 August 2020, had identified as short – and potentially longer – term positive effects of lockdown for service providers in Scotland. The survey captured the experiences of organisations working with people in particular situations: disabled people and people with long-term health conditions; at risk of domestic abuse or sexual violence; under the control of immigration authorities or involved in a refugee/asylum process; and imprisonment or other form of criminal justice control.

Using the first 36 responses (received between 28 July 2020 and 21 August 2020), this analysis will discuss how organisations responded to the following survey question:

What services does your organisation normally provide?

As well as two follow-up questions:

How has capacity to provide this service changed?

How has demand for this service changed?

These questions were designed to get a better sense of how service provision in Scotland has changed as a result of the pandemic. What did work ‘normally’ look like? What does it look like now? What kind of support or services are being asked for? Across those initial 36 responses, there was a total of 266 services to account for, with a response average of 7 services per organisation. Before lockdown, the most common services included:

  • Service referrals
  • Social activities
  • Training/skills
  • Telephone support
  • Advocacy

Unsurprisingly, many of these services were and continue to be significantly impacted by lockdown measures and restrictions.

Less and lost services

Group work had to stop entirely. For instance, we run a personal development programme exploring gender that had to stop as well as a recovery group for addictions, cookery project and more.” (Community development organisation for women)

We have not discontinued any services completely, however, we are offering face to face support only in emergency circumstances.” (Domestic abuse organisation)

When asked about changes in capacity to provide service during lockdown, organisations reported 44% of services were operating at decreased capacity or completely discontinued. The majority of them involved face-to-face work and support as well as community-oriented events such as group work, community meals, social events, and individual face-to-face support. Some organisations have mentioned that they needed to cut some services in order to maintain others, which emphasises the importance of funding and resources, particularly for smaller organisations with less financial stability.

More and new services

Two of our services (training and group work) were suspended temporarily, with group work participants receiving one-to-one online support instead. Both of these services are now back up and running online via webinars and online group support and activities. Both are reaching audiences who struggled to access these services in the past due to their geographical location, so this has been a good piece of learning for us.” (Organisation working with criminal justice affected)

At the same time, organisations are seeing service users looking for different forms of support and needs to be met. While food distribution capacity has not changed much, demand for food parcels has spiked significantly. We are also seeing increased demand for telephone support, social and cultural activities, and training/equipment provision to support digital inclusion (tablets, devices, internet connection, etc.).

Many organisations have found innovative and creative ways to respond to these challenges. Telephone support has become a vital way to stay in touch with service users for welfare checks and befriending. Some organisations are even providing mobile phones, top-ups, and training on how to use these devices so that people who were digitally excluded have a way of staying in touch with support workers. Within the context of the digital divide, it is likely some people will have lost contact, but these new organisational responses show us that efforts are being made to bridge that gap. More generally, it seems that day-today work is moving online if it had not done so already. Videoconferencing, online contact forms, remote appointments, blogging, and English for Speakers of Other Languages (ESOL) conversation Zoom groups are just some of the adjustments organisations are making to their daily activities in order to carry on.

Further and fuller analyses of the survey data is underway, but from this glimpse we can see that this has been a uniquely challenging time for organisations and service providers in Scotland. Priorities are shifting, support is taking new forms, and for many, work is becoming more personal than ever before. Within the survey responses there is a sense of exhaustion, but also perhaps a renewed sense of purpose as organisations evolve alongside these unstable circumstances. Yet, it must be asked whether this is sustainable? Can and should people continue to work in this way?

Ryan Casey is a Research Assistant in the Criminal Justice stream of the Scotland in Lockdown study. She is a PhD researcher at the University of Glasgow working on ‘Left to their own devices: A technosocial ethnography of penal electronic monitoring in Scotland.’

Positives of lockdown: Early analysis of our survey of organisations (Part 1)

In this blog, Gareth Mulvey, a co-Investigator in the Refugee and Asylum stream offers an early analysis of our study’s organisational survey.

Our survey has been completed by organisations and service providers in Scotland that are working with people in particular situations: disabled people and people with long-term health conditions; domestic abuse or sexual violence; control by immigration authorities or involved in a refugee/asylum process; imprisonment or other form of criminal justice control.

This analysis covers responses to the survey received between 28 July 2020 and 21 August 2020. It analyses responses to this question:

Are there any positives you have seen in the context of your work during this pandemic?

It finds a number of ways that organisations and groups identified short- and potentially longer term positive effects of lockdown. Of 36 responses received at this point, only 5 did not respond or responded ‘No, no positive effects of lockdown’. This left 31 respondents or 86% of the sample at this point of the pandemic seeing some positive sides of the response to Covid-19 lockdown.

While quite a number of responses to the question of whether there have been any positives arising from the pandemic unsurprisingly said no, there were also a number of responses that indicate positive changes in working practices as well as a flourishing of community care practices.

Regarding the former, many respondents talked of the crisis making them rethink how they do certain things, e.g. communication, using technology (for visits) etc. In some cases the changes were ones long discussed but never implemented and the pandemic has forced that implementation. For others, changes were more dramatic and immediate, but in both cases they seem to have been at least partly positive, evidenced in the fact many believe post-pandemic these practices will continue.

Some aspects of client engagement have increased: there are often more check-ins with clients (albeit not face to face) and a deeper understanding of their issues, though this must be put in the context of the digital divide, with concerning evidence that some people are falling off the radar of services completely.

Another impact on practice mentioned has been the mobilisation and joint working of the third sector. A number of responses talked in very positive terms about the ways in which the third sector and community groups have stepped into the vacuum created by the pandemic and the required changes in service provision. Very quickly these activities appeared to become coordinated so that organisations were working in complementary ways.

The creativity and drive of staff is also mentioned, though there must be some concern about longer term burn-out issues here. Nevertheless, staff and volunteers have been extremely motivated to help and groups and organisations are very appreciative of that. The fact that more staff are being enabled to work flexibly and that there appears to be a little more independence and autonomy for staff was also mentioned as a positive. Traditional top-down management styles in some cases have had to be loosened.

Less organisationally, there is also a sense that ‘out there’ in communities there have been some positive impacts of the pandemic. Increased neighbourliness is mentioned alongside a sense that new communities are in the process of being built around mutual aid groups and service provision. So community interaction has in some cases increased despite restrictions on movement and community generosity has been made more visible

A final issue worth mentioning is that some funders are seen to have responded well particularly in emergency/crisis support, and also in some cases with support being rolled over, though it is important to note analysed survey responses were those submitted prior to GCC’s announcement of huge third sector cuts.

Gareth Mulvey is co-Lead for the stream on Refugees, Asylum-seekers facing Destitution. He is Lecturer in Sociology at the University of Glasgow, working on issues of migration, migration policy and the impact of policy on diverse migrant communities.

Living through Covid-19 with type 1 diabetes: Emerging findings

Chris Bunn, an Investigator in the Disability and Health Conditions stream, shares emerging findings from interviews with people living with type 1 diabetes during the pandemic.

The Covid-19 pandemic has been testing for most people in one way or another. Those living with long term health conditions have had to confront the additional challenges of judging how to protect themselves from Covid-19 while still being able to feed themselves, adapt to new routines, access medical care and remain connected to their family and friends.

Early on in the pandemic, people living with diabetes were told that they face greater danger from Covid-19 than others. Small-scale studies, such as this one in China, emerged rapidly and suggested that diabetes increases the risk of death from Covid-19. Since then, researchers have conducted larger assessments of the connection between diabetes and Covid-19 outcomes, and have confirmed that there is a strong link. Responding to these developments, diabetes groups have played an important role in reassuring their members that they are not at greater risk of catching Covid-19, reminding them that for most the virus produces mild symptoms.

While such reassurances have been welcomed by many in the diabetes community, it is clear many of its members remain concerned about Covid-19. This became apparent to us when we launched our study and appealed for people to participate in interviews. We received a large number of replies in a short space of time from people living with type 1 diabetes who wanted to share their experiences. While we have also interviewed people with type 2 diabetes, we decided to respond to the groundswell of volunteers from the type 1 community and to explore with them what their lives have been like during this period.

The disappearance of specialist care

So far, we have interviewed about half of our intended target of 25-30 people. Most of the people we have spoken to have told us that their appointments with diabetes specialists have been cancelled and no new appointment date has been provided. While our interviewees have been understanding of the pressures the health service is under, many also expressed concerns about this loss of care. One described how eye and nerve-related complications from their diabetes are no longer being monitored, telling me that they feared this leading to preventable damage being missed. Several others have echoed this concern, describing how the cessation of regular screening for complications worried them. This is not surprising, given so much diabetes care emphasises the importance of monitoring the complications that can build up over time.

Others we have spoken with have given us accounts of how lockdown measures prevented them from starting new treatments. Two of our participants were due to begin using an insulin pump – a device which releases insulin into the body throughout the day, allowing patients freedom from having to inject themselves regularly. Insulin pumps are often recommended for people who are finding it difficult to meet the blood glucose targets that their doctors are pursuing with them, suggesting that Covid-19 related delays may be keeping these patients from accessing the treatment they need to attain better blood glucose regulation.

Common to all of the accounts we have collected so far is a sense that communication between diabetes services and their patients could improve. With the exception of one interviewee, remote consultation via telephone or video has not been offered and no information provided on how to access care if needed. In one interview this was a complaint that was emphasised, with the participant telling me that it would have been of great comfort to have had a list of services to contact in the event that different needs arose relating to diabetes.

Negotiating new routines

For people living with type 1 diabetes, routines can be important for managing their condition. The timing, amount and type of food that they eat and physical activity they do can make a big difference to their blood glucose levels. Unsurprisingly, for many of our interviewees the restrictions of lockdown led to changes to their usual activities and foods. Some of those we spoke to described how this led to fluctuations in their blood glucose levels which they struggled to contain. Some increased their insulin consumption, but others accepted higher levels, preferring not to risk hypoglycaemia at a time when they feared the potential consequences of hospitalisation.

The impact of disruption to routines was not just described as a challenge to physical health. Our interviewees spoke of how they have struggled with the loss of social contact that their routines provided them with. Whether through work, socialising or even visiting favourite shop keepers, some of those we spoke to found the absence of in-person contact made them feel down and question their mental health.

Some silver linings

While the challenges of living with type 1 diabetes during the Covid-19 crisis have dominated our interviews so far, some have described some positive developments in their lives. One interviewee told us of how the furlough scheme had enabled them to take a break from working which they had not had since they entered full time employment at the age of 16. This break gave them the opportunity to reflect on the direction their life was taking and decide to enrol in and start an access to university course, with the aim of improving their future.

Another of our interviewees spoke about how lockdown has allowed them to witness the growth and development of their newborn baby in a way that would not have been possible without lockdown and furlough. This person emphasised that this was an experience that could never be taken away from them and was a source of emotional strength during an otherwise difficult period of life.

Looking ahead

From the interviews we have conducted to date, it is clear that people living with type 1 diabetes in Scotland have faced significant challenges during the Covid-19 pandemic. While this blog post has shared just a snapshot of what we are learning, it underscores the most important message we have been given from the community: diabetes care has faced massive disruptions and many patients are not being communicated with.

While it is too early to know the full extent of the consequences this disruption will have for the health of those living with diabetes in Scotland, early warning sirens are starting to sound. A study in Naples, Italy has reported that foot amputations among diabetes patients with foot ulcers have increased three-fold in 2020 when compared to 2019. As the Covid-19 pandemic continues, diabetes care in Scotland and beyond needs to adapt rapidly to limit the damage that avoidable complications can do to the lives of people living with diabetes.

If you or someone you know is looking for guidance on managing diabetes and accessing care at this time, Diabetes Scotland has some useful information. They also offer a helpline, which you can reach on 0141 212 8710, Monday to Friday, 9am to 6pm, or by email –

Chris Bunn is a Lecturer in Sociology at University of Glasgow. His research is focused on living with, managing and preventing long term health conditions.