Coronavirus epidemic and Ipswich Disabled Advice Bureau

It is now late June 2020, and four months since the coronavirus epidemic started to affect the work of Ipswich Disabled Advice Bureau. It began during the third week in February 2020 when somebody dropped in for advice – they have a disability and worked part-time for a company with a contract with the Port of Felixstowe. ‘Furlough’ was still a month into the future, but because ‘no ships were coming from China’ the contract had been suspended resulting in the client being laid off until late May or June with no other income…..the first of many.

We hot desk a lot and so constantly cleaning desks, phones and keyboards quickly became the norm…..then the main entrance of the building, where we are based was closed to visitors, but we still saw some people for face- to-face appointments, whilst starting to change to telephone appointments for all clients as more and more received instructions to shield for a twelve week period.

The government started to talk about furlough in early March as many companies were, by then, in the same situation as the one at the Port of Felixstowe. On 17 March 2020, volunteers and staff started to receive notices from the NHS, instructing them, or a member of their household, to shield, indoors at home, for twelve weeks. Hence, by the time ‘lock down’ was announced things actually changed very little at Ipswich DAB, as our volunteers and most of our staff were shielding – we ‘furloughed’ our receptionist because we would not be having visitors for some time and they had to travel to work by public transport. A further member of staff is on statutory maternity pay until September. Effectively, just three staff were affected by lockdown, the Bureau Manager – deemed the ‘essential worker’ responsible for running the organisation, and two part time staff, an Adviser (7.5 hrs/wk) and our Funds Manager (4 hrs/wk).

Staff who were shielding wanted to work from home and we had a full appointment diary. Also, having a structure to their day would support their mental health and wellbeing and, help to ensure that there would be a role for the volunteers to return to in the future. If we furloughed them, they could not do any work for the organisation. We did not want to lose our staff and volunteers as they are trained and have years of experience. Normally, we can receive up to thirty telephone calls a day. Our new digital phone system – installed in July 2019 – could have an App installed, which staff could download to their smartphones. Their smartphones, when signed into the App, function as if they are the handsets in the office – which was a bit confusing for callers as we appeared to be answering when they dialled Ipswich DAB’s number, but at the same time a notice on the door was saying that the office was shut!

Whilst staff used their own equipment at home – fortunately everyone had a computer and printer – everything else they needed had to be delivered to them – stationery, stamps, ink cartridges, client files for Tribunal hearings, incoming post etc. The Bureau Manager has been the ‘courier’ and is doing a round trip of five miles several times a week. She also deals with phone and email requests-passing them to Advisers as appropriate, making bookings for appointments and circulating copies of the appointment diary. Most calls are for advice on a wide range of disability issues rather than appointment to complete forms, which is a change to our usual work pattern.

Then, in early April, one of our staff who was already shielding, began to have symptoms of Covid-19, which was very concerning. The only way to get tested was at a ‘drive-thru’ facility and they do not have a car. Home testing was still a week away but when it became available they did test positive, along with their partner. Their symptoms remained mild, but they tested positive again a week later and had to remain in quarantine for a further 14 days. However, they wanted to carry on working – so everything had to be recorded electronically for another Adviser to transfer onto claim forms, or print letters out and send to clients for signature..

We have had to modify our work patterns, and in the early days of lock down, the staff were watching with interest as the Bureau Manager, had to come to terms with owning and using, a smartphone for the first time, as the App on the digital phone system only works with Android!

Another example it that completing a PIP form rarely takes more than two hours in a face-to-face situation but clients can find it more difficult to concentrate on a phone call of that length and so, sometimes, completing the form has had to be split between two one-hour appointments on different days.

Tribunal hearings, via telephone conference calls, have all been longer than when they are heard in person. The presiding judge can be calling from anywhere in the country – Ashford, Cambridge, Hastings, Norwich, Harlow, Reading but only one in Ipswich so far – and we do not know whether the other panel members are at the same location. A very recent Tribunal hearing took place by telephone conference call between our representative who is visually impaired, the client who had her husband with her for support, as well as an interpreter by phone as her first language is not English, and a Tribunal panel by phone comprising the judge, a doctor and a disability specialist who had both a signer and sign language interpreter assisting them.

Our Senior Adviser often gets booked by HM Courts and Tribunal Service for two Tribunals at the same time – one will be a PIP and the other ESA or Universal Credit as they are dealt with by separate teams at HMCTS. Transferring this scenario to the telephone conference call situation, a cartoon emerges of him using one ear for one hearing and the other ear for the other hearing – and this very situation was scheduled to happen on 1 July 2020! However, another Adviser has changed her days around and will represent at one of them, so as to provide two ears for each hearing!!  

Recently, we have had more requests for client appointments via video links and one has already happened. We try to use Google Meet because we feel that it is more user-friendly for people with hearing loss or slow information processing, as it can show subtitles. We have steered away from Zoom as not all insurance companies are happy to cover it for business use; but we are looking at how we can use Whats App without using Advisers’ personal smartphones, as many clients use this App to contact their families and are familiar with it. We are lucky to have volunteer ‘IT and smartphone wizards’ to sort this out.

Clients, particularly those who are shielding, have chatted to us more than usual when we have contacted them, and this mirrors what we find during face-to-face interviews – they become less anxious during appointments as they feel that by talking to somebody, ‘their problem’ is being dealt with and some responsibility has been taken from their shoulders. It can be a huge effort mentally and physically for many clients to leave their homes to come to our office – and whether we should ask them to continue to do this, is a question for the future.

Also, we feel that some of our clients have become more confident and independent when dealing with their welfare benefits during lock down – not necessarily at completing the forms, but in following directions to get medical evidence, or simply being on the end of a phone with the paper work, that we had said they would need, in front of them when we contact them; signing letters sent to them and attaching the correct documents and getting them posted, and it has all had to be done at a distance. Whether we can build on this is another question for the future.

It gradually became apparent over the past four months that, sadly some clients who we have assisted for a number of years, we will not see again. Also, that our workload will increase as a result of the legacy of surviving Covid-19, especially for people who needed ventilation, or other support, to maintain their oxygen levels. There have been numerous forecasts of a Covid-19 legacy of health problems by senior scientific and medical professionals, and this is explained in the link below:-

The first Covid-19 survivor to contact us was S. and she did so in mid-June. S. has agreed for us to put her story on our website. We did already know S. as we have advised her son, who is a wheelchair user following a fall, resulting from a seizure.

S. works as a receptionist at Ipswich Hospital. Her husband was admitted to hospital on 8 March 2020 requiring oxygen support for breathing difficulties, which were initially diagnosed as pneumonia affecting one lung. A routine test, after admission, was positive for Covid-19. S. at that time was feeling very fatigued, despite often having additional periods of sleep during the day for up to five hours, but she put this down to worrying about her husband and supporting her son.

On 18 March 2020 she woke up and was struggling to breath……it was the day that her husband was due to be discharged from hospital and return home ……but she told her son to call an ambulance. Six hours later, she was in the Intensive Care Unit and connected to a ventilator. She remained on the ventilator for 19 days and recalls experiencing some vivid hallucinations. It took four attempts by medical staff for her to make the transition to breathing for herself through a mask providing additional oxygen. During the three failed attempts her heart could not cope with the demands on it, without the help of the ventilator. Four days after being disconnected from the ventilator, she was discharged to recuperate, shielding in a separate room at home, where she remained for two months.

S. is still shielding at home with the Critical Care Consultant keeping phone appointments with her. She has post-ventilation fatigue syndrome and he has told her that he cannot say when she will recover as he, and his medical colleagues, simply do not know how long it will take. She is also having some help from a Speech Therapist due to the effects of the tracheostomy, needed for the ventilator, on her vocal chords. Her only previous problems, of note, were pains in her legs which were under investigation. The period of time she was immobile on the ventilator has exacerbated this problem – now thought to be a vascular issue – and she is having difficulty walking around the house and standing to do short and simple tasks in the kitchen.

Mentally, she has to come to terms with the fact that she is very lucky to have survived, that Covid-19 is still around, and that she could have a long journey back to full-health.

Ipswich DAB’s staff and volunteers have now been shielding, with staff working from home, for over three months and our Trustees agree that this should continue for a further month at least. The government has said that ‘shielding’ will officially end on
1 August 2020 and those affected can return to work. However, further letters from the NHS have gone to people who are shielding stating that they can continue to go into their gardens, and meet up with one person outside of their household whilst socially distancing during July. There is a big gap to be bridged between the NHS instructions and working with clients face-to-face on the front line, and the responsibility to get this right appears to lie totally with employers.

Likewise for clients who have been shielding, it is going to be a huge step to get on a bus to travel to a face-to-face appointment. Added to which the building at 19 Tower Street, which is grade II* listed and dates back to the late 1700s does not lend itself to social distancing, particularly the entrance area and corridors. Plus, within a two minute walk of the building are four pubs whose customers will have to drink outside, rather than inside, when the pubs re-open and only one pub has a garden.

Therefore, home working and telephone appointments will not suddenly stop at a given date because they are enabling us to provide flexibility for clients, staff and volunteers; and appointments by video link look likely to increase. Face-to-face appointments will have to be managed differently in future, and they may no longer be the automatic choice of clients who have been shielding for over four months, if Covid-19 continues to be a threat and a vaccine is not available.

We are told that Covid-19 will be around until Spring 2021 when the virus could burn itself out, but our work related to the coronavirus epidemic will continue long after that – so watch this space.

Stay safe, keep well.