‘It’s Hard Work Being Poor’

A new report has found shocking evidence that women in Scotland are suffering increasing hardship, destitution, and food insecurity due to lack of support during the cost-of-living crisis.

In research conducted in partnership, the Poverty Alliance and the Scottish Women’s Budget Group (SWBG) found that women are experiencing increasing financial hardship and are at risk of falling into further debt as a consequence of the cost-of-living crisis. Women in low-paid work reported often missing out on social security support or cost-of-living payments, or free school meals, because they earn just above income thresholds.

The research was funded by abrdn Financial Fairness Trust and Esmée Fairbairn Foundation and included women from diverse backgrounds across Scotland. Women told researchers they are worried whether they will be able to afford their energy bills in winter and parents and carers are struggling to afford food and essential items like baby wipes, incontinence pads, and toilet roll.

The report contains 15 recommendations on how to better support women through this crisis and beyond. Key priorities include:

  • Ensuring adequate incomes for all through a “caring social security system”;
  • Investing in preventative public services and in support and advice services to help people manage debt;
  • Improving community amenities and services, ensuring that support provided is free from stigma;
  • For the UK government to uplift social security in line with inflation;
  • For the Scottish government to expand eligibility to sources of emergency support for women experiencing in-work hardship.

Download the report from here.

SWBG co-ordinator Sara Cowan said: “The costs crisis is affecting the vast majority of us, but this powerful research highlights again the unjust way that poverty especially affects women in our society.

“Women are more likely to be poor, have lower levels of savings and wealth, and are less able to find suitable work or increase their hours if they’re in work often due to caring responsibilities that fall disproportionately on women.

“The women in this research talked about the impossible decisions they had to make to prioritise feeding their children, and whether or not to turn the heating on. Or not being able to buy things like baby wipes, incontinence pads, or toilet roll.

“The Scottish and UK Governments can help by increasing and extending the emergency support available to people, and working to put justice and compassion at the heart of social security and our public services.”

Vivienne Jackson, Programme Manager at abrdn Financial Fairness Trust, said: “This important research shines a light on the real experiences of women in Scotland. It’s not right that people are struggling to afford to feed their families, or having to live in freezing cold houses because they can’t afford to put their heating on.

“We hope this research will add to the growing body of evidence that households need much more help from government during this crisis, and that we need to make financial fairness an urgent government priority.”

Fiona McHardy, Research and Information Manager at the Poverty Alliance, said: “This research shows that women are at risk of being pushed into destitution. The financial support that has been made available so far by both UK and Scottish Governments to help with the cost-of-living crisis is clearly not sufficient for many of the women in our study.

“It is vital that the UK Government increases the value of social security benefits in line with inflation. Any cut to UK benefits will led to unacceptable hardship for more women.

“In Scotland, we must find ways to expand eligibility for people who are in employment, are in need, but miss out on support. Too many women in Scotland are in urgent need of support – Scottish Ministers must leave no stone unturned in finding resources to support them during this crisis.”

Women’s Realities (case studies)

The diary entries and interviews document women’s increasing desperation and despair as costs kept rising and incomes stayed where they are.

Stella

Stella, a Black lone-parent mother living with her children. Due to illness and subsequently losing employment, she had to apply for Universal Credit two years ago.

Even before the cost-of-living crisis, she noted how Universal Credit was an ‘insufficient means of livelihood even under normal circumstances as a single parent’. Now, due to increased utility bills, Stella supplements income with credit cards, which are accruing debt, and asking to ‘borrow money from family and…friends for financial help’. Stella was concerned about her energy bills, so now she only uses the washing machine once a week for her family.

Stella’s children were conscious of rising costs: ‘even as a child [her son] realises how much food bills have increased, and it impacts him greatly’. On top of the impact this is having for her child, she shared that she is having to consider ‘significant changes in [their household’s] diet’.

Stella was becoming increasingly socially isolated because of the high cost and unreliability of public transport. Consequently, she is unable to ‘attend church every Sunday. This impacts me spiritually and deprives me of much needed interaction and social isolation’.

Her September entries were mainly focused on how price rises were impacting every aspect of her family’s life. Food was costing over £20 more each shop, and when thinking about the future, she noted: ‘it will be too much and [she] will not be able to afford it’.

Stella wrote: “This cost-of-living crisis have brought untold pain and suffering on women especially single parents and children because of the way it impacts our lives on a daily basis. Not being able to afford the essentials of life can be very stressful and robs women of their dignity and self-worth.”

Sue

Sue is a white lone parent mother who has long-term health issues. She works part-time and recently stopped accessing Employment and Support Allowance by taking on a second low-income job.

To manage increased costs of living on her low income, Sue made a list of ideas including getting another part-time job, asking for more hours in her current employment, asking for a mortgage holiday, skipping meals and selling jewellery and things in the house. She wrote: “Sad one this for me, sold jewellery, mine and my gran’s wedding rings…but it is to help in a crisis that our household is facing and needs action fast so it had to be done”.

Idia

Idia, a lone mother, reflected on the challenges of being able to afford food and going hungry in almost all her diary entries. On the small amount she receives as an asylum seeker for her family, she wondered how she is expected to be able to buy food with costs rising week by week. She shared the damaging impacts on her mental health. She also shared: “the most frustrating part of the week for me was not being able to afford to get my kids snacks”.

“I spoke to my friend who told me she has been starving and only eats at night,” Idia said. “I have started doing that though it didn’t go well with me the first day, but I will get used to it.”

Sarah

Sarah is a parent and works full-time in a role providing advice and support to people in the community. In October, she was concerned about managing her existing debts and rising energy costs, particularly as she lives in an old house with poor insulation. She is no longer able to afford to go out places and see family or friends. Her interview highlighted the challenges for people in low-paid work during the crisis. She is not entitled to benefits or support with the cost of living.

Sarah said: “And I was thinking, ‘How can I… how can I keep my daughter, how can I keep warm? What if I have to go to work and then come home and freeze my ass off every night. And I was, I honestly got to the point where I was thinking, ‘What’s the point of living?’ You were going into shops, the prices were going up so much, and it was like, ‘Well I work so God damn hard, I get no help. I’m helping people get help, do you know what I mean? But yet I can’t access any help myself?’.”

New campaign to maximise Scotland’s economic potential

Law firm CMS and the Fraser of Allander Institute has launched a new campaign aimed at bringing together Scotland’s business community, government and policy groups to maximise the nation’s economic growth potential.

The International Scotland initiative begins with the release of a new report highlighting some of the core opportunities for Scottish business, trade, and tourism to excel on the international stage.

The International Scotland report sets out how the nation punches above its weight in key sectors such as renewables, tourism and food & drink. It also recognises the strength of the Scottish university sector in supporting new, innovative companies and highlights how Scotland is an ideal location to attract international talent.

The report also focuses on some of the pros and cons of Brexit, suggesting that the UK’s exit from the EU could bring opportunities for the whisky market in nations like India and has also resulted in an upturn in international students at Scottish universities. It does, however, highlight the damaging impact Brexit has had on supply chains and many companies’ ability to do business, as well as its detrimental effect on foreign investment into Scotland.

A full copy of the International Scotland report can be found here

CMS and the Fraser of Allander Institute will now stage a series of events across Scotland involving direct engagement with the business community, Scottish Government ministers and other policy influencers.

Richard Lochhead MSP, Scottish Government Minister for Just Transition, Employment and Fair Work, will address the first event, focusing on Scotland’s transition to net-zero, in Aberdeen on 22 November.

Ivan McKee MSP, Scottish Government Minister for Business, Trade, Tourism and Enterprise, will then speak at an event focused on his ministerial remit in Edinburgh on 23 November. Mr McKee will also address the final ‘Invest in Scotland’ event, taking place in Glasgow on 7 December.

During the events, participants will discuss the key themes covered by the International Scotland report with a focus on developing policy proposals and recommendations aimed at reducing economic barriers and maximising global economic opportunities.

Companies and individuals wishing to apply to attend the events can register their interest here

Allan Wernham, Managing Director of CMS Scotland, said: “CMS is proud to join forces with Fraser of Allander Institute to launch the International Scotland campaign.

“Leveraging the knowledge and expertise within both organisations, we are focused on the core themes of business, trade and tourism; inward investment; and the transition to net zero and the key opportunities and challenges for Scotland in fulfilling its full economic potential.

“We now look forward to engaging in further discussions with the business community, government and policy groups to build consensus on the best way forward and develop innovative policy ideas that will help the Scottish economy to thrive.”

Professor Mairi Spowage, Director of the Fraser of Allander Institute, said: “We are excited to work with CMS on this new, internationally focused campaign.

“Using the evidence base highlighted in the International Scotland report, we will engage with a wider cross-section of stakeholders to explore the key barriers and enablers for the Scottish economy on the international stage.

“The forthcoming events taking place across Scotland will serve as the basis for feedback, input, further reflection and, ultimately, policy recommendation to drive economic growth.”

£150,000 Award for Civic Arts Organisations open for applications

Calouste Gulbenkian Foundation opens applications for £150,000 Award for Civic Arts Organisations

Cultural organisations across the United Kingdom have been invited to apply for the £150,000 Award for Civic Arts Organisations, run by the Calouste Gulbenkian Foundation. 

This year’s award is themed around ‘Co-Creating the Future’. It spotlights organisations that are helping to transform communities, even in the most challenging of contexts – whether by igniting joy, hope, compassion and energy, improving wellbeing, forging new connections, or developing solutions.

The Award for Civic Arts Organisations began in 2020, as a response to the Covid19 pandemic. This year, many arts organisations still face difficulties: according to Arts Council Wales, the costs of staging cultural activities have risen by as much as 40 per cent. The Award offers prize funding of £150,000, one of the largest amounts for an award in the arts.

Louisa Hooper, Director of the Calouste Gulbenkian Foundation (UK Branch), said: “The Award for Civic Arts Organisations is designed to support cultural projects that put community at their hearts. In difficult times, it’s more important than ever that art and culture are available to everyone.

“By prioritising co-creation, this year we’re looking to recognise organisations that create lasting change by working with and in communities to address their needs and concerns, deepen relationships, and use arts and creativity to enable positive change.”

Previous recipients of the award include The Art House in Wakefield, which created the first studio sanctuary for asylum seekers in the UK, Project Art Works, a collective of neurodivergent artists and activists based in Hastings, and Heart n Soul and the Museum of Homelessness, both based in London.

Baroness Bull, chair of the Award panel, said: “The Award for Civic Arts Organisations is vitally important in encouraging and rewarding genuine engagement and co-creation with local communities.

“In the years since the award was founded, we’ve seen hundreds of entries from organisations across the UK demonstrating a commitment to changing lives through art.”

Sydney Thornbury, CEO of The Art House in Wakefield, highlights the impact the award can have for organisations themselves: “The stability the Award provided combined with these new funding opportunities has deepened the work we were already doing and has opened up new opportunities for how we can further extend our civic impact.”

The independent panel of judges are Darren Ferguson, CEO/Founder, Beyond Skin; Ica Headlam, Founder, We Are Here Scotland; Philipp Dietachmair, Head of Programmes, European Cultural Foundation; Rachel Noel, Head of Programmes and Partnerships, Tate; Rhiannon White, Co-Artistic Director, Common Wealth Theatre; Saad Eddine Said, CEO/Artistic Director, New Art Exchange; and Sydney Thornbury, CEO/Artistic Director, The Art House (main recipient of 2022 Award).

The Calouste Gulbenkian Foundation UK Branch, founded in 1956, was one of the earliest champions of community engagement in the arts.

In 1959, it published the seminal report Help For The Arts, which pioneered ideas including artists and writers in residence in non-artistic institutions, and arguing for more focused and sustained funding for arts organisations outside London and the major cities.

‘Perfect storm’ of financial pressure facing Scotland’s cultural sector

A ‘perfect storm’ of financial pressure is being faced by Scotland’s cultural sector. This is the warning from the Scottish Parliament’s Constitution, Europe, External Affairs and Culture Committee.

In a report published this week, Holyrood’s Committee looks ahead to the Scottish Government’s 2023-24 budget and the impact of budgetary decisions on Scotland’s culture sector. It calls on increased urgency to address budget pressures through innovative approaches to funding.

The report underlines recommendations made by the Committee during previous budget scrutiny. It calls for these innovate approaches to be accelerated in order to address the difficulties being faced.

During its consideration, the Committee heard the challenges facing that sector have become more acute as it struggles to recover from the COVID-19 pandemic, and further compounded by the cost of living crisis following on from longer term budget pressures. The Committee has recommended taking an innovative approach to budgeting including greater use of public and private investment as well as multiyear funding.

The Committee also repeats its call from last year for the mainstreaming of the culture budget. It also asks the Scottish Government for updates on embedding culture more broadly as part its plans for a wellbeing economy.  This would take into account the contribution which preventative spend in areas like the arts and other cultural activities makes towards health and wellbeing.

Speaking as the report launched, the Committee Convener Clare Adamson MSP said: “Scotland’s cultural sector plays a vital role in Scottish life. But we heard blunt warnings from those within the sector that stark choices lie ahead.

“Increased operating costs come at a time when most cultural venues are still struggling to recover from the pandemic, and without truly innovative approaches to funding, there is a real danger that Scotland’s skilled cultural workforce will be lost along with some of our best loved cultural icons.

“There are no doubt considerable pressures across all areas of the Scottish Government budget, and there are no easy choices. But the current situation provides an opportunity to accelerate these innovative solutions. The Scottish Government must take action to protect this fundamental part of our society.”

Storm Arwen: Learning the Lessons

New processes in place one year on

Organisations across Scotland have put in place a series of measures to protect communities from the effects of severe weather ahead of winter.

It follows a review of the Storm Arwen response published in January 2022, which set out 15 recommendations for the Scottish Government and its partners.

A report published today updates on progress since then, with a range of improvements put in place ahead of winter. These include:

  • A full winter readiness exercise carried out by emergency responders across every area in Scotland by the end of November
  • A new online learning and training hub to help individuals, community groups and the voluntary sector to prepare, respond and recover from emergencies
  • The development of a new process to monitor and evaluate Scotland’s resilience system annually to identify and resolve issues quickly and effectively
  • Increased integration and engagement with the voluntary sector, and expansion of local directories of assets and capabilities to support resilience activity

Cabinet Secretary for Justice and Veterans, Keith Brown, said: “The Scottish Government committed to a full review of the circumstances of Storm Arwen, and this report demonstrates clearly the range of work that is underway to ensure that lessons are learned. 

“Our responder community, including our blue light services and our local authorities, will put these recommendations in place and we will support them to ensure our resilience arrangements continue to strengthen to protect communities.”

Chair of the Scottish Resilience Partnership Jim Savege said: “Responders have worked hard through the year, reviewing the risks we need to be prepared for, planning and exercising and making sure we are as prepared as we all can be for any future events and incidents we may have to respond to.

“More than ever, emergency services have considered wider risks that may be realised, and the growing reality of having to deal with concurrent risks and incidents.

“Significant additional work has been invested this year into working with voluntary organisations and communities to ensure their resilience and their ability to deal with incidents has been enhanced. Community and business resilience are the bedrock upon which emergency services work and respond.

“The SRP is grateful for all of the work that so many colleagues have invested in ensuring we are as prepared as we can be for the winter ahead.”

Report: Ukraine six months on

Russia’s invasion of Ukraine has led to nearly one third of Ukrainians being displaced from their homes. The United Nations High Commissioner for Refugees estimates that more than 7.6 million Ukrainians had been displaced across Europe.

🔎 The Scottish Parliament Information Centre (SPICe) has taken a closer look at Scotland’s Homes for Ukraine Scheme, six months after it was introduced.

You can read it here: https://spice-spotlight.scot/…/displaced-ukrainians-in…/

Inequalities in voting and volunteering: who participates in Scotland?

On 5th September, the Conservative party elected a new prime minister of the United Kingdom. Scotland has not voted for a conservative government since 1955, and Liz Truss marks the twelfth prime minister in the last hundred years elected without majority support in Scotland (writes Fraser of Allander Institute’s ALLISON CATALANO). 

The last time Scotland’s vote mirrored the majority was in 2005 – the last time that a general election resulted in a Labour majority.

The Brexit vote in 2016 is another good example of how far Scotland’s opinion differs from that of the UK majority – less than 40% of Scottish voters approved the referendum to leave the EU, compared to more than 50% from Wales and England.

Scotland’s status as a minority among the UK electorate isn’t so surprising from a population standpoint – Scotland only accounts for about 9% of the total UK electorate. England, by contrast, claims 84% of all voters.

The vast difference between Scotland’s opinion and UK electoral outcomes may result in worsened well-being for the Scottish population. People derive a sense of satisfaction from having the ability to participate in and impact politics and governmental structures. This satisfaction, termed “democratic well-being,” is weakened by perceived or structural inequalities.

Participatory inequality stems from any situation in which a particular group is unlikely to or discouraged from some form of civic participation, which includes behaviours like voting, interacting with political campaigns, activism, or volunteering.

Examining voting in particular, Scottish voters may feel disenfranchised from the political sphere in the UK because of the perceived lack of political power on a national level, and may be less likely to choose to vote or express an interest in politics.

Certain groups in Scotland may also be more or less inclined to participate in national or local elections.

Income levels, health, and educational attainment may all result in different levels of participation both within Scotland and when comparing Scottish participation to the rest of the UK. In this sense, there may be participatory inequalities within the Scottish population and when comparing Scotland to the UK as a whole.

Using Understanding Society: the UK Longitudinal Household Survey, we determined that age, income, health, education, and employment statuses are correlated with an individual’s level of interest in politics, and the likelihood that they voted or volunteered recently. Understanding Society is a yearly panel survey, with yearly data available from 2009 to 2021.

Does participation differ in Scotland compared to the rest of the UK?

Scotland has a high level of average engagement across all survey years relative to Northern Ireland and Wales, but a lower level than England.

  • Scottish residents are more likely to have volunteered in the past year than residents of Northern Ireland or Wales, but less likely to have volunteered than English residents.
  • Scottish voting habits vary. Scotland had the lowest turnout in 2001 and 2005, and the highest turnout in 2015 and 2019. Scotland generally has higher turnout than Northern Ireland but lower turnout than England or Wales (Figure 1).
  • Scottish residents are more likely to express an interest in politics than in Wales and Northern Ireland. Scotland’s responses are roughly similar to England. Interest in politics across the UK increased in 2016 following the EU referendum vote, particularly in Northern Ireland, and peaked in Scotland in 2018 (Figure 2).

Figure 1: General election voter participation by constituent country

Figure 2: Interest in politics by constituent country

Despite Scottish residents being relatively politically engaged, Scotland experiences substantial gaps in participation based on health, income, education, and employment.

  • Scotland has the largest gap in participation between individuals that considered themselves in good health and individuals that considered themselves in poor health in the United Kingdom (Figure 3).
  • The lowest income quintile in Scotland is more engaged than the lowest income quintile in Wales or Northern Ireland. However, Scotland experiences larger gaps between the highest and lowest income quintile than the national average in political interest. Notably, the bottom income quintile in Scotland was more likely to have voted than in any other part of the UK. Political interest was also higher than the national average for the lowest earners.
  • Individuals with no qualifications in Scotland are less likely to volunteer than anywhere else in the UK, although they are more likely to have voted in a general election than the UK average. Unqualified individuals in Scotland are less likely to express an interest in politics than in England or Wales.
  • Scotland experiences a greater gap in participation based on work-related benefits compared to the rest of the UK. Individuals receiving in-work income or unemployment benefits are less likely to have voted, volunteer, or express a political interest in Scotland than anywhere else in Great Britain.

Figure 3: The gap in civic participation between self-reported good health and bad health is wider for each behaviour in Scotland compared to the rest of the UK

How do inequalities impact civic engagement in Scotland?

Health and income inequality are consistent predictors of voter turnout in Scotland. Scotland’s wide range of participatory behaviour based on health is particularly interesting.

Scotland has a unique relationship with health inequalities, and a history of unusually poor health outcomes based on region, education, and income.  Although health inequality takes many forms, life expectancies provide a good frame of reference.

In general, higher incomes beget longer lives. Scotland is a complete anomaly in this regard – despite having the highest average income in the United Kingdom, Scottish people have the shortest life expectancy.

Life expectancies also vary widely within Scotland, and even within cities and neighbourhoods. For instance, a male born in Glasgow between 2018-2020 has a life expectancy that is 7.5 years shorter than one born in the Shetland Islands.

Within Glasgow neighbourhoods, the difference in life expectancies is striking – males born in the least deprived areas can expect to live 15 years longer than males born in the most deprived areas.

I examined the health impacts on voting, volunteering, and political interest based on individual’s self-perceived general health, mental health, long-term illness or disability, and receipt of any illness or disability benefits.

Individuals that consider themselves in poor health are less likely to engage in civic behaviour compared to those that considered themselves in generally good health (Figure 4). Overall, self-perceived general health was the most significant health predictor of civic behaviour.

Figure 4: Inequalities in civic participation by self-reported health status

Surprisingly, claiming a long-term illness or disability did not impact an individual’s ability to participate. This is largely because of the broadness of the term “disability” – a person can be disabled in a way that limits their ability to vote, but many disabilities are easier to manage and would have no impact on someone’s ability to understand politics or volunteer. Receiving disability benefits, however, indicates that a person’s circumstance is difficult enough that it interferes with regular work and income.

The Understanding Society Survey has 41 different benefit classifications. Using their descriptions as illness or disability benefits, I looked into people who received at least one of the following benefits: severe disablement allowance, industrial industry disablement allowance, disability living allowance, war disablement pension, incapacity benefit, received working tax credit (including disabled person’s tax credit), and any other disability benefit or payment.

Scottish residents receiving some form of disability benefit were:

  • 10% less likely to have voted in the most recent election than Scottish residents that did not receive disability benefits
  • 19% less likely to report an interest in politics
  • 41% less likely to have volunteered in the past year

Receiving work or income benefits is another way of looking into the degree to which income inequality affects participation. I considered the following benefit classifications to be low income or unemployment benefits: income support, job seeker’s allowance, national insurance credit, housing benefit, rent rebate, universal credit.

Receiving work or income benefits affected participation more substantially than those receiving disability benefits (Table 1).

Table 1: Proportion of each population which participated in the following civic behaviours

Voted in a recent electionInterested in politicsVolunteered in the past year
Receiving unemployment or income benefits66%20%8%
Receiving illness or disability benefits72%26%10%
Total Scottish population80%32%17%

Income inequality is also closely related to civic participation. By dividing household income into five quartiles of the population, we found that the highest-earning 20% of the Scottish population was significantly more likely to participate in civic behaviours (Figure 5). This is a clear example of participatory inequalities based on income.

Figure 5: Civic participation inequalities based on income quintile

Education also has a significant impact on all aspects of civic participation. Volunteering is the most notably impacted behaviour by education; only 4.4% of Scottish residents without educational qualifications reported volunteering in the past year, compared to over 27% of Scots with university degrees.

Table 2: Percentage of each population which participated in the following civic behaviours

Voted in a recent electionInterested in politicsVolunteered in the past year
No educational qualifications73.5%21.3%4.4%
Scottish average80%32%17%
Has a university degree87.6%38.4%27.1%

Scotland suffers from unequal participation across a number of metrics, most notably education, income, health, and benefit receipt status. Poorer, less educated, and less healthy Scottish residents are less likely to have participated in voting and volunteering. The differences in participation are also larger within Scotland than any other constituent country in the United Kingdom.

Civic participation – whether by voting or by selecting causes to volunteer for – ultimately shapes political agendas. Values that are important to low-income, unqualified, or unhealthy members of society may be overlooked on a national scale due to disproportionately low levels of participation among these individuals.

The more equality in participation among all levels of society, the more that any particular group is able to better their circumstances.

Sustained progress needed on Scotland’s National Performance Framework ambitions, says Holyrood’s Finance Committee

In a report published yesterday, the committee sets out a suite of recommendations aimed at ensuring the NPF is a “much more explicit” part of policy making.

This begins, says the committee, with the Scottish Government making clear how it will use the NPF in setting national policy, and in collaborating with local government and wider Scottish society.

The report also says Scottish Government funding decisions need to be aligned with NPF outcomes, and that greater scrutiny and accountability is required.

Finance and Public Administration Committee Convener Kenneth Gibson said: “The NPF remains an important vision of the type of place Scotland should aspire to be, but there needs to be more sustained progress towards achieving that vision.

“While there is no single solution, of key importance is positioning the NPF as the start of a ‘golden thread’ from which all other frameworks, strategies and plans flow, through to delivery on the ground.

“We recommend that the government explicitly set out how its policies will contribute to the delivery of specific NPF outcomes, their intended impact on NPF outcomes, and approaches to monitoring and evaluation.

“Similarly, government funding decisions should also be aligned with National Outcomes. From the wide range of organisations we heard from the NPF is not currently seen to drive financial decisions, nor is it a mechanism by which organisations are held to account for spending effectively.”

The report also makes recommendations for strengthening and refocussing scrutiny – including by parliamentary committees – over how organisations have regard to the NPF.

Patients in mental health crisis twice as likely to spend 12-hours or more in Emergency Departments than other patients

A new report from The Royal College of Emergency Medicine finds that patients presenting with mental health problems are twice as likely to spend 12-hours or more in Emergency Departments than other patients.

National data show that nearly one in eight (12%) mental health patients presenting to an Emergency Department in crisis face a 12-hour stay from time of arrival, compared with nearly one in 16 (6%) of all attendances.

A recent SNAP survey of Emergency Departments found that more than one third of clinical leads reported patient stays of 72 hours or more in the last week, for patients with mental health needs.

‘Mental Health Emergency Care’ is the latest report in our series of explainers looking at the web of issues facing Emergency Departments. The report highlights that while patients with mental health presentations account for a very small proportion of Emergency Department attendances, they spend a disproportionate amount of time waiting for a mental health bed if they need admission.

Often, it is the patients who are most unwell and vulnerable that wait the longest. Those of greatest concern are patients waiting for a mental health bed, patients waiting for an assessment under the Mental Health Act, and Children and Young People presenting in crisis.

The prevalence and complexity of the mental health needs of children and young people increased during the pandemic, while capacity is struggling to meet surging demand.

Half of Emergency Departments in England reported waits of 12 to 24 hours for a child or young person to see a specialist mental health professional, despite the accepted standard for adults being a one hour wait to be seen.

If admission is needed, 46% of Emergency Departments reported that children and young people will wait more than 48 hours for a bed, with two respondents reporting a wait of five days in the Emergency Department.

The report looks in detail at factors contributing to these long waits, such as the reduction in mental health beds, inadequate numbers of children and adolescent mental health professionals, and poor organisation of professionals to assess patients under the Mental Health Act. It also examines the consequences for patients and departments and makes wide reaching recommendations.

Commenting on the findings of the report, Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said: “The system is failing patients who present to Emergency Departments in mental health crisis.

“Those waiting the longest are children and young people, patients waiting for admission to a bed, and patients waiting for assessment under the Mental Health Act. It is unacceptable.

“We know long waits in a busy and crowded environment are harmful for any patient, but for these patients it can cause deep distress and upset and worsen their mental state. We must do more to ensure that these patients are seen, treated, and directed to the right care quicker.

“These patients presenting to Emergency Departments are extremely vulnerable, they are in crisis and seeking Emergency Care, yet are left waiting for hours and even days, before being treated and admitted.”

The explainer also shows that the UK has only 37 psychiatric beds per 100,000 population – far lower than the OECD average of 71 psychiatric beds per 100,000 population – and that since 1987, over 48,000 NHS mental health beds have been cut in England, with 5,000 mental health beds having been cut since 2011 alone.

Dr Henderson said: “Data show that bed occupancy at mental health trusts averaged nearly 90% between 2017-20, 5 percentage points higher than the recommended 85%. The NHS mental health bed numbers are clear; capacity does not meet demand.

“While the move towards a provision of community mental health care has been positive, the cuts to emergency mental health care beds have been devastating. Now, the most vulnerable and desperate patients are truly suffering.

“We urgently need to see an increase in mental health bed capacity, so we are able to admit these patients to a bed and provide the care they urgently need. We regularly hear heart-breaking stories of young people being admitted a long way from their home and family.

“We urge the new Prime Minister and new Health Secretary to prioritise Mental Health care provision in Emergency Departments, especially ahead of winter.

“We are failing these patients and they are suffering; our report and supporting survey show the extent of this crisis. We need urgent action now. To ensure we are able to quickly and effectively help vulnerable patients in crisis the government must increase mental health bed capacity in Trusts.

“Capacity for Children and Adolescent Mental Health Services (CAMHS) is especially important, and CAMHs should be expanded to 24/7 so that children and young people can be assessed and triaged whenever they present at Emergency Departments, rather than face long waits for these services to open.”

Report into Mental Health Tribunal for Scotland recommends changes to ensure patients’ voices are heard

Pioneering study heard from patients, named persons, practitioners and tribunal members

An Edinburgh Napier University-led study, funded by the Nuffield Foundation, into stakeholder experiences of the Mental Health Tribunal for Scotland (MHTS) has recommended several ways it could improve its processes and decision-making.

Addressing the influence of clinicians, encouraging participation of patients and offering more support for named persons are among the suggestions put forward in the report.

The MHTS was set up authorise and review compulsory psychiatric measures under the 2003 Mental Health (Care and Treatment) (Scotland) Act 2003 and began operating in October 2005. The legislation is underpinned by human rights-based principles which govern the way that the MHTS makes its decisions about compulsory psychiatric care and treatment.

This study is the first of its kind since the Tribunal’s formation and heard from patients, their named persons, MHTS panel members, lawyers, independent advocates and health and social care professionals.

The timing of the study’s report means that its findings will be used to help inform the Scottish Mental Health Law Review, which is due to publish its recommendations on Scottish mental health, capacity and adult support and protection law this autumn.

Jill Stavert, Professor of Mental Health and Capacity Law at Edinburgh Napier University said: “Our study revealed several areas of agreement across all participant groups on how the Mental Health Tribunal operates and evidence of considerable caring goodwill on the part of the Tribunal and health and social care practitioners.

“However, there were certain areas where the experience and perceptions of patients and Tribunal panel members was not shared, particularly surrounding patient perceptions of their ability to participate during tribunal hearings.

“An important test whether human rights principles are effective is not only whether they are given effect by state authorities, such as tribunals, but also the extent to which they are felt to be given effect by rightsholders such as patients.”

Some of the report’s recommendations include, among others, addressing perceptions of the influence of clinicians and diversity issues, supporting patient participation, and supporting named persons more.

Professor Stavert continued: “Some of these, we consider, should be addressed by the Tribunal itself while others are for other bodies to take up.

“This is very important as human rights requirements increasingly require active respect for the rights of persons with psychosocial, cognitive and intellectual disabilities.”

Report exposes “frightening” reality of cost of living crisis

A new report from Citizens Advice Scotland (CAS) details the breadth and depth of the cost of living crisis, with soaring energy bills driving “frightening” demand for advice around food insecurity.

The charity is publishing a quarterly cost of living analysis looking at advice demand. It found that in more than 1 in 10  utilities cases, the client also required advice around food insecurity such as a food bank referral.

Comparing the first quarter of this year to the previous financial year, the analysis also shows soaring views of online advice in energy areas such as:

At the same time, online page views relating to cost of living issues has increased massively, with “Get help with bills” increasing 122%. The page “Struggling with living costs” has seen a 67% increase, meanwhile views of “Food banks and other crisis help” is up 33%.

Across the CAB network itself, last year 26% of all utilities advice related to cost of living or income crisis measures. In the first quarter of this year that had grown to 35%.

Last year 36% of finance and charitable support advice was food bank referrals or shopping vouchers. In quarter one of this year this had grown to 45%.

The report also analyses demand across demographics, and finds that council rented tenants and those out of work, or unable to work, are seeking advice related to the cost of living at higher levels than other groups.

The charity is warning that this increased demand is before the impact of  a “toxic cocktail” this winter of the energy price cap going up, higher inflation, and increased interest rates.

Citizens Advice Scotland Chief Executive Derek Mitchell said: “The Citizens Advice network gives a wraparound service when people come to us for advice because people have complex problems and need help with multiple issues. Our data tracks the patterns and connections between the advice we are giving out and the problems society faces. What we are seeing is frankly frightening.

“More than one in every ten people seeking help with an energy issue also requires help with food insecurity. Let’s be absolutely clear what that means – some people face the prospect of freezing or starving this winter.

“This crisis is affecting everyone, but some people are especially at risk – our data shows higher demand for advice from council tenants, those out of work and those unable to work. That to me suggests broad support alone will not be enough – there needs to be targeted help for the vulnerable.

“We are seeing these issues before a toxic cocktail this winter of soaring energy bills, growing inflation and higher interest rates. People are hanging on by their finger tips and it’s the summer – how are they expected to cope when the temperature drops and bills rise?

“CABs are here for people during this crisis. We helped 171,000 people last year and a further 2.5 million checked our online advice. We are for everyone regardless of background or circumstance and it’s so important people understand we are here for them with free, confidential and impartial advice. We don’t judge, we just help.

“That help though, needs to be back up by policymakers delivering the kind or urgent and significant policy interventions to help people. Make no mistake, this is a challenge on a scale of the 2008 financial crisis or the 2020 pandemic, and will require solutions to match that.”