Unequal impact? Coronavirus, disability and access to services: full Report Contents

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2Access to food

8.Access to food was an immediate concern for many disabled people as the implications of the pandemic unfolded and lockdown restrictions were first introduced. Survey data show that 60% of disabled people struggled to access essential supplies, including food, in the early months of the pandemic.7 Nearly 90% of disabled people were concerned to some extent about access to food, with more than one in five “extremely concerned”.8 Below we consider the Government’s and food retailers’ approaches to maintaining disabled people’s access to food and compliance with equality law in fast-moving, emergency circumstances.

Barriers to food shopping facing disabled people during lockdown

9.There is a wealth of evidence on the effects of the pandemic on disabled people’s access to food. Disabled people who relied on friends, family or carers to shop for and deliver food to them faced considerable food insecurity in the first national lockdown, as did those who relied on, or now needed, online shopping delivery slots, demand for which substantially increased. Some supermarket websites and telephone helplines were inaccessible to people with sensory impairments. Disabled people faced increased barriers to physical shopping because of difficulties complying with social distancing measures and changes to the physical layout of shops. Increased demand for food caused long queues outside supermarkets and consequential difficulties for disabled people who struggled to stand for long periods.9

The Clinically Extremely Vulnerable group and national shielding

10.The Government’s approach to providing food for those in need focused on a group of around 2.2 million people identified by the NHS as being clinically extremely vulnerable (CEV) to the virus. This group included solid organ transplant recipients and people with specific cancers, severe respiratory conditions, including cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease, some rare diseases that significantly increase the risk of infections, such as homozygous sickle cell, and people undergoing immunosuppression therapies. In March, the Government’s advice to people in this CEV group was not to leave their homes, including to shop for food, for a period of 12 weeks.10

11.The Government worked with national food distributors, local authorities and local voluntary groups to establish a national service, which delivered free, weekly, standardised food boxes to people in the CEV group who were in need and had requested help via the Gov.uk website.11 The first food boxes were delivered over the weekend of 28 and 29 March, via bulk deliveries to local authority hubs. Subsequent deliveries were made direct to people’s homes each week.12 A month later, more than 500,000 boxes had been delivered.13 By late June, when the Government announced plans to “pause” the national shielding programme from 1 August (see below), it had delivered over three million food boxes.14

A medical model of disability

12.Disabled people, their organisations, academics and lawyers pointed out that many disabled people outside of the CEV group also “desperately needed” help to access food.15 Fazilet Hadi of Disability Rights UK (DRUK) reported that:

[…] tens of thousands of other [non-CEV] disabled people felt that, for various reasons, maybe not medical, they could not go out either. It may have been that they were blind or had learning disabilities and felt social distancing would have been difficult. […] it might have been because they could not stand in queues for a long time. There are a whole host of reasons.16

13.Fry Law, a specialist legal firm, noted that the CEV list was entirely medicalised and therefore argued that the Government’s approach failed to “embed social and human rights models” of disability.17 The social model of disability is a conceptual framework in which “people with impairments are disabled by the barriers operating in society that exclude and discriminate against them”, as opposed to a medical model, in which people are understood as being disabled by their impairments. The social model was developed by disabled people as a way of recognising, highlighting, and campaigning to remove, the social barriers they face.18 It is widely accepted, including by the Government Equalities Office, and its use has been encouraged by the Government since at least 2015.19

Unintended consequences

Access to online delivery slots for the broader disabled population

14.The Government Digital Service shared data on people in the CEV group who had requested food boxes with supermarkets, so that people on the list could be prioritised for click and collect services and online delivery slots if they needed them.20

15.Witnesses drew attention to an obvious adverse effect of this approach for the broader population of disabled people. Prioritising people on the CEV list for a limited number of delivery slots meant that many disabled people who were not on the list but needed slots, for the range of reasons set out above, could not access them.21 Fazilet Hadi argued that:

If we had joined up our thinking about who might need supermarket deliveries and not just prioritised one group over another group without thinking it through, we could have avoided that. Government acted with good intentions, but in a siloed thinking approach, which then caused knock-on problems for tens of thousands of disabled people.22

Reasonable adjustments for disabled people

16.Witnesses reported that supermarkets were not making reasonable adjustments, required by the Equality Act, to allow disabled people access to both online and physical shopping.23 Fry Law wrote that “supermarkets are confusing the legally recognised definition of disability, as set out in Section 6 of the Equality Act, with the very limited qualification for access as set out in [the CEV list].”24

17.These issues were raised by the Equality and Human Rights Commission (EHRC) in April. Its Chief Executive wrote to the British Retail Consortium (BRC), setting out the problems the broader population of disabled people were experiencing in accessing food shopping and urging supermarkets to act.25

18.The BRC’s reply emphasised the limited capacity of the online food delivery market, noting that it makes up only around 8% of all sales. Its, and the Government’s, focus was on providing delivery slots for the CEV group. While accepting there was demand for slots from a wider range of disabled people, it had:

[…] long argued that a community response is essential, and we have urged people consider picking up food for vulnerable, disabled or self-isolating neighbours. The primary aim for retailers was to help to ensure clinically shielded groups identified by Government could easily access food without added risks to their health.26

The BRC believed that “the only way” to ensure everyone’s needs were met was to “supplement priority online deliveries with neighbours, relatives and volunteers who can shop on behalf of others.”27

19.In oral evidence, DRUK’s Fazilet Hadi, who is blind, gave us her reaction to the BRC’s response to disabled people’s concerns:

I want to express my dismay and astonishment that someone from the British Retail Consortium should be telling disabled people to go and use friends, family and volunteers. If I want to use friends, family or volunteers, that is my decision. […] [it] is a bit like telling me that, rather than my bank giving me a braille bank statement, I should go and get someone else to read it for me. I feel absolutely outraged about this because the Equality Act applies to supermarkets. I do not know if they know that, but they act like they do not.28

20.The EHRC was also dissatisfied with the initial response and published an open letter expressing concern that the BRC’s letter:

[…] fails to acknowledge the legal obligations on retailers to make adjustments for disabled people under the Equality Act 2010 and the rights of disabled people to live independently.29

The Commission warned that it was reviewing over 300 individual claims against the major supermarkets for “failure to consider the needs of disabled people and make adjustments to allow people to shop for essentials.”30

21.On 20 May, Melanie Field, Executive Director at the EHRC, told us that “some of the initial issues” had “eased slightly”. Supermarkets had been able to create some additional online delivery slots, for example. She told us that the Commission was in “constructive discussions” with the food retail sector and Ministers about disabled people’s remaining concerns. She also emphasised that the broader problems with disabled people’s access to food were set in the “general context of strong support for the shielded group”, which had been “rapid and generally effective”.31

22.The BRC’s written evidence, submitted in July, stated that it had “been clear from the start that there was insufficient capacity to supply all vulnerable consumers through online delivery” and had “pressed Government to ensure other facilities were available”. It believed that “the Government could have been quicker to appreciate this and set up alternative arrangements to help vulnerable consumers.” It made clear that it had been “directed by the Government” to prioritise the CEV group. It argued that food retailers had “prioritised disabled consumers” for online deliveries but reiterated that there was limited capacity to do so.32 Later, concerns emerged about some supermarkets increasing the price of priority online delivery slots or raising the minimum value of free deliveries, disproportionately affecting disabled people, for whom online food deliveries continued to be vital.33

23.In response to disabled people’s ongoing concerns, the EHRC published new guidance to food retailers on 3 September. The guidance sets out retailers’ legal obligations in relation to the needs of their disabled customers. The guidance includes four steps that retailers should take to meet these obligations:

• Provide a service that meets the needs of all customers: anticipate, prepare and make reasonable adjustments for disabled customers;
• Plan ahead to think about the needs of your disabled customers: consider and make changes to policies and procedures, as well as provide extra support and equipment, where necessary;
• Communicate with your customers: inform customers about how they will be supported through a variety of ways such as easy to read signs and spoken announcements; and
• Train your staff: ensure that staff are supported with the right tools to help disabled customers, in line with the latest government guidelines on coronavirus (covid-19).

The new guidance was accompanied by a letter to the Chief Executives of supermarkets and retail consortia, in which the Chief Executive of the EHRC stated that:

No matter what decisions and actions are made [in response to the pandemic], all retailers have a legal duty to abide by equality law. It is essential that disabled people are not left behind as retailers continue to meet the challenges of the ongoing pandemic.34

24.In the light of these issues, we wanted to know what assessment the Government had made of the effectiveness of using CEV status as the proxy for disabled people’s need for help accessing food. Ministers defended the effectiveness of their approach but were unable to confirm whether the Government had undertaken, or planned to undertake, any assessment.35 Ministers were clear that the CEV list was based on guidance from the Chief Medical Officer and was “very much a clinically led process”.36

25.We wanted to know what efforts the Government had made to emphasise to food retailers the importance of their compliance with equality law, to ensure equal access to food for disabled people through reasonable adjustments. Victoria Prentis MP, Minister in the Department for the Environment, Food and Rural Affairs (Defra), said she was aware of the correspondence between the EHRC and the BRC, and had “asked whether I could politely bang heads together a little bit and facilitate communication”.37 She was wary of being drawn into legal arguments around reasonable adjustments during the pandemic but her broad view was that the supermarkets had gone “above and beyond”. She believed they were “really trying hard to meet the needs of their communities” and that everyone ought to be grateful for the efforts they had made. She told us she hoped that “we need not get too legalistic about this.”38

26.The Government’s focus on people defined as “clinically extremely vulnerable” (CEV) to the virus, while rational from a medical perspective, was an inappropriate proxy for the need for support with access to food and had unintended consequences. It was rapidly established and broadly effective for those on the CEV list, for which everyone involved should be congratulated, but it also set one group of people with clinical needs against others with social barriers to food shopping during the pandemic. The Government’s predominant focus on supporting CEV people, and its clear direction to the food sector to prioritise them, may have contributed to some supermarkets overlooking their legal obligations to make reasonable adjustments for the broader population of disabled people, which has led to legal challenges.

27.We welcome the steps the Equality and Human Rights Commission (EHRC) has taken to emphasise that food retailers’ legal obligations to make reasonable adjustments for disabled people have remained in place throughout the pandemic. We fully endorse its new guidance to food retailers on the steps required to continue to meet their obligations, including in emergency situations. The Government should also publicly state the vital importance of reasonable adjustments to allow disabled people equal access to food during the pandemic. We recommend the Government better promote the EHRC’s new guidance to food retailers, including in its ongoing discussions with the food retail sector on maintaining disabled people’s access to food during the remainder of the pandemic.

28.We further recommend the Government consider, with disabled people, as part of its consultation on the proposed National Strategy for Disabled People, the steps needed to more effectively adopt a social model of disability in relation to maintaining disabled people’s access to food for the remainder of this pandemic and in future crises. This consultation should consider the actions required to eliminate barriers to physical and online food shopping. The Government should consider with disabled people how, in crisis situations, to identify and reach a single category of people, including disabled people who may not have clinical needs and people with medical conditions who may not be disabled, who need food deliveries. It should consider not only the steps required by retailers to meet obligations under the Equality Act but also steps required by the Government to meet its obligation under the UN Convention on the Rights of Persons with Disabilities to respond to emergency situations in a way which includes consideration of the needs of disabled people.

Local shielding arrangements: assessment of need and funding

29.When we heard oral evidence from Ministers on 2 September, the national shielding programme, including free food boxes, had been “paused” since 1 August. This followed the publication of less restrictive guidance on 6 July, in which people in the CEV group were “no longer advised to shield”, as coronavirus infection rates continued to fall across most of the country. People who had been shielding and continued to need support could arrange for deliveries of food, medicines and other essentials they had purchased via NHS Volunteer Responders or local authorities, and anyone registered with the national programme by 17 July continued to be eligible for priority supermarket slots.39

30.By early September, several parts of the country, including Greater Manchester, East Lancashire, Preston, and West Yorkshire had already returned to stricter coronavirus measures in response to now rapidly rising infection rates. The guidance for people in the CEV group in these “local lockdown areas” was to “resume shielding” if they received a letter from the Government advising them to do so.40

31.There were calls from local politicians in some areas that had returned to stricter measures for the Government to reinstate the full national shielding service in those places. A joint statement from Andy Burnham, Greater Manchester metro mayor, and all ten Greater Manchester local authorities, argued that central Government’s advice to people to resume shielding, while not simultaneously reinstating the national shielding programme would:

[…] cause considerable uncertainty and risks sending mixed messages to those shielding in Greater Manchester. We therefore call on the Government to extend the shielding arrangements in the areas that are subject to intervention until these restrictions are lifted. Our councils will need additional financial support to help us deliver that additional support.41

We consider the clarity of the Government’s messaging around shielding, and other communications, in chapter 5.

32.Similar concerns were expressed when the Government reintroduced national restrictions on 5 November, with CEV people once again advised not to visit shops and instead shop online or rely on the support of friends, family, volunteers, including NHS Volunteer Responders, or seek help from their local authority.42

33.Victoria Prentis MP told us the Government’s view was that “we need to get away from the food-parcel model.” She said the Government’s approach was to enable local authorities to meet local needs and it was providing funding for them to do so.43 The Government launched a new Gov.uk webpage with links to the range of local support available, including help to get food.44

34.The Government has so far provided around £4.1 billion of additional grant funding, to cover additional costs across all services and support local authorities during the pandemic but concerns remain that many councils are over-stretched.45

35.On 2 November, as England prepared for the reintroduction of national restrictions, the Local Government Chronicle reported that the Government had indicated to council leaders and Chief Executives that local authorities would receive “£14 per clinically extremely vulnerable person in their area to ensure they have access to essential supplies.”46 We were, and remain, unaware of any central government assessment of the level of disabled people’s needs for help accessing food, including free food box deliveries, before or since the decision was made to “pause” the national programme in August.

36.Ministers paused the national shielding programme in August and in September asserted that “we need to get away from the food parcel model”, without offering any evidence of the Government’s assessment of the level of disabled people’s needs for help accessing food, including free food deliveries. Since then, there have been local lockdowns and a return to national measures, with clinically extremely vulnerable people once again advised by the Government to avoid leaving their homes, including to shop for food. People must now rely on friends, family, carers, volunteers and local authorities, which have been provided with additional funding but whose resources are over-stretched. In circumstances in which the Government is asking people to shield, we believe it has a duty to ensure that the local support arrangements that have replaced the national shielding programme, and the funding in place to support them, are adequate to meet the level of need. The Government must immediately publish its assessment of disabled people’s needs for support accessing food, including provision of free food box deliveries. It must also publish a plan to review the adequacy of local arrangements and central government funding to support disabled people who need help getting food while coronavirus restrictions remain in place. We expect such a plan to be published within two months of publication of this Report, and be both updated and re-published regularly during the remainder of the pandemic.