Soon after the first national lockdown started in March 2020, my next-door neighbour told me about the difficulties she faced leaving the house to get food; she was considering requesting help from Bristol City Council through their Meals on Wheels service. I was not aware that Meals on Wheels still existed, so I spent the next couple of months reading about the service provision in the UK, but also other countries, like the work conducted by Meals on Wheels America.
Two things became obvious from my readings. First, that people who deliver the meals and coordinate the service in local authorities (and often in private provision, although this is less documented), are an absolute lifeline to people who are in need of care and support. Second, that Meals on Wheels are highly under-researched in the UK. If the ultimate goal of research is to improve people’s lives by affecting policies, then we need to make the voices of everyone involved in Meals on Wheels provision heard.
What we did
We interviewed eighteen service providers (drivers who deliver the meals, service coordinators and manages) from two local authorities in South West England. We explored their experiences around the benefits and challenges faced by the service, and how these experiences changed during the first UK national lockdown.
1. Meals on Wheels offer essential benefits to service users: encouraging clients to eat and keep physically active, carrying out welfare checks and household chores, tackling isolation and loneliness, and helping older adults remain independent in their homes and communities.
2. Meals on Wheels assume an emergency response in challenging situations and should be considered the ‘fourth emergency service’: they coordinate a response from other emergency agencies to ensure clients’ wellbeing; meals are delivered ‘come rain, come shine, come pandemic’.
3. Meals on Wheels employees obtain their own benefits: working for the service brings a sense of pride; the social interactions and relationships they develop with clients are mutually rewarding.
4. The service is essential for reducing pressures on families, who might not be able to provide meals or support for their relatives, particularly during the pandemic.
5. Meals on Wheels experience many challenges: funding cuts, ongoing threats of closure, lack of appropriate publicity, a need for more human resources to allow drivers to spend more time with clients who need it the most.
6. There was uncertainty of how the service would cope in future pandemics or if lockdowns continued. The future of Meals on Wheels would highly depend on support received from local authorities and the national government.
What does this mean?
An increasing number of local authorities are withdrawing their Meals on Wheels provision, contract the service to, or only signpost to a list of, external providers. Yet, demand for the service increased during the pandemic, and is likely to increase further due to an ageing population. Our findings show that it is crucial for Meals on Wheels to receive enhanced and ongoing support from local and national governments to keep up with the need for the service.
The wider recommendations include:
1. Social care policies should acknowledge the value of Meals on Wheels as a central emergency service, with a crucial preventative role in maintaining the wellbeing and independence of adults who are in need of support during the pandemic, and beyond.
2. Local and national governments should protect, enhance, or revive Meals on Wheels, by allocating appropriate funding and resources to allow effective continuation of the service.
The continuation of Meals on Wheels by local authorities could save councils and service users thousands of pounds (costing an average of £40/week for a two-course meal), compared to the costs of residential (>£600/week) or nursing care (>£800/week).
The network of Meals on Wheels in the UK is extensive, with many providers and organisations (e.g. APSE, NACC, and Sustain) advocating for its crucial role in the community. Yet many potential service users still do not know that the service exists, or the extensive support it provides. We need to consider a coordinated approach and provide more high-quality evidence to sustain and enhance this important service. If you: 1) have ideas on how to enhance Meals on Wheels or what research we need to conduct to advocate for the service; 2) would like to share your experiences with the service, or; 3) are interested in the development of a Meals on Wheels network or in supporting future work, please get in touch with me by email (firstname.lastname@example.org) or, follow me and send me a message on Twitter (@AngelikPapadaki).
For the latest news and developments in local authority meals on wheels services, please contact APSE Principal Advisor Vickie Hacking on email@example.com