“The mortar between the bricks of services”: How third sector staff’s risk work supported people who were homeless to access healthcare during the COVID-19 pandemic.

Abstract

This study explores the experiences of third sector organisation (TSO) staff in supporting people who were homeless to access healthcare during the COVID-19 pandemic in Scotland. Based on in-depth qualitative interviews with 10 TSO staff members, the analysis illustrates how the activities of TSO staff to identify and address factors which inhibited healthcare access can usefully be conceptualised as ‘risk work.’ This risk work was seen across the different stages of the process of accessing healthcare: helping people identify a need for healthcare, guiding people as they navigated the system of services, facilitating the practicalities of access and supporting interactions with the NHS. The work of these staff encompassed all three aspects of risk work (translating risk, minimising risk and caring in the context of risk). The strongly relational focus of TSO staff’s ways of working meant that the element of social relations (caring in the context of risk) was seen to underpin the success of their work. Risk work was also carried out both in a client facing way to support people who were homeless to access services, and in a system facing way to support services to be more accessible. This challenges the typical conceptualisation of healthcare access as a bilateral interaction between the patient and the healthcare system, and instead demonstrates the value of TSO staff as a third-party actor supporting access.

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http://creativecommons.org/licenses/by/4.0/

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Identifiers

DOI

https://doi.org/10.1080/13698575.2025.2569489

Repository URI

https://www.research.ed.ac.uk/en/publications/ae63dc65-eea4-42b4-84ab-e9c540d78830