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Background: The COVID‐19 pandemic put unprecedented pressure on weight management services. These services were required to adapt to continue to provide care for people living with obesity. This study sought to develop consensus recommendations on the best practice solutions adopted by weight management services in the United Kingdom during the COVID‐19 pandemic. Methods: This study utilised a semi‐structured interview and a modified Delphi methodology to develop a consensus of best practice recommendations identified by specialist weight management services during the pandemic. Results: Twenty‐three healthcare professionals working in weight management service across the United Kingdom participated in the study. Analysis of interview transcripts identified four key thematic domains: outpatient, patient education and support, perioperative care and team working. Of the initial 43 unique recommendations, 30 reached consensus agreement. Outpatient recommendations focused on communication strategies, patient self‐monitoring and remote patient tracking. Patient education and support recommendations addressed the development of online educational resources and support groups. Perioperative care recommendations emphasised case prioritisation, waiting list support and postoperative care. Team working recommendations targeted the use of digital collaboration tools and strategies for effective teamwork. Conclusion: Developing consensus recommendations on best practice is a critical step for weight management and outpatient services to achieve higher standards of care. These recommendations provide a springboard for departmental discussions, paving the way for improved experiences for individuals living with obesity as they progress along their weight management journey. Key points: During times of crisis, healthcare providers in weight management services can rapidly adopt innovative digital solutions to support good patient care.Thirty expert consensus recommendations relating to outpatient management, patient education and support, perioperative care and team working were found.Collaborative research is key to further guideline development on obesity management in areas of outpatient care, patient education, perioperative care and team working. [ABSTRACT FROM AUTHOR]

Background: Groups at high risk of severe illness/death from COVID-19 (older people and those identified as clinically extremely vulnerable: CEV) experienced increased restrictions, poor mental health and loneliness during the first UK lockdown. Methods: Seventeen older adults, eight CEV adults, one parent of a CEV child, and two family carers of CEV adults, shared their experiences of the first UK lockdown through various media: written reflections, interviews, poetry, videos, photographs, and visual artwork. Results: Through a positive psychology lens, five themes were identified: experiencing loss; community and connection; finding joy, hope and optimism; adapting to change; and sense- and meaning-making. Conclusion: High-risk groups fostered wellbeing and flourishing and formed a sense of coherence in a time of great loss. Engagement with artistic, creative, and cultural activities facilitated this. The arts not only provided a creative means of collecting data but was also identified as a central thread in the findings. [ABSTRACT FROM AUTHOR]

Summary: The COVID-19 pandemic and subsequent public health restrictions caused an unprecedented impact on long-term care services in the United Kingdom (UK). A qualitative study was conducted in the East Midlands, UK, to explore how home care provision was perceived and experienced, by those organizing, commissioning, or providing care, and those receiving care, during the pandemic. Fifteen semi-structured telephone interviews were conducted between September to December 2020 with people who organize, commission, or provide home care (n = 9), recipients of home care (n = 3), and their informal carers (n = 6). Findings: Three broad themes were constructed through a thematic analysis: (1) positive about home care; (2) fear of infection; and (3) social isolation. In addition to these overarching themes, specific group themes were identified amongst group one: those organizing, commissioning, or providing care, and group two: those in receipt of the care and informal carers. Those in group one spoke about the pandemic creating stressful working conditions, regardless of whether organizing, commissioning, or providing care. Despite working throughout the pandemic, they felt a forgotten part of the essential workforce, when compared to those employed in the National Health Service and institutional care. Those in group two experienced a loss of control with visits cancelled or frequently occurring outside of scheduled times. Dissatisfaction with the visits was directed at the management level, rather than at the staff visiting the homes. Applications: Awareness and understanding of the experiences of home care will provide useful knowledge when commissioning future services. [ABSTRACT FROM AUTHOR]

Livestreaming and filming death rites and funeral ceremonies to enable remote engagement proliferated rapidly during the COVID-19 pandemic, and many expect these options to remain prevalent going forward. This paper draws on interviews with a diverse UK sample of 68 bereaved people, funeral directors, officiants and celebrants. It illustrates how, and explains why, people's experiences and evaluations of hybrid funerals can vary. In a context when in-person gatherings were limited, hybridisation played a valuable role in enabling more people to engage with funerals. However, virtual attendance was often considered less satisfying than in-person attendance because it did not enable people to participate well in the funeral activities that mattered to them or to participate with others as they would in person. Scope for participation was partly contingent on the functionality and use made of technology, including whether and which steps were taken to facilitate engagement and a sense of connection for those joining online. People's evaluations of hybrid funerals could also reflect their relationships to the deceased and their frames of reference – for example, whether they were comparing virtual attendance to attending in person, or to being unable to attend at all, or to an overwhelmingly large funeral. [ABSTRACT FROM AUTHOR]

Many young women turned to digital fitness technologies (DFT) to support their health and wellbeing during the covid-19 pandemic. The present study explores young student women's retrospective perceptions of their cumulative engagement with DFT, across periods of restriction and easing (March 2020–2021). Seventeen UK-based women (Age M = 20.29, SD = 1.72); Ethnicity White = 94.12% participated in one-on-one interviews using an adapted scroll-back technique. Data was analysed using narrative-informed reflexive thematic analysis. Three themes were developed: My lockdown #fitnesstransformation: DFT as information and inspiration, My unrealistic expectations: DFT as a source of comparison and concern and My new body positive and resilient self: DFT as a catalyst to self-development. Themes highlight how perceptions of DFT changed over time as a consequence of repeat engagement, sociocultural context and psychological meaning-making. Crucially, findings underscore the importance of examining the collective and cumulative effects of DFT engagement on health and wellbeing, both positive and negative. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic placed a huge strain on healthcare services around the world, including community services. Students also faced substantial disturbance to educational programmes. Student district nurses are usually employed members of staff and can be recalled to the workforce, whereas pre-registration students cannot. Aims: This paper explores the feelings and experiences of student district nurses during the first UK national lockdown of the COVID-19 pandemic. An interpretative phenomenological approach was taken. Method: A semi structured 1:1 interview and focus group was held via zoom in July 2020. A total of eight student district nurses, who were all registered adult nurses, took part. Data was analysed using the Braun and Clarke model to identify themes. Results: The findings related to their experience of being a community adult registered nurse on the frontline, while also being a student district nurse. Three themes were identified from the analysis: anxiety and uncertainty, management of risk and teamwork. Conclusion: This study highlights the contribution that community nurses made in the clinical response to the COVID-19 pandemic. It adds to a paucity of literature available from this clinical setting and specifically from the viewpoint of a student district nurse. There is much written on the strains on hospital care, but it should be remembered that district nursing is the service that never shuts its doors because it has reached capacity. This study found that a lack of communication and uncertainty about their future as students contributed to heightened stress and anxiety. Teamwork and camaraderie are a vital aspect of any team and one that can support resilience in times of heightened stress. A lack of face-to-face interaction can lead to team members feeling isolated. Digital technology can be used to reduce this feeling when possible. [ABSTRACT FROM AUTHOR]

Background: Working together and co‐production with public advisors have become popular among health researchers. This practice extends to doctoral researchers who involve public advisors at different stages of their research or throughout their doctoral journey. Objective: A doctoral researcher and two public advisors jointly evaluated public involvement in doctoral research. Methods: Using the established public involvement evaluation framework by Gibson and colleagues, public advisors and a doctoral researcher mapped and evaluated their experiences of public involvement in doctoral research. The four‐dimensional framework allowed the authors to reflect on (1) the strength of the public voice, (2) the number of ways in which public advisors had an opportunity to get involved, (3) whether the discussion was about the public or organisation's (doctoral researcher, university or funder) concerns and (4) if the organisation changed or resisted feedback. Results are presented in a diagrammatic and narrative way. Results: Public advisors saw themselves as having a stronger voice in doctoral research than the doctoral researcher perceived. All agreed that there existed multiple ways for public advisors to be involved. Public advisors' feedback was taken on board, but it was also limited due to restrictions of what the doctoral programme allowed. Conclusion: Public advisors ensured that the doctoral research was more relevant to the public. The ongoing involvement also shaped the doctoral researcher's thinking and views. Patient and Public Involvement: Two public advisors were involved throughout the 3 years of this doctoral research. They co‐evaluated this involvement and are co‐authors of this paper. [ABSTRACT FROM AUTHOR]

Although reduced working time and furlough policy initiatives are widely regarded as important for economic and business reasons, little is known about their impacts on workers' mental health at the onset of COVID-19 pandemic. Using data from the UK Household Longitudinal Panel Study data from 2018 to February 2020 and April 2020 and change score analysis, this study aims to compare mental health changes between those who worked reduced hours, were furloughed and left/lost paid work. The results suggest that at the onset of COVID-19 reduced working time and furlough can protect workers' mental health, but only for men not for women. The gender differences remain significant even after controlling for housework and childcare responsibilities at the onset of COVID-19. These results highlight the importance of distributing paid work more equitably and formulating gender-sensitive labour market policies in protection of workers' mental health. [ABSTRACT FROM AUTHOR]

Humanitarian organizations in Bangladesh introduced emergency services to protect Rohingya refugees from COVID-19. This article aims to explore the roles front-line leaders from those organizations played in reducing the spread of the infection and protecting the refugees. By using in-depth interviews with 42 first-line managers (FLMs), it explores the innovative actions and strategies adopted by these managers to implement COVID-19-related programs and services. Initiatives such as training and engaging Rohingya volunteers and developing services promptly in order to raise awareness and manage testing, treatment, and psychosocial interventions contributed significantly to pandemic management in Rohingya refugee camps. Humanitarian groups must realize the crucial role first-line managers (FLMs) play in managing their staff while providing high-quality services in times of crisis. FLMs must be both leaders and managers in order to deal with a pandemic, in which uncertainty and a lack of knowledge create a complicated and demanding environment. Both functions are critical to providing quality services when resources are limited and only a few workers are available. The FLMs focused on mass-level awareness programs with active community engagement and participation, counseling for behavioral change, the provision of information in order to address socio-cultural barriers to community engagement, better utilization of agency services and resources, and pandemic management so as to reduce the spread and the rate of infection of COVID-19 among Rohingya refugees. Senior and middle management commitment was required to help FLMs manage a pandemic, even in the face of uncertainty, unpredictability, ambiguity, and a lack of information about the virus and its cure. They must serve as role models. FLMs should be empowered to fulfill their leadership roles through the better use of community strengths and resources during pandemics or other crises by strengthening local leadership skills, community capabilities, and an overall sense of communal responsibility. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the experiences of women with kidney disease, residing in the United Kingdom (UK), living through the first 18 months of the COVID‐19 pandemic with specific focus on preconception decision‐making, family planning, and parenting. Methods: We conducted a mixed‐methods study, comprising an online survey and follow‐up interviews, with UK‐resident women aged 18–50. Results: We received 431 surveys and conducted 30 interviews. Half (n = 221, 51%) of the survey respondents considered that COVID‐19 influenced the quality of communication with healthcare professionals and 68% (n = 295) felt that the pandemic disrupted their support networks. Interview participants indicated that delayed and canceled appointments caused anxiety, grief, and loss of pregnancy options. Women's perception of themselves as (good) mothers as well as their capacity to have and raise a child, meet partners, and sustain healthy relationships was negatively affected by the "clinically extremely vulnerable" label. Women's trust in their healthcare was dismantled by miscommunication and variation in lockdown rules that caused confusion and increased worry. Women reported that COVID‐19 contributed to postnatal depression, excessive concern over infant mortality, preoccupation over others following rules, and catastrophising. Conclusion: Some women in the UK with chronic kidney disease lost or missed their opportunity to have children during the pandemic. Future pandemic planners need to look more holistically and longer term at what is and is not classed as an emergency, both in how services are reconfigured and how people with chronic conditions are identified, communicated with, and treated. [ABSTRACT FROM AUTHOR]

Introduction: The COVID‐19 pandemic (2020–2021) resulted in isolation due to social distancing rules and lockdowns, during which technology was used to enable families and friends to maintain contact. Despite loneliness being high in parents, little is known about which parents are more likely to experience loneliness and strategies to support them. Method: This mixed‐methods study examines which parents were lonely during the pandemic and how digital technologies were used to reduce loneliness and social isolation. Data were collected during the first UK lockdown from May to July 2020 via an online survey (N = 145) and follow‐up interviews (n = 13). Results: Loneliness reported during lockdown was greater than retrospective reporting of loneliness for all respondents, but it was higher in single parents, those caring for children with specific needs, and those with lower household incomes before and during lockdown. Parents rapidly adapted to and experimented with using technology for social connection during the lockdown, which helped to reduce feelings of isolation and loneliness. Video calling was found to be useful for making connections and enhancing social presence, but parents also experienced anxieties and difficulties with its use. There were mixed views about technology use; some were keen to continue using technology for socializing after the lockdown ended, but for others, it was only a temporary measure. Conclusion: Although technology was invaluable during the pandemic, it was not a panacea, and the way parents used it was influenced by their approach to technology and existing social behaviors and networks. [ABSTRACT FROM AUTHOR]

Aim: To gain staff feedback on the implementation and impact of a novel ambulatory monitoring system to support coronavirus patient management on an isolation ward. Design: Qualitative service evaluation. Methods: Semi‐structured interviews were conducted with 15 multidisciplinary isolation ward staff in the United Kingdom between July 2020 and May 2021. Interviews were audio‐recorded, transcribed and analysed using thematic analysis. Findings: Adopting Innovation to Assist Patient Safety was identified as the overriding theme. Three interlinked sub‐themes represent facets of how the system supported patient safety. Patient Selection was developed throughout the pandemic, as clinical staff became more confident in choosing which patients would benefit most. Trust In the System described how nurses coped with discrepancies between the ambulatory system and ward observation machines. Finally, Resource Management examined how, once trust was built, staff perceived the ambulatory system assisted with caseload management. This supported efficient personal protective equipment resource use by reducing the number of isolation room entries. Despite these reported benefits, face‐to‐face contact was still highly valued, despite the risk of coronavirus exposure. Conclusion: Hospital wards should consider using ambulatory monitoring systems to support caseload management and patient safety. Patients in isolation rooms or at high risk of deterioration may particularly benefit from this additional monitoring. However, these systems should be seen as an adjunct to nursing care, not a replacement. Implications for the Profession and/or Patient Care: Nurses valued ambulatory monitoring as a means of ensuring the safety of patients at risk of deterioration and prioritizing their workload. Impact: The findings of this research will be useful to all those developing or considering implementation of ambulatory monitoring systems in hospital wards. Reporting Method: This manuscript follows the Consolidated criteria for Reporting Qualitative Research (COREQ) guidelines with inclusion of relevant SQUIRE guidelines for reporting quality improvement. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Introduction: The Covid‐19 pandemic dramatically altered the way cancer care services were accessed and delivered, including for colorectal cancer (CRC). In the United Kingdom, patients were discouraged from presenting in primary care, many consultations took place remotely, investigative procedures and screening programmes were temporarily suspended, and fewer operations and treatments were delivered. People had to face the practical consequences of having cancer during a pandemic and navigate never before seen pathways, often alone. We examined the experience of being diagnosed and treated for CRC during the pandemic, and the implications of this on people's cancer journeys. Methods: Semi‐structured interviews were undertaken with people diagnosed with CRC during the Covid‐19 pandemic (January 2020–May 2021), in the North East of England. An iterative topic guide was used during interviews, which took place remotely (telephone or Zoom), were audio recorded, pseudo‐anonymised and transcribed. Initial transcripts were independently coded by two researchers, and a code 'bank' developed for application across transcripts. Development of themes and overarching analytical constructs was undertaken collaboratively by the research team. Results: Interviews were conducted with 19 participants, analysed and four key themes identified: (1) The relative threats of Covid‐19 and Cancer were not comparable, with cancer seen as posing a far greater risk than Covid‐19; (2) Remote consultations were problematic, affecting patients' abilities to build rapport and trust with clinicians, assess nonverbal communication, and feel able to disclose, comprehend and retain information; (3) Stoma follow‐up care was seen to be lacking, with long wait times for stoma reversal experienced by some; Finally, (4) Being alone during consultations negatively impacted some peoples' abilities to absorb information, and left them without the support of loved ones at an emotionally vulnerable time. However, some participants preferred being alone at certain points in their pathways, including receiving a diagnosis, and most frequently when receiving in‐patient treatment. Conclusion: Being alone brought unexpected benefits, absolving people from undertaking emotions work for others, and instead focus on their recovery, however, remote consultations negatively impacted patients' experiences. This study highlights the complex benefits and burdens of pandemic‐located cancer journeys, including how these shifted at different points across cancer pathways. Patient or Public Contribution: Lorraine Angell, a cancer survivor, has been central to this study from idea conception, contributing to: development of study focus and design; securing funding; production of patient‐facing materials; development of interview topic guides; analysis and interpretation of data; and drafting of key findings and manuscripts. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to uncover perspectives on the COVID‐19 pandemic and the responses implemented by the UK and Scottish Governments to help control the spread of infection. Such understanding could help to inform future responses to pandemics at individual, community and national levels. Method: Q methodology was used to elicit perspectives from people in England and Scotland with different experiences of the pandemic including public health officials, key workers, those on furlough, those who were unvaccinated or vaccinated to different levels, those who were 'shielding' because they were at higher risk and people with different scientific expertise. Participants rank‐ordered phrases about different aspects of COVID‐19 according to their viewpoint. Factor analysis was then conducted in conjunction with interview material from the same respondents. Results: A four‐factor solution was statistically supported and was interpretable alongside the qualitative accounts of participants loading on these factors. These four perspectives are titled Dangerous and Unaccountable Leadership, Fear and Anger at Policy and Public responses, Governing Through a Crisis and Injustices Exposed. Conclusion: The four perspectives demonstrate plurality and nuance in views on COVID‐19 and the associated policies and restrictions, going beyond a binary narrative that has been apparent in popular and social media. The four perspectives include some areas of common ground, as well as disagreement. We argue that understanding the detail of different perspectives might be used to build cohesion around policy initiatives in future. Patient or Public Contribution: The development of the statement set, which is rank‐ordered by participants in a Q study, and factor interpretations were informed by views of the general public. The statement set was initially developed using existing publicly available material based on members of the general public experiencing the pandemic first hand. It was then piloted with members of the public experiencing different challenges as a result of COVID‐19 and the subsequent lockdown and updated based on feedback. Finally, interpretations of the identified factors were presented publicly and edited according to their feedback. [ABSTRACT FROM AUTHOR]

Background: Healthcare workers (HCWs) in the United Kingdom (UK) have faced many challenges during the COVID-19 pandemic, some of these arising out of their social positions. Existing literature explicating these challenges (e.g., lack of appropriate PPE, redeployment, understaffing) have highlighted inequities in how these have been experienced by HCWs based on ethnicity, gender or, job role. In this paper, we move a step ahead and examine how the intersection of these social positions have impacted HCWs' experiences of challenges during the pandemic. Methods: We collected qualitative data, using interviews and focus groups, from 164 HCWs from different ethnicities, gender, job roles, migration statuses, and regions in the United Kingdom (UK) between December 2020 and July 2021. Interviews and focus groups were conducted online or by telephone, and recorded with participants' permission. Recordings were transcribed and a hybrid thematic analytical approach integrating inductive data-driven codes with deductive ones informed by an intersectional framework was adopted to analyse the transcripts. Results: Thematic analysis of transcripts identified disempowerment, disadvantage and, discrimination as the three main themes around which HCWs' experiences of challenges were centred, based on their intersecting identities (e.g., ethnicity gender, and/or migration status). Our analysis also acknowledges that disadvantages faced by HCWs were linked to systemic and structural factors at the micro, meso and macro ecosystemic levels. This merging of analysis which is grounded in intersectionality and considers the ecosystemic levels has been termed as 'intrasectionalism'. Discussion: Our research demonstrates how an intrasectional lens can help better understand how different forms of mutually reinforcing inequities exist at all levels within the healthcare workforce and how these impact HCWs from certain backgrounds who face greater disadvantage, discrimination and disempowerment, particularly during times of crisis like the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic influenced the way individuals conducted their lives, with consequences relating to mental health deterioration. Whilst researchers explored this outcome in the general population and athletic populations, less focus was on athletes with disabilities. The aim of this study was to investigate how the pandemic influenced the mental health of elite para-athletes in the United Kingdom. Nine elite-level athletes with disabilities participated in semi-structured interviews. Three broad themes were interpreted from the data using reflexive thematic analysis, two themes reflected the negative impact of COVID-19 on mental health and one theme reflected positive outcomes of the pandemic. Athletes explained that losing face-to-face interactions and delays in major sporting events were significant factors in their mental health decline. This population group reported different challenges to able-bodied communities. Differences included increased susceptibility to contract the virus, difficulties in communication where face masks and online interactions became necessary and perceptions of vulnerability relating to shielding protocols. Finally, positive outcomes related to the additional time to recover, to prepare for major events and time to reassess their values. Exploring experiences of a pandemic on this population group warrants further exploration to enhance the effectiveness of mental health support services in para-sporting organisations. [ABSTRACT FROM AUTHOR]

Free School Meals (FSM) have been the site of renewed contestation and extensive campaigning in the last half-decade. Until recently, children in families with 'no recourse to public funds' because of their immigration status were excluded from accessing FSMs, despite being some of the most destitute in Britain. Through an analysis of campaign materials and interviews with advocates, we consider this dynamic policy terrain in light of the UK's 'hostile environment' and consider lessons for campaigners. By exploring imaginaries of childhood, poverty, and nation shaping FSM policies, we offer a warning that campaigns can end up justifying exclusions at the same time as aiming for more expansive support. How campaigns represent their causes has implications, which, in this case, is often through the exceptionalism and hyper-deservingness of childhood. We argue these representations reduce discussion to technical questions about who is 'deserving', thereby risking shoring up an exclusionary and hostile state. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, many face-to-face group activities for new parents moved online. In this article, we share findings from 14 interviews conducted during the first lockdown in the United Kingdom with parents of babies under 12 months about their experiences of participating in online groups. Attendance at groups was treated as a survival mechanism or even a panacea for some parents, providing well-rounded entertainment and support for parents, their children and the parenting relationship. However, reviews of the online groups were mixed, with some deemed more adequate than others for online delivery. Parents expressed concerns about the lack of informal spaces in online contexts to share private conversations and the unnatural group conversations affected by the custom of taking turns to talk. These experiences highlighted what was important to parents: the need for the embodiment of connection. The peculiarity of the online setting saw the emergence of parenting display work; parental awareness of online impression management and self-presentation strategies. While online technologies are ubiquitous, online groups for parents are nascent, and these technologies require careful analysis and evaluation from users and facilitators. [ABSTRACT FROM AUTHOR]

In March 2020, Coronavirus‐19 (COVID‐19) rapidly spread across the globe impacting the mental health of the population and putting an overwhelming pressure on health services. Much has been written about the impact of the pandemic on health‐care workers working in hospital settings but less attention has been paid to its effect on community mental health teams (CMHTs). This study is based on 21 remote interviews with community mental health professionals during the first wave of the COVID‐19 pandemic. Interviews were transcribed and analysed using a thematic analysis whereby codes of similar meaning were grouped into main themes. Analysis identified three major contributors to moral distress; changes in the nature of contact with service users, changes to the place of work, and difficulties of balancing risks to the families of CMHT staff and service users. This study demonstrates that necessary organizational changes instituted to minimize the spread of COVID‐19, required different ways of working which were not perceived to be in the best interests of service users or the families of CMHT staff. In order to comply with Government directives, CMHT staff were forced to behave in a way which did not match their moral values causing them to experience moral distress. [ABSTRACT FROM AUTHOR]

Purpose: This service evaluation aims to understand the experiences of service users (SUs) who accessed an early intervention in psychosis (EIP) service during the Coronavirus pandemic using qualitative and quantitative methodologies and compare these to a previous pre-pandemic study conducted within the same service (Watkins et al., 2018). Design/methodology/approach: This paper collated experiences of individuals accessing an EIP service to inform service development. Questionnaires and individual interviews were conducted to provide quantitative and qualitative data. Descriptive statistics and T-test confidence intervals were created from the results and compared to findings of Watkins et al. (2018). Interviews were transcribed verbatim and analysed using Braun and Clarke's (2006) thematic analysis. Findings: Data showed participants were largely satisfied with all areas of the service with "work or education", "living skills", and "addictions" scoring highest. Though participants reported no overall dissatisfaction, satisfaction levels dropped in "social activities" compared to the findings of Watkins et al. (2018), perhaps due to the national restrictions put in place to manage the spread of Coronavirus during this time. Interview analysis identified three themes of importance consistent with prior literature, highlighting the importance of relationships and validation during recovery. Research limitations/implications: This evaluation did not consider whether participants had accessed the service prior to the pandemic or only during, meaning that some participants could have a point of comparison with the service pre-pandemic, whereas others might not. Similarly, the participants were not the same as those of the Watkins et al.'s (2018) evaluation, meaning that direct comparisons of pre- and post-pandemic experiences were not possible. In addition, this evaluation collected data at only one time point early in the pandemic; therefore, it is unknown if client experiences of services differed as the pandemic and restrictions continued over time. Originality/value: The Covid-19 pandemic has been an unprecedented challenge for health services, and the effects of this are becoming widely reported. This evaluation of clinical services offers a valuable perspective of service user experience of receiving mental health services during a global health crisis further offering a comparison to pre-pandemic services and the experiences of those who used them. [ABSTRACT FROM AUTHOR]

In this article, we take forward sociological ways of knowing care‐in‐practice, in particular work in critical care. To do so, we analyse the experiences of staff working in critical care during the first wave of the COVID‐19 pandemic in the UK. This moment of exception throws into sharp relief the ways in which work and place were reconfigured during conditions of pandemic surge, and shows how critical care depends at all times on the co‐constitution of place, practices and relations. Our analysis draws on sociological and anthropological work on the material culture of health care and its sensory instantiations. Pursuing this through a study of the experiences of 40 staff across four intensive care units (ICUs) in 2020, we provide an empirical and theoretical elaboration of how place, body work and care are mutually co‐constitutive. We argue that the ICU does not exist independently of the constant embodied work of care and place‐making which iteratively constitute critical care as a total system of relations. [ABSTRACT FROM AUTHOR]

When it became clear that the COVID-19 pandemic would require significant shifts in working practice, staff in the Adult Complex Needs department at the Tavistock clinic designed a study to explore the emotional impact of remote working on clinicians and patients, and to consider related clinical implications both individually and collectively. A set of semi-structured questions were designed to tap into experiences of working remotely, and clinicians were interviewed. The material arising from these interviews has been summarised into themes. The predominant theme was clinicians' awareness of the importance of their own emotional milieu in delivering psychoanalytic psychotherapy, especially at a time of crisis, in their initial emotional responses and as they gathered further remote experience. They raised challenges around maintaining an analytic frame amid therapeutic uncertainties, and in the context of the many physical losses of a remote frame: blurred clinical boundaries, altered emotional experiences and resonance, and important impacts on holding, patient attendance, and worsening distress and risks for patients who struggled remotely. Strategies to adapt were key, particularly remaining emotionally consistent and observant amidst uncertainty, and support was paramount to do so. These experiences assist in informing clinicians about the limitations and uses of remote clinical work. [ABSTRACT FROM AUTHOR]

Aim: To generate, test and refine programme theories that emerged from a rapid realist review investigating practising UK Nurses' and Midwives' experiences of effective leadership strategies during the COVID‐19 pandemic. Background: The realist review of literature generated six tentative theories of healthful leadership practices reflecting, working with people's beliefs and values; being facilitative; multiple means of communication and; practical support. The review yielded little insight into the actual impact of the leadership approaches advocated. Methods: A realist study, informed by person‐centredness using mixed‐methods. Online survey (n = 328) and semi‐structured interviews (n = 14) of nurses and midwives across the UK in different career positions/specialities. Quantitative data analysed using descriptive statistics and exploratory factor analysis. Framework analysis for qualitative data using context (C), mechanism (M), outcome (O) configurations of the tentative theories. Results: Three refined theories were identified concerning: Visibility and availability; embodying values and; knowing self. Healthful leadership practices are only achievable within organisational cultures that privilege well‐being. Conclusions: Leaders should intentionally adopt practices that promote well‐being. 'Knowing self' as a leader, coaching and mentoring practice development is important for leadership development. Implications for Clinical Practice: Nurses who feel valued, heard, cared for and safe are more likely to remain in clinical practice. Job satisfaction and being motivated to practice with confidence and competence will impact positively on patient outcomes. Impact: The study addresses the role of leadership in developing healthful workplace cultures. The main findings were six leadership practices that promote healthful cultures. The research will have an impact on strategic and clinical leaders, nurses and midwives. Reporting Method: This study used EQUATOR checklist, RAMASES II as reporting standards for realist evaluations. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

The imposition of nation-wide lockdowns and sporadic transition to remote work produced unforeseen psychological challenges likely to impact the medium of care and workload of mental health professionals. The present study explored the lived occupational experiences of clinical psychologists, counsellors, and psychotherapists working in the National Health Service (NHS) and private practice in the UK during COVID-19 pandemic. Nineteen professionals (11 employed in the NHS and 8 working in independent settings) were interviewed about their professional experiences during first and second waves of the pandemic. Data were analysed using interpretative phenomenological analysis. Three main themes emerged from the analysis: (i) transition from face to face to online therapy; (ii) novel changes and wellbeing; and (iii) uncertain professional support in uncertain times. The findings suggest that lack of experience in providing online or telephonic psychotherapeutic services from home negatively impacted professionals' physical and psychological health and wellbeing. Thus, to cope with it, they availed psychological and structural support from colleagues, co-workers, clinical supervisors, managers, organisations, and professional bodies. This study adds to the existing body of research on the impact of the pandemic on UK-based mental health professionals and from an applied perspective, it highlights the need for skill-upgradation of professionals. [ABSTRACT FROM AUTHOR]

Inter- and intragenerational relationships are known to be important in maintaining the wellbeing of older people. A key aspect of these relationships is the exchange of both emotional and instrumental social support. However, relatively little is known about how this exchange of support changes in the context of widespread disruption. The COVID-19 pandemic provides an opportunity to examine how older people's family relationships are impacted by such social change. The present qualitative study explores how older people in the United Kingdom experienced changes in inter- and intragenerational support during the COVID-19 pandemic. Participants (N = 33) were recruited through a large-scale nationally representative survey (https://www.sheffield.ac.uk/psychology-consortium-covid19). We asked how life had been pre-pandemic, how they experienced the first national lockdown and what the future might hold in store. The data were analysed using constructivist grounded theory. This paper focuses on the importance of family relationships and how they changed as a consequence of the pandemic. We found that the family support system had been interrupted, that there were changes in the methods of support and that feelings of belonging were challenged. We argue that families were brought into disequilibrium through changes in the exchange of inter- and intragenerational support. The important role of grandchildren for older adults was striking and challenged by the pandemic. The significance of social connectedness and support within the family had not changed during the pandemic, but it could no longer be lived in the same way. The desire to be close to family members and to support them conflicted with the risk of pandemic infection. Our study found support for the COVID-19 Social Connectivity Paradox: the need for social connectedness whilst maintaining social distance. This challenged family equilibrium, wellbeing and quality of life in older people. [ABSTRACT FROM AUTHOR]

Good practice on disaster response emphasises the importance of leadership and cohesive group identities. The COVID‐19 pandemic provided an opportunity to explore how low‐paid health and social care workers (HSCWs) accounted for the UK government's response, given worker's limited resources and disproportionate impact on their lives. Thirteen semi‐structured interviews took place with low‐paid HSCWs in England. Interviews were analysed using critical reflexive thematic analysis that is influenced by discursive psychology and membership categorisation analysis to explore the construction of identities and how they are used to account for the pandemic response. Three themes were generated from the data: (1) 'They kind of knew what was coming': UK government slow to react to pandemic developments; (2) 'the right thing kept changing every five minutes: Frustrations with changing guidelines and (3) 'all about the NHS and what about the rest of us?': Private sector HSCWs presented as inferior. This research highlights the importance of addressing the minimisation of low‐paid HSCWs through communications and access to material resources. There is a need to address economic disparities within the social care sector and for the UK government to plan future crisis management with all frontline staff at the forefront to form a collective identity. [ABSTRACT FROM AUTHOR]

Purpose: In 2021, an opportunity arose to place four counselling and psychotherapy (C&P) students in three care homes across Greater Manchester as part of a 6‐week interprofessional education (IPE) care home scheme. Whilst, due to ethical concerns around confidentiality, the C&P students could not participate in interprofessional activities as intended, they still undertook their clinical placement in the home to provide accessible therapy support for care home staff. This paper aims at reporting on the varied factors that influenced the implementation of C&P student placements in care homes. Methods: At the start and end of their placement, four C&P students were interviewed about their experiences. We draw on data from these eight interviews and two reflective vignettes: one from a C&P student and the other from the C&P programme coordinator (C&PPC). Results: The data were thematically analysed, and two key themes and six subthemes were constructed. They broadly unpack the factors that facilitate and challenge the implementation of C&P student placements in care homes. Conclusion: This paper highlights the value of utilising care homes as placement sites for C&P students. We propose four key recommendations for future practice: (1) it is important to establish clear lines of communication, support and collaboration; (2) a dual‐space supervisory approach supports student learning in this "new" placement environment; (3) preplacement supportive frameworks are important to clarify initial role uncertainties within the care home; and (4) opportunities to provide therapy services should be well defined and referral processes put in place before the student arrives. [ABSTRACT FROM AUTHOR]

To explore the experiences of children and young people (CYP) with attention deficit hyperactivity disorder during the COVID-19 pandemic and lock down restrictions. Semi-structured, online interviews were conducted with 17 children and young people from the UK, Northern Ireland, aged 10–14 years with ADHD. Over half the participants had a co-existing diagnosis, such as autism spectrum disorder. Interviews were recorded and transcribed verbatim before being subjected to thematic analysis. Four themes were identified; the emotional impact of the pandemic, adjustments to daily living, impact of remote learning and the effect on relationships. Many CYP citied feelings of sadness, loneliness and anxiety, others found the reduction in social demands favourable. As one of few studies to capture the experiences of children and young people with ADHD during the COVID-19 pandemic, this research highlights the potential negative long-term impact on emotional welfare, schooling and relationships. Health care professionals should be aware of the overall impact on health and well-being for children and young people with ADHD following the COVID-19 pandemic and lockdown restrictions to ensure that the effect of these are minimised and managed in the future. Educators and clinicians should be cognisant of the long term consequences of poor mental health during the COVID-19 pandemic and should put in place pro-active strategies to support children and young people with ADHD. Children and young people with ADHD may suffer greatly from reduced access to sports and leisure facilities. Policy makers should be conscious of the potential negative consequences of placing limitations on access to such facilities. [ABSTRACT FROM AUTHOR]

Background: Young carers are children or young people aged up to 25 years old who undertake unpaid caring responsibilities for a friend or family member. Young carers faced significant challenges brought on by the COVID-19 pandemic. We explored the impact of the pandemic and associated restrictions on mental health, wellbeing and access to support in young carers in the United Kingdom (UK) to understand how to improve services, as well as support this population in future health emergencies. Method: We conducted 22 qualitative semi-structured interviews from May to November 2021 with 14 young carers and eight staff working in organisations that supported them. Interviews took place remotely over video or telephone call and explored participant experiences of the pandemic and its impact on their health, wellbeing and caring responsibilities. We used reflexive thematic analysis to analyse interview transcripts. Results: We identified four overarching themes pertaining to the impact of the pandemic and associated restrictions on mental health, wellbeing and access to support in young carers in the UK: (1) challenges in protecting loved ones from the virus, (2) changes to and loss of routine, (3) reduced access to pre-pandemic informal and formal support structures and (4) better understanding of inner resilience and goals. Many participants struggled with their mental health and wellbeing as a result of pandemic related restrictions which impacted on support structures for themselves and the individual they cared for. However, positive impacts pertained to additional support provided by local authority and third sector organisations. Conclusions: Our findings highlight some of the changes that affected young carers during the COVID-19 pandemic. The impact of changes to routine and a reduction in pre-pandemic support were the greatest concerns reported by participants in this study. The additional support provided by local authority and third sector organisations during social restrictions suggests such organisations could play a greater role in supporting this population going forward and that schools and Governments may wish to put in additional strategies and provisions to protect young carers in the future. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic has affected many industries, and reports indicate that this includes the illicit drug market. Recent research suggests that the homeless are particularly vulnerable during the pandemic, and the UK Government has acted to house rough sleepers. Research is scarce regarding homeless people's experiences of the illicit drug market. This study aims to explore homeless people's experiences of the drug supply in the UK during COVID-19. Design/methodology/approach: Eight homeless people who use illicit drugs, residing in hostels for homeless people in Southampton, participated in semi-structured one-on-one telephone-based interviews. Findings: A thematic analysis revealed five themes: availability of drugs, presence of dealers, quality of drugs, finances and personal experiences. Participants reported varying experiences of the drug supply, with lockdown measures expressed as the main reason for reduced supplies, as users found it difficult to find dealers and generate income for purchasing drugs. Research limitations/implications: The results may lack generalisability to the wider population, such as rough sleepers and drug dealers, suggesting a need for further research into people's experiences of the drug supply during COVID-19. Research on this topic could be more in-depth through the use of research methods that are convenient for the homeless population. Practical implications: Services should invest in harm reduction services and encourage homeless people who use drugs to engage in substitution treatment. Homeless services should provide psychological support for homeless people who use drugs. Social implications: The changes in homeless people's behaviour following the pandemic may have implications for their interactions with the rest of society (e.g. begging in town centres may reduce). These changes in behaviour may also change the way society can best support homeless people. Originality/value: The results are partially consistent with other research findings about the illicit drug supply; however, they also suggest that some individuals experienced minimal change in the illicit drug supply. [ABSTRACT FROM AUTHOR]

We conducted a service evaluation of the medical support worker (MSW) role at Oxford University Hospitals NHS Foundation Trust following the Coronavirus 2019 (COVID-19) pandemic. The aim was to explore the roles of MSWs, their contributions to the NHS, factors influencing their career choices, and the goals of the MSW position, to inform quality improvement in relation to their integration into the Trust. The perspectives of MSWs, their supervisors and recruiters were analysed through nine semi-structured interviews and two focus group discussions involving 18 participants. Results were categorised into micro-, meso-, and macro-levels of the health system. At the micro-level, MSWs were recognised as a diverse group of highly qualified international medical graduates (IMGs) who had a crucial role during the pandemic. At the meso-level, participants emphasised the importance of a comprehensive induction by the hospital, to clarify responsibilities and familiarise MSWs with the health system. At the macro-level, the role facilitated MSW integration within the NHS, with the aim of practising as doctors. The importance of comprehensive hospital induction, with role clarity for both MSWs and their teams, supportive supervision and assistance with applying for registration with the General Medical Council, were highlighted as key quality improvement areas. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic has had both a psychological and physiological effect on the human race. For those working in health care, particularly in critical care, the pandemic has put unprecedented strain on staff. Witnessing suffering during crisis in an organizational setting can be a traumatic experience and critical care nurses often risked, not only their own lives, but their psychological well‐being, so that those infected with the virus might have a better chance at survival. Aim: The aim of this study was to explore the challenges to mental health and psychological well‐being experienced by Critical Care Nurses during the COVID‐19 pandemic. Study Design: A longitudinal, qualitative study involving semi‐structured interviews with 54 critical care nurses across 38 hospitals in the United Kingdom and Ireland. Interviews were transcribed verbatim and analysed using thematic analysis. Results: Four key themes were identified which represent the challenges faces by critical care nurses during the COVID‐19 pandemic: Lack of control, Psychological trauma, Unexpected leadership, Public‐political betrayal. Conclusions: While public‐political praise may lead to a short‐term lift in morale for front line workers; where it is not accompanied by practical support in terms of appropriate equipment, leadership, emotional support and renumeration it is likely to be damaging in the longer term. Relevance to Clinical Practice: This study has provided a greater understanding of the factors which affected the well‐being and mental health of critical care nurses during a global pandemic. [ABSTRACT FROM AUTHOR]

Aim: To understand the experience of critical care nurses during the COVID‐19 pandemic, through the application of the Job‐Demand‐Resource model of occupational stress. Design: Qualitative interview study. Methods: Twenty‐eight critical care nurses (CCN) working in ICU in the UK NHS during the COVID‐19 pandemic took part in semi‐structured interviews between May 2021 and May 2022. Interviews were guided by the constructs of the Job‐Demand Resource model. Data were analysed using framework analysis. Results: The most difficult job demands were the pace and amount, complexity, physical and emotional effort of their work. Prolonged high demands led to CCN experiencing emotional and physical exhaustion, burnout, post‐traumatic stress symptoms and impaired sleep. Support from colleagues and supervisors was a core job resource. Sustained demands and impaired physical and psychological well‐being had negative organizational consequences with CCN expressing increased intention to leave their role. Conclusions: The combination of high demands and reduced resources had negative impacts on the psychological well‐being of nurses which is translating into increased consideration of leaving their profession. Implications for the Profession and/or Patient Care: The full impacts of the pandemic on the mental health of CCN are unlikely to resolve without appropriate interventions. Impact: Managers of healthcare systems should use these findings to inform: (i) the structure and organization of critical care workplaces so that they support staff to be well, and (ii) supportive interventions for staff who are carrying significant psychological distress as a result of working during and after the pandemic. These changes are required to improve staff recruitment and retention. Reporting Method: We used the COREQ guidelines for reporting qualitative studies. Patient and Public Contribution: Six CCN provided input to survey content and interview schedule. Two authors and members of the study team (T.S. and S.C.) worked in critical care during the pandemic. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To explore the experiences of nursing students in England who had worked through the first wave and transitioned to qualification in the ongoing pandemic. Background: Experiences of health professionals and student nurses during the pandemic are now well documented, but the transition of students to qualification is less well understood. In Summer 2020, we interviewed 16 student nurses who had worked as health care assistants on paid extended placements as part of the COVID‐19 response in the East of England, finding surprisingly positive experiences, including perceived heightened preparedness for qualification. A year later, we re‐interviewed 12 participants from the original study to hear about transitioning to qualification during the ongoing pandemic. This study provides novel insights into their experiences. Design: A qualitative study design was used. Methods: Twelve newly qualified nurses who had participated in the original study took part in qualitative, online interviews where they shared their experiences of working and transitioning to qualification during the ongoing pandemic since we spoke to them a year earlier. The data was analysed using thematic analysis. COREQ guidelines were used in developing and reporting this study. Results: Three themes were identified. Constant change: in the clinical environment and arising out of the transition to newly qualified nurse, mental health and well‐being and reflecting on the past to learn for the future. Conclusions: Participants experienced a unique transition to qualification. The perceived heightened preparedness for qualification that participants who had worked as students during the first wave of the pandemic had become a reality, ameliorating some of the known effects of transition. However, increased expectations and added responsibilities in extremely busy, fluctuating clinical environments with minimal support add weight to calls for mandatory preceptorship programmes. While heightened resilience was evident, provision of ongoing mental health and well‐being support is strongly recommended. Relevance to Clinical Practice: We need a partnership approach with nurse educators and practice colleagues which ensures preparation for qualified practice is appropriate. If we do not effectively prepare students for qualified nurse posts, patient care will almost certainly be compromised. [ABSTRACT FROM AUTHOR]

Loneliness is a pernicious problem in older adulthood, associated with physical decline and isolation from valued social groups. However, the long‐term evolving experiences of ageing, identity and loneliness have yet to be elucidated. We use a Qualitative Longitudinal Research interview approach with nine vulnerable older adults (Agemean = 79.4 years), in which five participants were interviewed twice between 2019 and 2020, and four participants were interviewed at three‐time points from 2019 to 2021. This study aims to understand the unfolding experiences of ageing, social identity and loneliness during a prolonged period of social isolation during the Coronavirus pandemic. A theoretically guided thematic analysis highlights that participants initially experience 'Categorisation as Vulnerable and Loss of Agency' and 'Shrinking Social Worlds', leading to 'Undermining of Reciprocal Support' and 'Fears of Persistent Loneliness'. Findings suggest that interventions to ameliorate loneliness among older adults would benefit from addressing age‐based stereotypes and emphasising the value of reciprocal contributions that older adults can make to their networks, as well as scaffolding and enhancing social identification with new groups. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

Summary: Unpaid carers were profoundly impacted by the coronavirus disease 2019 pandemic and public health responses. In the UK, in March 2020, people identified as clinically extremely vulnerable and their household members were advised to "shield" for an initial 12-week period, which meant minimizing all contacts from outside the household and not leaving the house at all, unless in an emergency. In a modified form, shielding guidance remained in place until August 2020 and was reinstituted from December 2020 until April 1, 2021. This article, reporting on qualitative interviews with 47 unpaid carers in Wales, thematically analyzed using a coding framework, explores the experiences of unpaid carers affected by this shielding guidance and their wider implications for social work with unpaid carers in the future. Findings: Participants in our study described ways in which their caring role expanded, due to the need to provide additional practical and emotional support for loved ones who were shielding, and who lost access to other avenues of support. Some also described their caring role as becoming more involved and complex due to the declining health or self-care capacity of the person cared-for as a direct consequence of shielding restrictions. Alongside the increase in their caring responsibilities, carers reported losing access to important avenues of support for their own well-being. Applications: We draw on ecological systems theory to highlight the importance during care planning and management of exploring the carer's mesosystem to identify and optimize sustaining forces, and of attending to the microsystem involving the carer and person cared-for. [ABSTRACT FROM AUTHOR]

Social science research on polio has been centred in the global south, where countries that remain endemic or vulnerable to outbreaks are located. However, closely-related strains of poliovirus were detected in the sewage systems of several New York State counties and London boroughs in 2022. These detections constituted the first encounters with polio in the United States and United Kingdom for a generation – for both public health agencies and publics alike. This paper takes the transnational spread of poliovirus in 2022 as an opportunity to critique how public health memories of twentieth-century polio epidemics were mobilised to encourage vaccine uptake among groups considered vulnerable to transmission, notably Orthodox Jewish families. The study integrates data collected in London and New York as part of academic engagement with health protection responses to the spread of polio. Methods in both settings involved ethnographic research, and a total of 59 in-depth semi-structured interviews with public health professionals, healthcare providers, and Orthodox Jewish community partners and residents. Analysis of results demonstrate that narratives of epidemiological progress were deployed in public health responses in London and New York, often through references to sugar cubes, iron lungs, and timelines that narrate the impact of routine childhood immunisations. While memories of polio were deployed in both settings to provoke an urgency to vaccinate, vulnerable publics instead considered the more recent legacy of the COVID-19 pandemic when deciding whether to trust recommendations and responses. Critical attention to memory places analysis on the divergences between institutional (public health agencies) and peopled (publics) responses to disease events. Responses to re-emerging infectious disease outbreaks engender a temporal dissonance when historical narratives are evoked in ways that contrast with the contemporary dilemmas of people and parents. • Memories of past polio outbreaks were deployed to encourage vaccination in 2022. • Vulnerable publics were instead concerned with the legacy of Covid-19 mis/management. • Memory provokes diverging concerns for public health agencies and communities. • Learning from community experiences of outbreaks may inform engagement strategies. [ABSTRACT FROM AUTHOR]