Table 2 Service Provider interview quote examples

(LWC_31_06/20)

… We’ve been given shielding lists by the practices, so the people who are vulnerable, we’re checking on them, but that is not our normal conversations again. That’s just like, “Do you have food and medicine?” if you know the guidelines, stuff like that … checking that people are okay and they’ve got access to food and medicine, that they’re coping with it mentally and they know what they should be doing.

(Manager_3_06/20)

The type of support that we have been providing has changed slightly as well, in the early days. So, people were very worried and concerned, naturally, about COVID and what the likely impact that would potentially have on themselves and their health. They needed information around what they could and what they couldn’t do. So, it was just really to help them understand what the government was saying. So, a lot of time, initially I think, was supporting people around understanding of what the lockdown restrictions meant for them and finding out what support they needed. Because obviously, a lot of people don’t have family or friends and if they are shielding or isolating, they can’t go to the shops to get their shopping and stuff like that.

(Manager_4_05/20)

So, if you have improved your condition by getting out a bit more and feeling more hopeful and enlightened by that, and now you have been told you can’t go out, then there will be that bit- It is much easier to do something the first time than if you have gained some success and then slipped back. So, it is that bit of just trying to help people wherever possible not to lose the ground that they have gained.

(Manager_2_06/20)

I think the priorities initially were right, you know, checking in on the people in our current caseloads, making sure they had contact, and whether there was anything that they needed- that sort of immediate support-, or they still wanted to engage with ongoing support … Whilst obviously it has chucked everything up in the air for everybody, you know, still using our skills and our knowledge to be able to support people to manage this as best they can, and identify if there are goals, although they will be reframed, to still be able to work towards that even in the current climate.

(SLW_32_06/20)

(Manager_8_09/20)

The nature of our role is that we are very flexible and we maintain contact. It is very much a contact role and a communication role. I think that is important for people who have been self-isolating and haven’t left their homes. Some people: maybe the furthest they have gone is the garden. It is reassuring to know that you are ringing, they can contact you or if they are having problems with things, that you can ask the right questions to the right people and you can feed back information. Even if you haven’t got the information at the time, to be able to tell them that you are still waiting for information, but you have asked the question. I think that gives reassurance at a very difficult time. I think that is definitely a strength

… there was a sense that people were like, “Why would I discharge them at a time when everything in their life is up in the air?” So I think there was a sense that they were, kind of, keeping things open for a little while. I don’t think that’s the case anymore [in September]. I think things feel more stabilised

(Manager_2_06/20)

I think there was getting that balance between, “Here are the people that I know that I’ve been working with that I would identify as a priority.” But actually recognising that it was important for us to try and check-in with as many people, if not everybody, on our caseload to try and see what the impact of this situation was.

(Manager_1_06/20)

So we also had discussions with them about understanding on the caseload, people that actually probably didn’t need our support. Just to be able to discharge, for want of a better word, people that probably were coming to the end of their intervention with ourselves so we could really focus on those that really did need our support.

(LW_9_06/20)

But because of the current situation, I haven’t closed them or anything, because of the current situation.

(LW_9_06/20)

if you’re not digitally connected there’s an obvious gap for a lot of our clients’

(LW_33_06/20)

Some of our clients aren’t particularly tech-savvy. Some are on the internet and doing FaceTime with grandchildren and all that kind of thing, but I do have … Fairly recently … I’m finding this a challenge and I’m finding it difficult to know how to overcome really. I do have a couple of clients that are unable to read or write. Ordinarily, where I’d be sending an email with some links to websites or something like that for information during this time or even posting out something, printing something off my own printer, I don’t have that option with these two individuals

(LW_31_06/20)

(LW_31_06/20)

The transition to phone calls has been difficult, because even though we do that anyway, when we first do a [assessment] with someone, the face-to-face of that is so important because you’re introducing yourself, what the service is. You need to build that rapport, otherwise people aren’t going to open up to you. So, introducing that over the phone has been quite hard. Then everything has changed, so you can’t see what people are doing body-language wise, face wise. We’re told to hold silences, but that is very different over the phone

“things aren’t open, so things that I might like to signpost people to, I can’t.”

(SLW_32_06/20)

The people who I have spoken to don’t express an interest in anything like that [online activities]. I mean, a good example would be a client who was attending Slimming World. He mentioned about the Zoom facility that Slimming World that have and he said it didn’t work for him. It wasn’t the same as actually going to a group, seeing people and talking to them. This 2D representation, if you like, wasn’t the same as having that actual social contact.

(LW_33_06/20)

Some clients are like, “Oh, I prefer face-to-face because then I can see your facial reactions and your body language and all the rest of it.” It’s the same, I guess, for us, because we can’t really see how things land. If we’re saying something, a lot of the communication cues are visual rather than verbal.

(LW_9_06/20)

People who haven’t answered the phone are now answering the phone and they’re wanting to chat. Now that is brilliant, because a lot of people … who wouldn’t have wanted to come to the doctor’s surgery [to visit the link worker], or find it difficult … they will happily chat on the phone for half an hour, an hour, and they’re really engaging at quite a good level with that, they’re someone who is DNA [did not attend], coming to the doctor’s surgery before. And when I’m now chatting to them, it’s obvious that actually to physically come to the doctor’s surgery is difficult.

(LW_9_06/20)

nearly everyone picks up the phone immediately, and they want to talk to you, they haven’t got other stuff going on. So that’s been amazing. (Laughter) Partly because a little bit of their worries and stuff- They are quite open to ideas to benefit their health, because actually they’re a bit frightened. … I think the COVID thing has opened up people to a whole load of different new ideas. I kind of sense that a bit, that some people are just thinking, “Oh, I’ll give that a go.” It’s like opened up a different intensity about their health almost, that they’re now thinking that there might be other ways of doing things, and stuff

(SLW_32_06/20)

We are very social and there is a big social element, I believe, in motivation. For example, if somebody wanted to talk about smoking cessation, we would discuss realistic approaches and, maybe, reduction with a view to them moving on to cessation. I find that that can be quite difficult because people may be motivated to want to change, but not having that contact as well... That contact can be reassuring. “Oh, I can go and see [Link worker] at the GP.” They can book the appointment and come in and see me, have a chat about it and have a real face-to-face conversation as opposed to over the phone.

(LW_31_06/20)

they [clients] don’t really care about behaviour change at the minute … I think people just don’t really want the conversation that we want. They’re happy to talk with someone because they’re so bored-“I think it is just trying to stay on track of what we actually are, which is a behaviour change service. …. So, even if we’re not doing the conversations like I said, not all focused on behaviour change, we’re still speaking to someone, listening to them and if they do desperately need anything, we can signpost them to that. That is the main job of social prescribing, doing the signposting.