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Table 4 31 Themes derived from thematic analysis in phase 3 of data analysis for the 7 interview questions

From: RETRACTED ARTICLE: A thematic analysis of system wide learning from first wave Covid-19 in the East of England

Interview Questions

Themes Derived from Analysis

Number of data sets identified in the second level analysis showing strength of the theme

Q1. What has worked?

Theme 1: Collaborative, resilient, flexible teams who mutually support each other, cascade information and have risen to the challenge.

72

Theme 2: Cross-boundary working with, shared priorities, improved relationships, pooled resources, streamlined processes enabled new services

24

Sub-theme 2.1: Ideas implemented have spanned technical innovations and standard passports for volunteers in acute settings to sharing medications in short supply and adapting new ways of working in the community

5

Theme 3: Seeing the person in the patient, and with care and patience working with or for family members across the spectrum of care from recovery to death

24

Theme 4: Technology has contributed to normality and innovation through patient consultation/decision making, improved response times, EoL experiences, team communication, remote working, staff wellbeing, and recruitment

20

Q2. What has not worked?

Theme 5: The correct use and dehumanising impact of PPE and obtaining consistent supplies within a changing context

33*

Theme 6: Confusing messages, not knowing what is happening with impact on: mental health assessments, hospital admissions and attendance, university programmes and conspiracy theories

15

Theme 7: System not joined up or resilient impacting negatively on patient flow, social care, use of volunteer potential, track and trace or redeployment

9*

Theme 8: Unrequired actions in acute care yet social care left high and dry

2

Q3. What have been the challenges?

Theme 9: Managing emotional impact of the pandemic on people (staff, patients, residents, students) but keeping them hopeful and safe

45****

Theme 10: Caring for self and each other when anxious about passing virus onto others, suffering fatigue and stress, with no end in sight

41****

Theme 11: Supporting residents/patients with the impact of social isolation and their understanding of social distancing whilst also not seeing own families

42*******

Theme 12: Inconsistent policy and guidelines, and discontinuity across the system impacting on other parts of system, pace of change and uncertainty about when it will end - the new normal

28*****

Theme 13: Not knowing who has the virus, worrying about the risks to others (own families, patients, vulnerable others) and being more vigilant about safety.

19**

Theme 14: Exposure to increased number of people dying and impact of Covid related EoL care

9*

Q4. What have been the key challenges?

Theme 15: An amazing workforce – kind caring, supportive, strong teamwork and spirit has created a sense of pride, joy and feeling valued

85******

Theme 16: Everyone worked and learned together with a can-do attitude, supported by community spirit, everyone playing their part and the role of social care highlighted

41*******

Theme 17: Feeling valued and appreciated by so many – will it continue

29****

Theme 18: Strengthened relationships with own neighbours, family and relatives, spending quality time with them and better work-life balance

21**

Theme 19: Technology a success story for treatment, communication, virtual visiting, connecting and communicating with people, system efficiency, productivity and carbon footprint

13***

Q5. Learning Opportunities

Theme 20: Appreciate learning across the NHS and society to do things better or differently, enabling all parts to feel empowered to make a difference

30*******

Theme 21: Increase understanding for vigilance and keeping people safe and funding

14****

Theme 22: Continuing new ways of working – system focused integrating health and social care with good business planning to protect key supplies and human resources

15******

Subtheme 22.1: Wider recruitment across health and care economy, with reservists and volunteers and shorter recruitment processes to support permanent staff

7****

Subtheme 22.2: Ensure the right skills are in the right place at the right time

5*

Subtheme 22.3: System requirements to support high numbers of people requiring rehabilitation and needs of vulnerable people and those with mental health challenges

3*

Theme 23: Support for staff wellbeing

14**

Theme 24: Keep IT enhanced initiatives, recognising the need for good broadband connectivity

13****

Theme 25: Consistent and clearer messages on role of testing, applying social distancing sooner

4*

Q6. New insights

Theme 26: Developed greater recognition of own strengths, the importance of balancing support for self and others, maintaining wellbeing and appreciating the little things e.g. a job I enjoy.

50*********

Theme 27: Sustaining new ways of working, community spirit and cohesion

20**

Theme 28: Looking to the future, the new normal will be different wont need big offices, more flexible and home working, services will change what they can offer

15

Q7. Impact on Roles

Theme 29: Learning readily to work differently, adapting flexibly, making adjustments, supporting others in new roles or taking on new roles whilst coping with increased workload

89*******

Theme 30: More prepared for safety, stricter infection control, safeguarding so people feel safe

33****

Theme 31: Communicating more to get the right message across

5*

  1. NB * indicates the number of groups in addition to individual participants that identified the themes indicating the strength of each theme