Table 2 Subthemes of theme II, with illustrative quotes

2a) Positive extension and growth in screeners’ role

“….. it is a role that doesn't go anywhere ….. With the introduction of this health screen, it has transferability into other screening programmes ….. like I said, it isn't a role where they can extend upwards, past the one before ..... as this will be an additional element in their role that they'll be screening two conditions um rather than one ..... so I think overall – yes, it is a positive thing. With the detection rate for triple A is declining, I think there needs to be an additional um function to the role as well – to make the – to ensure the continued viability of the screening programme …..”

(AAA Screening Programme administration manager, Interview 1)

“So, in some programmes, technicians become bored because of the repetitiveness of the triple A, and if you introduce um PAD and BP screening, then that will introduce different element to their role .....”

(AAA Screening Programme staff, Focus group 8)

2b) Incorporating additional procedures in a resource-constrained context

“….. additional time to remove extra clothing ….. I mean at the moment all we do is, we just ask gentlemen to lift their upper clothes up – that's all we have to do, so if you're incorporating ‘You need to remove your shoes and socks, then you know, that's a whole different – a whole different game.”

(AAA Screening Programme staff, Focus group 6)

"I think a lot of our screening programmes did ten minutes with two technicians – that obviously increased to initial Covid-secure, sort of, um appointment. Um so it's gonna be interesting ….. will be interesting to see if programmes can actually do that.”

(AAA Screening Programme staff, Focus group 5)

"….. in how we work – it would almost, if we were doing the trial – that it would almost be better to have a separate clinic, specifically for that, so it wouldn't – ‘cause obviously we've all got catch-up to do after Covid, you know – we're way behind in our numbers. So like, in the next few years, you know – we've got pressure already there from – from – ‘cause we've got 9,000 people to scan a year .....”

(AAA Screening Programme staff, Focus group 2)

2c) Reconfiguration of roles, responsibilities and relationships

“You’re there to screen, and the results ….. I think as well, when it comes to giving results ….. because, you know, managing the blood pressure is really primary care, isn’t it. It’s down to the GP. Um you know, how much do you say to these people ..... It has to be very clearly defined ..... it's quite clear (within AAA screeening programme), isn't it – you're also um getting them an appointment with the nurse. You are actually responsible for the next stages with the nurse, whereas with this (i.e. PAD+BP screening) ..... you're sending them up to the GP, which is really mixed – everything is different .....”

(AAA Screening Programme staff, Focus group 2)

“The other thing would be the actual – because it's GP that decides whether they – what they decide to do or not ..... With the aneurysm screening ..... two weeks on, or whatever the timescales are, you’re likely to have an operation – not definitely – not guaranteed, but it's a possibility. Actually, if you go to GP, he's too busy to do – or doesn't think the patient has got peripheral arterial disease, or something like that – very – quite variable.”

(AAA Screening Programme staff, Focus group 5)