Table 4 Key characteristics of individuals and exemplar quotes

Knowledge and beliefs

Staff

Generally positive opinions of NROL

S07: We're getting a lot of staff that feel it's worthwhile. A lot of patients that feel it's worthwhile as well, and a lot of really positive feedback from the staff that are doing the sessions.

NROL was valuable for increasing opportunity for practice

S11: Provided a lot of opportunities for practice, and to learn new skills and even remind them of some of what they've already gone over…

Some reluctance to changing practice

S07: NROL has its place and there are a lot of benefits to NROL, but I think as a team we need to make sure that we're not diluting our service for our face-to-face contact.

S02: Some staff just don't wanna do it. Some people don't want the tech. Some people don't want to change their practice. Some people say it's too much hassle, and they can just go along with what they know. And so I think there's a whole raft of reasons, some of which are acceptable and some of which aren't.

Patients

Positive experience of NROL from a physical and mental health perspective

P03: ending up after the exercise session in a complete sweat and absolutely knackered [Laughter]. Which is always a good sign. And they can see what you're doing and what the issues are and they can give you advice on how to correct. I didn't think they could do that through a video link, but they can, they absolutely can.

P05: it meant so much. Because between appointments, you tend to feel abandoned nobody is listening, nobody is bothered by what problems you have, and this a way of discussing things. So for me, it's just been a great benefit…. I can’t praise the sessions enough basically.

NROL provided an extra layer of therapy

P01: To me NROL is an extra addition to a person's normal therapy and it just provides an additional layer of therapy to a person.

Group format with peer support identified as valuable

P03: You get a little bit of a bond with the people you're doing that with 'cause you're all going through a similar kind of thing, … I think seeing other people and how they are progressing. It gives you a little bit of motivation to progress yourself. You feel like you're not on your own. Sounds a bit stupid, but you know, sometimes you can feel you're battling this on your own and actually, you’re not.

Self-efficacy

Staff

Gained confidence over time

S01: the first block was quite nervy to be honest. 'Cause it was new … as I've done a few groups, I’m less anxious now.

S09: I've enjoyed the different platform and the challenges. It's made me adapt as a clinician.

Patients

Gained confidence and motivation

P13: before I was super confident, I wouldn’t have any problems …so this is giving me that bit of confidence to talk to people a bit more… You know, it's like a stepping stone I guess.

P02: I had to quit work, I was self-employed. I could barely speak to the customers, … but now I've been interacting with people. It's made me able to interact more with strangers. It’s helping me come round.

P07: I said I've got grade 8 on my piano,… And I said, I've not touched it…they were like ‘no come on, do it, do it do it’. Now, I’m playing the piano and I'm walking a mile into my local town. Yeah, whereas before I used to get taxi.