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Table 3 Open ended responses—qualitative coding—stop smoking services (SSS)

From: How a sample of English stop smoking services and vape shops adapted during the early COVID-19 pandemic: a mixed-methods cross-sectional survey

SSS Theme/s Example
What arrangements did you put in place for vulnerable people who smoker? SMS support
Longer prescriptions
Posting prescriptions/prescription collection
Telephone consultations
App
Partnerships with vape industry (e.g. wholesalers, vape shops)
Collaborations with drug/mental health services
Costs:
Postal/mileage delivery costs
App licence costs
Extra IT equipment for staff
BUT savings on venue and staff millage
“For those who were self-isolating we either arranged for their pharmacy to post products to them or we advised the client to join the 'Good Sam' app and a volunteer would pick up their products
We also arranged for those who were self-isolating but who wanted Champix for the appendix 1 of the PGD to be completed by the pharmacist over the phone
Two vouchers which is equal to a month’s supply of product were posted to clients so they did not have to go to pharmacies as many times and stand in long queues”
We are trying to identify new pathways to good practice, please tell us anything that has worked for you Telephone consultations
Welfare checks and opportunistic smoking cessation
Joint working with vape shop
Peer group support on teams
Staff meetings/training on zoom
Webinar training sessions for other HCPs
Alternative to CO testing
Clients missing less appointments/completing more paperwork
Social media recruitment successful
Redeployment to welfare roles provided new opportunity to reach clients
“We have the same quit conversion rate at 4 weeks as face to face consultations. A key factor is possibly client's do not miss many appointments, making it more likely they will quit even without the perceived benefit of face to face
Clients get a quit guide and top tips in the post when they set a quit date, this was hit and miss before and dependant on the advisor. Similarly, at the 12-week quit point they get a certificate, staying quit guide, evaluation form and sae which before was very hit and miss. We are now receiving a beneficial amount of evaluation forms back
About half of our small team were redeployed to make welfare checks and were involved in emergency food parcel deliveries. We used the opportunity when speaking to people seeking stop smoking support to check they had access to food and basic necessities and referred them for emergency help if necessary
No CO monitoring so we have used a breathing challenge identifying how long they can breathe in and out and hold and working to improving their lung capacity”
What has been difficult about delivering the service remotely? No CO monitoring
Dealing with client emotional issues
Impact on rapport
Demands from commissioners
Difficulty engaging pregnant women
IT issues
Demands on resources, e.g. more demand and less staff, missing calls, constant calls, long calls, IT issues working from home, confidentiality issues working from home
“Advisors missed the relationship and face to face interaction. No Co monitoring as no face to face so had to take clients word about staying quit and motivation of seeing CO reading go down to non-smoker used to be a good talking point and motivation for clients”
“The pregnancy side has proved more difficult, more women declining the midwives, possibly due to no co screening or maybe it is just easier to say no via phone. It could be a training need for midwives”
Have you had any feedback from customers about the service change (please briefly outline) More convenient than face to face
Checking in with shielding clients
Appreciation of service adapting to remote contact
Increased rapport
“Being in lockdown has helped some people to avoid other smokers”
The regular contact has been valuable to them and often a comfort that someone is looking out for them”
“Patients are so grateful that we care about them during the pandemic and I personally have learnt so much more about them their lives and interests than I normally would of”
Are you considering implementing any of changes that you made during COVID-19 in the longer term? Yes. Please tell us: Text More virtual clinics
Implementation of smokefree app
Continue telephone support