Table 5.
Summary of Key Changes
| Changes Described | Staff experience | Patient’s experience | Parent’s/Carer’s experience |
|---|---|---|---|
| Experiencing “lockdown” restrictions. | Having one clinician onsite- difficult to fit face to face contacts in. Lonely, isolating. Missed colleagues support. |
Have more space and time to focus on recovery. Feel like missing out on less in general life. Relief avoiding restaurants. Less distractions, more time to think. More exposure to social media. |
Fantastic team response, always available and responsive despite lockdown. |
| Moving to virtual video consultations. | Feels inappropriate for high risk. Those in good recovery engaged well. Not limited by room availability. |
Travel avoided which can be tiring. Easier to access from home. Harder to open up on a screen. Can’t see body language. Feels easier to hide how actually doing. Feels less genuine. Technological difficulties are a barrier. Miss face-to-face as easier to open up. Would enjoy choice but may choose easier option for anorexia. |
Mix would be good to limit demands of travel. Difficult when IT and connection problems. Face-to-face needed to build trust in beginning. Affected discharge and ending – felt abrupt, left with high anxiety. |
| Having telephone appointments. | Feels inappropriate for high risk cases. Less effective. Raised staff anxieties. | Felt family were less involved and received less support. Shorter consultations. Need family to be involved and a bigger part of it. | Impractical. Family sessions don’t involve family. Sessions much shorter. Feel left on own with anxieties. Feel more responsibility to communicate what is not visible e.g., child’s response. |
| Using emails for contact. | Enjoyed being able to ensure messages got to practitioners and enjoyed quick response. | ||
| Being restricted to one parent in the session. | Asking one parent to relay information to another parent not effective. Need whole family for family treatment. | Wished parents had more support. Parents need family sessions for themselves and to help recovery. Parents essential to recovery. | |
| Accessing/Offering support from home environment. | Difficult. Much rather be on site. Isolating. Can be left with strong feelings on own, at home. Very hard managing childcare at the same time. Miss travel to switch off. | More comfortable. Easier to leave if want to. Less afraid of practitioners and consequences of not adhering to meal plan. Feel intimidated to ask for something else as feels like how the service is provided is not within the services control. |
Able to give more support to child, more supervision. Better meet their needs. Feels more intense in lockdown. No respite. Harder if can’t get food in shops. More to deal with. |
| Virtual MDTs. | Good to have more space on own, not limited by room size. Easier to access and attend. IT issues make more challenges. Not seeing people’s faces hard to pick up cues. Affects feeling of team working. Easily distracted by laptops. |