The shift from face-to-face to remote care during the COVID-19 pandemic: a qualitative survey analysis of users of UK drug and alcohol services

The provision of publicly funded UK drug and alcohol services moved from a predominantly face-to-face to a remote care model in response to COVID-19. This major natural experiment can inform policy and practice in service delivery. The self-reported experiences of N = 2723 receiving remotely provided services during the pandemic were collected via an anonymous online survey. The survey was available for completion June to November 2020. Cross-sectional survey data were analyzed, using thematic analysis, at five consecutive timepoints. This allowed for information on changing perspectives and experiences to be fed back to services in real time to underpin service user-informed practice. Experiences of the switch to remote care were characterized by both positive themes: (1) feeling safe; (2) feeling supported; (3) greater convenience; (4) the positive impact of remote care on my progress, and by negative themes: (1) limits of remote care; (2) missing face-to-face care; (3) loneliness and isolation; (4) not enough support; and (5) lack of person-centered focus. Informed suggestions to improve the remote care offer, post-COVID comprised: (1) leave remote care in place; (2) increase support; (3) new models of working. Longer-term provision of remote care will be welcomed by some, but not all, service users. Work to tailor remote care to account for preferences and personal circumstances has the potential to provide greater choice and expand capacity—potentially necessary to absorb an anticipated surge in new treatment starters post-COVID.