Digital Adoption During COVID-19 Pandemic: Longitudinal analysis of move from face-to-face to online services by UK organisation supporting unpaid carers.

Ala Szczepura, Amir Jahan Khan, Deidre Wild, Sara Nelson, Sonja Woodhouse, Mark Collinson

Research output: Working paper/PreprintPreprint



The COVID-19 pandemic catalysed a move from face-to-face to online delivery of healthcare services by hospitals and primary care. But little is known about the impact on organisations supporting unpaid caregivers (carers).


To analyse longitudinal changes in carer support service utilisation patterns during the COVID-19 pandemic, including impact on key service performance and quality indicators, and client carers’ views of the digital services introduced.


Design and Setting: Analysis of data files on service use and client views provided by an English carers support organisation covering a city and surrounding rural areas with a total population of 0.98 million. Method: (i) Longitudinal analysis of fully anonymised routinely collected data on 20,237 carers over the period January 2019 - June 2021. Including impact on number of registered carers, number of contacts, move from face-to-face to remote (digital/telephone) access, and types of service accessed. (ii) Comparison of service performance and quality indicators for financial years 2019-20 and 2020-21. (iii) Client survey to include: digital services accessed; barriers/facilitators to access; computer proficiency (CPQ-12); and views on online services. Quantitative data analysed utilising Stata 13. Thematic analysis used for open-text responses.


(i) Monthly contacts increased from 2,000 to 6,500. Remote contacts rose from 1,300 to 5,500 per month (growing from 65% to 85% of total); digital contacts increasing from 500 to 2,300. Pre-pandemic, remote contacts were exclusively by email or text. Distinct patterns were observed for digital uptake by city versus rural carers. (ii) Comparison of annual service performance and quality indicators indicated large increases in one-to-one contacts (89%) and carer assessments (21%). Indicators showed no detriment to quality of contacts (ranging from +4% to -1%) plus a 13% increase in contacts leading to reduced stress. (iii) 152 carers completing the survey had similar demographics to all registered carers. Computer proficiency scored were high. The online services most highly rated were carer’s wellbeing assessment, support needs checks, and peer support groups. 29% reported they had joined an online group activity, most frequently training and resilience courses. Thematic analysis of open-text responses identified three main aspects for future digital service development: ‘Things to help me use digital services in future’, ‘Offering selection of wellbeing services, including online’ and ‘Tailoring services’.


The pandemic increased the number of carers requiring support. The resulting greater number of contacts were handled by introducing online services without obvious detriment to service performance or quality. Client surveys indicated a desire for a blended service (offering both face-to-face and online options). Considering the economic importance of unpaid carers nationally, more attention should be given as part of any future digital strategy to organisations funded to provide support for carers. Clinical Trial: Not applicable
Original languageEnglish
PublisherJMIR Publications
Publication statusSubmitted - 10 Feb 2023

Bibliographical note

© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.


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