Table 2

Examples of participant quotes supporting each theme

ThemeExample excerpt
(1) Hesitation and self-censorship Minimisation of one’s needs in comparison to others
I didn't really want to go to the GP and bother them when other people might need to see somebody more than I do. (F, 18–29)
Hesitation due to concerns about COVID-19
I think I would feel more secure to stay home and not to go to a GP practice with people already … I guess now I am being more paranoid or more careful. (F, 18–29)
Resignation after encountering barriers
It just got too difficult to get hold of any (of the pill) again, I just gave up, and I thought, this isn't worth it. … It was too much effort, you know. (F, 40–49)
I can’t get a referral … I was honestly going around in circles all the time. In the end because I was getting turned away all the time by the … on phone calls, I’d just think well what’s the point, there’s no point in me even ringing up. In the end I just suffered on really. (F, 30–39)
(2) Navigating access to telemedicine and ‘socially-distanced’ services Incorrect information and contradictory procedures on service access
I’d ring the phone numbers that were on the letters from previous … if you need to contact us, contact us on this number that type of thing. I’d ring and it would just ring and ring, and ring, and ring. I don’t know who to get in touch with. (F, 30–39)
They said you should go and speak to the hospital. (And the hospital said) ‘There’s no phone appointment, only phone appointments are available in GP’. And GP said ‘This is not our department, contraception clinic is not our department, we can't say, we can't do anything, we can't prescribe … you have to go to hospital and speak to them’. (F, 40–49)
They kept messing her about saying to her, ‘come’, then ‘don’t come’, then ‘come’, then ‘don’t come’(to have a weight-check before accessing contraception)” (M, 30–39)
Factors facilitating service access
There’s a special ward for mums that are having problems. So, it’s like am emergency type of thing, so that was quite difficult to access … we’ve got family who are doctors, so they know how these work … So, we were able to understand what the system was like, but I think people who don’t have people in the know it must be a lot more difficult. (M, 30–39)
Impact of encountering barriers to service access on choice and autonomy
They sent me two packets of oral contraceptives through the post, which, to be fair, I never took, I just never took. Because that wasn’t what I was after, it wasn’t what I wanted, I just wanted my coil replaced. My coil has been great … it helped to level out my mood. … I just want a new coil. (F, 40–49)
I was left helpless, stuck with menopause symptoms … it just made me feel like I didn’t matter (F, 40–49).
(3) Experiencing telemedicine and ‘socially-distanced’ services Privacy during remote/‘socially-distanced’ consultations
You have to talk through an intercom, from the outside (of the GP). And everybody now knows what’s wrong with you, … it’s on the street, as well, so anybody walking past can just hear what you're saying. (F, 40–49)
Accessibility barriers to remote service access
There’s always a bit of a delay on the video, and because it’s a bit stilted, and because I’m hard of hearing, I can’t always lip read. So when they’re asking me questions, sometimes, I’m completely in the dark about what they’re asking me. (F, 40–49)
Impact of lone navigation of SRH services
As good as all the staff are, if you're getting bad (pregnancy) news in a situation like that it is going to cause you a lot more stress if you don't have someone with you. (F, 30–39)
He feels less involved (in the pregnancy). He’s not there to see and hear for himself sort of what’s going on. He’s having to sit and wait for me to relay everything. (F, 30–39).
Positive experiences of remote/‘socially-distanced’ SRH services
There were a few silver lining moments. We didn't have to wait that long to go into our appointment, the appointments themselves were a lot faster. We still got the good service from the midwives. (F, 30–39)
They did all the tests there and then, but they had to send them off and then they phoned me, I think, a week later to say that everything was fine apart from the chlamydia which was positive and that they would … they posted the antibiotics out, so that was quite easy actually, it arrived in the post. (F, 40–49)
Increased comfort during remote appointments
The phone probably is easier because you’re not having to look at somebody and you don’t get the nervousness … if you’re suddenly kind of face-to-face with somebody that looks quite official, that might make you clam up. (M, 30–39)
(4) Attitudes towards the continuation of telemedicine Increased convenience of telemedicine
It (telemedicine) would just fit in better with day-to-day life. Because obviously, like modern life, you haven’t got a lot of time today now, you don’t really want to have to take time sat in a doctor’s surgery, you know, just to pick up some pills. (M, 30–39)
I would totally like that (remote appointments) because sometimes for a (fertility) treatment you just have to do consent forms that you have to be there present but if they're done online that’s hopefully saved or like a few hours of your time. Sometimes just a brief discussion of what the process would be you don’t have to go to the clinic or the place. Yeah, these are really welcome changes from my point of view, and my partner as well. (F, 30–39)
Limits to the suitability of telemedicine
I feel like my personal privacy is not at its best at the moment in my current living situation. So, I’d rather nothing of that sort comes (referring to remote appointments or postal delivery). (M, 18–29)
We still need real people to be there and to assess because technology is not necessarily accessible to everybody. (F, 18–29)