Help-seeking and access to care for stroke and heart attack during the COVID-19 pandemic: a qualitative study

In this paper we explore how people who experienced a stroke, transient ischaemic attack (TIA), or heart attack sought health care during the COVID-19 lockdown periods. Semi-structured interviews were conducted with 27 patients admitted to hospital between March 2020 and May 2021, and one carer, recruited from cardiac and stroke rehabilitation services in two large acute NHS trusts in England. Drawing on concepts of candidacy, illness and moral work, we discuss how people’s sense-making about their symptoms fundamentally shaped both their decisions about seeking help, and the impact of COVID-19 on help seeking. Risk perception and interactional ritual chain theory allow further exploration of constructing symbols of national identity in times of crises, managing risk and levels of acceptable risk, and critique of ambiguous national messaging over accessing healthcare services for people with emergency healthcare needs. Our findings have wider implications for supporting access into healthcare for those with life-threatening conditions under highly publicised strain on the health system, including winter pressure and staff strikes, also policy-making and public messaging.