Coping during the COVID-19 pandemic: insights from a qualitative study of organizational resilience in an English substance use support service

Introduction : The COVID-19 pandemic posed unprecedented challenges to health and care services, including substance use support, necessitating adaptations to maintain operational continuity. A lack of research exists into the factors that helped substance use services cope and maintain provision. This study aimed to elucidate the organizational resilience factors that assisted a substance use support service in sustaining operations and adapting during the COVID-19 pandemic. Theory : The study draws on recent conceptual and theoretical developments in the study of organizational resilience, examining findings primarily through the lens of bounce-back and bounce-forward resilience, and Duchek’s three-stage framework. Method : Participants were 36 staff members working for (n = 28) or in partnership with (n = 8) an organization delivering substance use support services across an area of northern England. A multi-method qualitative approach, including digital timelines (n = 19), in-depth interviews (n = 18), and five focus groups (n = 17), was employed. Timeline text was treated as qualitative text-based data. Interviews and focus groups were recorded and transcribed prior to coding. Data underwent Framework Analysis. Results : Seven themes were identified: 1) pre-existing relationships and effective multiagency working; 2) prioritization of service delivery; 3) development and implementation of guidance and protocols; 4) autonomy, devolution, and deference to expertise; 5) effective communication, regular meetings, and coordinated decision-making; 6) allowing flexibility and creativity; and 7) development of new and innovative approaches to facilitate the pandemic response. Discussion : This study identifies resilience factors that substance use and other support organizations should focus on in preparation for potential future crises, to minimise adverse impacts on vulnerable populations.