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ContextIn England, Personal Assistants (PAs) are part of an international trend towards state funded but client-hired or directly employed care workers. The Covid-19 pandemic highlighted and exacerbated pre-existing risks and advantages of this arrangement for both PAs and people with care and support needs.ObjectivesWe aim to report PAs’ reflections on their experiences of working since the pandemic started in 2020 and highlight the longer-term implications for health and care services.MethodsWe undertook a large-scale, qualitative study in 2016–17 involving interviews with 104 PAs about their working lives. We re-interviewed PAs from this group twice to ask how the pandemic had affected them, once at the start of the pandemic in Spring 2020 and again in December 2021 –April 2022. This article reports findings from the last set of interviews undertaken with 38 PAs. Thematic analysis was conducted of interviews in which PAs discussed changes in tasks and responsibilities, pay and conditions, training, relationships and plans.FindingsThis article focuses on the following themes: PAs’ perceptions of their outsider status; support and training needs; job security; and whether PAs have an appetite for regulation to provide greater professional standing and connections.LimitationsInterviews in this study were carried out during the Covid-19 pandemic over the telephone or virtually rather than in person so may have missed certain body language or informal relationship building. The sample may be under-representative of non-British PAs. We were unable to triangulate participants’ accounts with others’.ImplicationsThis study highlights the importance of national and local government including the PA workforce in planning for national emergencies. Consideration should be given by policy makers and local health and care systems to how PAs can be better supported than currently.

研究背景：
在英国，个人助理（Personal Assistants，以下简称PAs）属于国际趋势中的一类群体：由政府出资，但由服务对象雇佣或直接聘用的护理人员。新型冠状病毒肺炎（COVID-19，以下简称新冠疫情）凸显并加剧了这一用工模式对PAs及有护理与支持需求群体而言原本就存在的利弊。

研究目标：
本研究旨在汇报PAs自2020年疫情暴发以来的工作体验反思，并阐明该模式对卫生与护理服务体系的长期影响。

研究方法：
本团队于2016至2017年开展了一项大规模质性研究，对104名PAs进行工作生活相关访谈。随后对该队列中的PAs进行了两次回访，以调研疫情对其工作的影响：第一次于2020年春季疫情初期，第二次于2021年12月至2022年4月期间。本文报告了针对其中38名PAs的最后一轮访谈结果。研究采用主题分析法，对PAs围绕工作任务与职责变动、薪酬与工作条件、培训、人际关系及职业规划展开的访谈内容进行编码分析。

研究结果：
本文聚焦以下四大主题：PAs对自身"局外人"身份的认知；护理支持与培训需求；工作保障；以及PAs是否支持制定监管规范以提升其职业地位与行业联结。

研究局限：
本研究的访谈均在新冠疫情期间以电话或线上形式开展，而非面对面访谈，因此可能遗漏了部分肢体语言信息与非正式人际互动的捕捉。研究样本对非英国籍PAs的代表性可能不足。此外，本研究无法将受访者的陈述与其他相关方的表述进行三角验证。

研究启示：
本研究凸显了将PAs队伍纳入国家与地方政府的国民应急规划体系的重要性。政策制定者与地方卫生及护理系统应思考如何为PAs提供优于当前水平的支持保障。