How to refer to the Long COVID service?
Referrals are being accepted from GPs only, by submission of this form.
You will need to confirm that it is over 12 weeks since COVID symptoms started (or as early as four weeks in patients with a high symptom burden or significant, unmet rehabilitation needs), and you must include all of the information, test results etc. requested in the form.
Referrals are checked and if accepted, patients may be offered an initial assessment by phone prior to their appointment with the multidisciplinary team (MDT).
The service is suitable for patients who were treated for COVID-19 either in hospital or in the community and have signs and symptoms that developed during or after an infection that have continued for more than 12 weeks after initial infection (and are not explained by an alternative diagnosis) or as early as four weeks if clinically appropriate.
Timing is based on individual need and is at the discretion of the assessing clinician. Recovery time is different for everyone, for many people symptoms will resolve by 12 weeks (NHS, C1248, April 2021).
If predominantly organ specific problems have been identified, patients should be referred via existing routes to local specialists, rather than the Long COVID service. If patients have an underlying long-term respiratory condition and are experiencing an increase in breathlessness, once treatment has been optimised, they can be referred to the Long COVID service for further support and referral to appropriate services
COVID disease is an infection caused by a corona virus. Long COVID is a term to describe the effects of COVID-19 that continue for weeks or months beyond the initial illness. The health watchdog NICE defines Long COVID as lasting for more than 12 weeks, although others consider symptoms that last more than eight weeks to be Long COVID.
Details of how some people are affected by Long COVID are still emerging, but research suggests around one in five people who test positive for COVID-19 have symptoms for five weeks or longer. For around one in ten people, they last 12 weeks or longer.
These long-term effects are often reported by people who didn’t need to go to hospital during the acute phase of COVID. Long COVID symptoms commonly experienced by patients include:
- anxiety and depression
- chest pains
- joint or muscle pain
- not being able to think straight or focus (‘brain fog’)
- persistent cough
- loss of taste or sense of smell.
At our clinics, people can be seen by different members of the team. Each patient will have different problems due to their COVID-19 and our aim is for you to see the right people to help you and, meet your needs.
Members of the team you could see on the day of your appointment may include:
- GP and Community Matron
- Social Prescriber
- Pulmonary rehab physiotherapist.
Each appointment will focus on the different symptoms that you may be experiencing so you may not need to see every member of the Long COVID Team.
The clinic is designed to help people who still have symptoms related to a COVID infection after 12 weeks. The aim of the clinic is to identify what symptoms a person is experiencing and how this is affecting them day to day. We help them find resources and/or treatments to manage these symptoms effectively so they can rehabilitate to living a fulfilling life.
The community matron will phone to introduce the service and complete the COVID-19 Yorkshire Rehab Screening Tool. This information allows us to understand whether the patient is experiencing problems related to coronavirus and allows us to focus on the things that are important to them.
If an assessment by phone is offered, the call usually takes place the week before the clinic appointment. It will take up to 30 minutes. This call focuses on the wider holistic assessment which means that we will assess physical problems but also consider the social, mental or financial impacts that symptoms have had.
A social prescriber from the health improvement team may also phone the patient. This call focuses on the wider holistic assessment which means that we will assess physical problems but also consider the social, mental or financial impacts that symptoms have had.
On completion of appointments, this may include referrals to other services, the team will meet to produce a care plan.
This will be a summary of the plan that each person has discussed during the patient’s appointments.
The care plan will be posted to the patient and the GP.
Patient’s may be invited to attend the clinic six months later. The decision whether the patient needs to be seen in the clinic will be a joint one between the patient and the member of the team who contacts them.
There are many helpful resources available:
- Your COVID Recovery | Supporting your recovery after COVID-19
- Information for the public | COVID-19 rapid guideline: managing the long-term effects of COVID-19 | Guidance | NICE
- Long COVID rehabilitiation booklet
- Managing fatigue: The Royal College of Occupational Therapists has put together some useful pacing advice to help you slowly build up your activity level
Managing breathlessness: The British Lung Foundation has created useful resources to explain breathlessness and suggest ways to manage it
A breathing guide to help you recover from COVID-19: Physiotherapy for Breathing Pattern Disorders
Having Long COVID is very distressing and can often impact your mood, making you feel sad or low or more anxious than usual. There is support available, you can find the support local to you by following the links:
- Improving Access to Psychological Therapies (IAPT): A talking therapies or online mood management course offered as one to one or group depending on your needs.
Self-help booklets for common issues such as stress, sleep, depression, anxiety.
Psychology Tool has produced a couple of free booklets on Post traumatic Stress Disorder and anxiety linked to COVID: Critical Illness Intensive Care And Post-Traumatic Stress Disorder (PTSD) – Psychology Tools
Many people talk to us about the worry of getting COVID again. This booklet tackles this issue: Living With Worry And Anxiety Amidst Global Uncertainty – Psychology Tools
This booklet helps you to work through how to do what matters in times of stress: Doing What Matters in Times of Stress (who.int)
A short video on managing anxiety linked to COVID: FACE COVID – How To Respond Effectively To The Corona Crisis – YouTube
Managing vertigo: A link to a booklet you can download with information about vertigo and how to manage it
Managing tinnitus (ringing in your ears): The British Tinnitus Association explains what tinnitus is and some ways to manage it - COVID-19 guidance for people with tinnitus
Managing loss of taste or smell: The NHS has provided some information and ideas for how to help your recovery aimed at people who have lost or have a changed sense of taste or smell
Building up exercise: The Chartered Society of Physiotherapy (CSP) has put together some advice on building up strength, managing breathlessness and pacing up activity
If you need information on sick leave please visit the following websites:
- Taking Sick Leave (GOV UK)
Sickness and absence because of long COVID: Long COVID – advice for employers and employees – Acas
More information when planning return to work:
Other charities or services that you may find helpful offering emotional support and information to those experiencing mental health difficulties, their families and carers:
- Samaritans call free on 116 123 or email jo
- SANE Mental Health helpline: 0845 767 8000
Call NHS 111 (free from a landline or mobile) when you need medical help fast but it’s not a 999 emergency. Available 24 hours per day.
Mersey Care also provides phone support for people experiencing a mental health crisis via the freephone numbers below:
- If you live in Liverpool and Sefton and are aged 16 and over, call our 24/7 freephone helpline: 0800 145 6570
- If you live in Halton, Knowsley, St Helens and Warrington and are any age, call our 24/7 freephone crisis line on: 0800 051 1508
- If you live outside of the above areas find your local mental health crisis line on the NHS website.