Is your patient still experiencing covid symptoms beyond 12 weeks?

Have symptoms been investigated and no alternative diagnosis identified?

What is it?

A holistic post-covid assessment clinic for patients experiencing longer term health consequences following covid-19 infection. The rehabilitation clinic offers physical, cognitive and psychological assessment and therapy. The clinic is not a diagnostic service and patients will be required to have had full investigation of their symptoms prior to referral.

Who is it for?

The service is for patients who are complaining of symptoms 12 weeks after covid-19 infection. This includes patients who had a positive covid-19 test and those clinically diagnosed with covid-19 without a confirmatory test (i.e. early in the first wave).

It also includes patients who self-managed symptoms at home, in a care setting or in hospital with Covid-19 symptoms.

What does the service offer?

The service offers assessment and rehabilitation for the following ongoing symptoms

· breathlessness

· dysfunctional breathing

· fatigue

· dizziness

· myalgia

· swallowing issues

· cognitive and neurological symptoms

· depression

· anxiety

The service also offers Specialist Nurse assessment of respiratory status and requirement for oxygen therapy.

What is the scope of the service?

The post-covid rehab service is for patients who have ongoing symptoms of Covid-19 for more than 12 weeks after diagnosis of the illness. It is not a diagnostic service.

The clinic is a therapy-led rehabilitation service so any alternative medical diagnoses and pre-existing medical conditions must have been investigated and excluded prior to referral.

Why was my referral rejected?

The service needs assurance that the patient is medically fit and stable for rehabilitation. If this is not explicit here the referral may be declined.

Patients with symptoms that pre-date their episode of covid infection are likely to be declined.

Where investigations are indicated by the symptoms and there is no evidence that they have been undertaken and/or details of results not given the referral may be declined.

Which investigations are needed before referral?

Each patient referred should have their symptoms investigated for non-covid causes if clinically indicated. This is a rehab service rather than a diagnostic service so the following advice should be noted:

· The referral form requires basic observations to be performed e.g. oxygen sats, respiratory rate, heart rate and blood pressure.

· Patients with respiratory symptoms must have had a Chest X-ray.

· Patients referred with chest pain should have evidence of the appropriate respiratory and cardiac investigations performed.

· Bloods should have been done to check for alternative causes for symptoms.

· ECG should be performed if indicated by symptoms, if not please explain in referral.

· If there are clinical symptoms or signs suggestive of PE this should be appropriately investigated prior to referral.

How do I refer?

All referrals go through LCHS Ops centre. The referral form is available on System One and EMIS if you search through your normal referral channels for ‘Covid-19 Primary Care Rehab Referral Form’

Send all referrals to LHNT.LCHSreferrals@nhs.net