Information for Health Professionals
What is Post-COVID Syndrome?
The National Institute for Health and Care Excellence (NICE), the Scottish Intercollegiate Guidelines Network (SIGN) and the Royal College of General Practitioners (RCGP) have defined post-COVID syndrome as:
"Signs and symptoms that develop during or following an infection consistent with COVID-19 which continue for more than 4 weeks and are not explained by an alternative diagnosis. The condition usually presents with clusters of symptoms, often overlapping, which may change over time and can affect any system within the body. Many people with post-COVID syndrome can also experience generalised pain, fatigue, persisting high temperature and psychiatric problems. Post-COVID-19 syndrome may be considered before 12 weeks while the possibility of an alternative underlying disease is also being assessed."
Lincs Post-COVID Rehab Service
The multi-system nature of the long term effects of COVID-19 is best served by generalist management in primary care in the first instance. This enables patients with ongoing COVID-19 symptoms to have holistic, relationship-based care that considers the physiological, psychological and social impacts of their condition.
Patients and their GPs work together to make decisions about what care is best for them, according to their needs and preferences.
The optimal management of persistent COVID-19 is dependent on the severity of ongoing symptoms:
- Patients with mild ongoing symptoms can be self-managed in the community. These patients may contact their GP for support, sick certification and reassurance.
- Patients with moderate ongoing symptoms will require GP led care and possible investigation. It is essential that symptoms are investigated fully to ensure serious or life threatening diagnoses such as an underlying cancer are not missed.
- Severe ongoing symptoms will require initial generalist-led care and investigation followed by specialist intervention when appropriate, such as onward referral to the Lincs Post-COVID Rehab Service.
What is the Lincs Post-COVID Rehab Service?
The Lincolnshire Post-Covid Rehab Service is a rehabilitation service for people in Lincolnshire who are experiencing ongoing symptoms of COVID-19.
The service was established on the 21st of December 2020 and works alongside system partners by bringing together existing rehabilitation services from across the Lincolnshire Health and Care System.
Multiple services meet virtually to discuss which services might be best placed to help patients with their recovery, personalised care plans are created, and patients receive regular follow up from the team. Referrals are to be made via your GP.
What do we do?
We will provide treatment or management for ongoing symptoms such as breathlessness, dysfunctional breathing, lethargy, myalgia, cognitive change, depressed mood or anxiety or neurological symptoms.
Who is it for?
The service is for people experiencing symptoms associated with COVID-19 for 4 weeks or more from the initial onset of infection, whose presentations cannot be better explained or better treated by any other explanation. As Post-COVID-19 syndrome may be considered before 4 weeks, it is possible for referrals to be accepted as early as four weeks from initial infection, although the possibility of an alternative underlying disease need to have been fully assessed.
People accessing the service must be medically fit and stable to engage in a rehab programme and able to safely engage in an exercise programme with no contraindications.
Please consult the checklist below before referring your patient to the service:
- Is your patient experiencing ongoing symptoms beyond the initial acute infection period?
- Have other possible medical diagnoses and pre-existing medical conditions been investigated and excluded as the cause of these current symptoms?
- Is the patient medically fit and stable for rehabilitation?
- Are there no contraindications to this patient participating in an exercise programme?
How do we refer into it?
Referral into the service is via the form on SystmOne “Post COVID-19 Rehab Service Referral Form Version KK5”. The form is available on Ardens and an EMIS compatible version is available.
- Read NICE COVID-19 Rapid Guidelines: Managing the Long term effects
- Visit NHS England's National Guidance for Post-COVID Syndrome assessment
- Read more on managing ongoing or persistent COVID-19 in primary care/ patient referral routes and patient journey.
- Visit the Future NHS Collaboration Platform - search for Long COVID Network
- Download BACME's A guide to managing Post Viral Fatigue
- Download United Lincolnshire Hospital NHS Trust's patient information booklet on self-management at home
- General Practitioners Practice Pack:
Download the Lincolnshire Post-COVID Service Referral Form