Post COVID-19 Syndrome is when the symptoms of the COVID-19 virus do not disappear after the initial infection. If the symptoms last for more than 12 weeks after the initial infection, you are likely to have Post COVID or more commonly known in the general community as Long COVID.

This NHS page has more information on symptoms and other links.

Long-term effects of COVID-19 (long COVID) – NHS (www.nhs.uk)

This page provides informative videos on the condition:

Long COVID Video Series — Long COVID Physio

How does Post COVID19 Syndrome get diagnosed?

If your GP believes you may have Post COVID-19 Syndrome they can refer you to the Post Covid Assessment Service. They must have completed all the relevant tests prior to referring you to the service, the relevant tests can be found on the referral form. You will then be assessed by one of our GP’s who will confirm if you do have Post COVID-19 Syndrome and signpost you to the correct support services.

The NICE Guidelines for Post COVID-19 Syndrome can support you or your GP to further your understanding of the condition.

Overview | COVID-19 rapid guideline: managing the long-term effects of COVID-19 | Guidance | NICE

Referral

The Post COVID19 Assessment Service requires a GP referral. Further information can be found on the Information for Referrers drop down.

The above image is a flowchart showing the journey through the service. It will be described in more detail now.

Journey through Post COVID-19 Assessment Service

If your GP believes you to have Post COVID-19 Syndrome they will refer you to the service.

The referral will be triaged to ensure all correct tests have been completed within the set time frame. Any outstanding tests will result in a rejected referral returned to your GP. If your referral is accepted you will be contacted by a Health Navigator to explain the next process (this will be a phone call from a withheld number).

You will then be placed on a waiting list to have an appointment with our GP.

Appointment with GP

This may be via video consultation or over the telephone.

At this consultation the GP will discuss the history of your illness, your past medical history and medications, ongoing symptoms, and any other factors relevant to your condition.

They will confirm if you do have Post COVID-19 Syndrome and agree a management plan moving forward. This may involve referral to other services, signposting you to relevant information, or requesting your GP to complete further tests or referrals.

Depending on your symptoms, you may be signposted to other services including;

• Physiotherapy
• English National Opera
• HOPE programme
• Talking Therapies
• Nuffield Rehab
• Peer Support
• Fatigue Management

The Health Navigators will contact you after this appointment to discuss the referrals and advice provided and ensure you understand the next steps.

If you do not require another appointment with the Post COVID GP 12 weeks after your first appointment, you will be discharged from the assessment service. A Health Navigator will contact you prior to this date.  Being discharged from the assessment service has no impact on other referrals to, for example, physiotherapy, or fatigue management.

If you are referred for fatigue management you will be referred into the ME/CFS service for support with your Post COVID-19 syndrome fatigue.

Peer Support

If you have Post-COVID-19 syndrome you may find it helpful to meet people in the same position. Talking with others who know how you’re feeling is a great support and can help you identify new ways of managing your symptoms.

The groups are held online and run for an hour. You can drop in as little and often as you like.

You will be offered to attend the groups once you have had your appointment with the PCAS GP.

The groups are run by a facilitator. If you need to contact us about the support groups you can do this via the following email address: peersupportgroupPCAS@somersetft.nhs.uk  OR  postcovid19recovery@somersetft.nhs.uk

Fatigue Management

If you are experiencing Fatigue as a symptom of your Post COVID-19 Syndrome you will be referred to the ME/CFS Service for support with your Fatigue Management. This does NOT mean you have now been diagnosed with ME/CFS.

As part of the fatigue management support, you will be offered to attend 4 online Managing Fatigue to Live Well group workshops. These will include introducing self-management strategies to support you living with fatigue.

They run consecutively on the same day of the week usually at 10:30am via Microsoft Teams – you will be informed of the dates and times when you have been booked onto the course.  Please aim to arrive 5-10 minutes early.

You will be sent a link to your email address for the groups the day before, you do not need to have a Microsoft Teams account to attend the group. If you have not received an email, please check your junk mailbox.

If you are unable to attend the group, you must inform us prior to the sessions. If you are having difficulties logging on to the meeting, please call the service number and ask for support.

You will be sent 4 handouts with information covered in the groups and presentation slides via email prior to attending. If you require these in paper format, please let us know. It may be useful to familiarise yourself with this information before the group.

The above image is a flowchart explaining the journey through the Managing Fatigue to Live Well groups, this will be described in words below.

There are currently four groups offered which cover:

• Group 1 – Fatigue and associated symptoms, dysregulation, activity diaries and pacing.
• Group 2 – Living at a baseline, effective rest and stress.
• Group 3 – Cognitive Difficulties and sleep.
• Group 4 – Altered breathing patterns, communication and setbacks and next steps.

Once you have completed all groups you will be placed on a 12 week open appointment, you have 12 weeks to request further support from us including 1:1 support. If we do not hear from you in that time you will be discharged.

If you do request 1:1 you will then be contacted by a Health Navigator to offer support sessions with activity diaries. Once you have completed your allocated appointments and in agreement with you and your practitioner you will be discharged.

Activity Diary Support

1:1 appointment with a Health Navigator to support you to complete your activity diaries prior to attending Follow Up sessions with a Fatigue Practitioner.

This will be organised between you and the Health Navigator, it will likely take place over Microsoft Teams.

1:1 Follow Up

These sessions aim to apply the self-management strategies and information covered in the groups, to your individual life.

This is an opt in option, you must inform us, via email, after the groups if you would like to have 1:1 sessions. If we do not hear from you 12 weeks after your last group, we will discharge you.

Follow up sessions are approximately 45 mins – 1 hour long. They are generally carried out via video consultation.

If you are unable to attend your appointment, you must let us know. If you do not attend your appointment without informing us, we will contact you via post. If we do not hear from you within 2 weeks, we will discharge you from the service. If you do not attend 2 consecutive appointments without informing us 48 hours prior to the appointment, we will discharge you.

It is important you feel you are currently in a place to manage behaviour change or inputting self-management strategies into your life. Not everyone will be ready at the same time, and it may be sensible to wait until you are in a position to manage this before attending the service.

Employment Workshop

We provide a one off, online employment workshop for anyone living with Post COVID-19 Syndrome trying to return to employed work, or maintain employed work.

The workshop runs approximately every 6 weeks on a Wednesday at 10:30. The information is aimed at people who are currently employed by someone else, but some of the information may be of value to someone who is currently self-employed.

If you have a patient who has persistent symptoms, lasting more than 12 weeks following a COVID infection please consider a referral to the Post Covid Assessment Service.

Criteria for Referral:

The patient:

• Is 18 years or older (separate referral to paediatrics for under 18 years)
• Had suspected or confirmed COVID-19 >12 weeks before the point of referral.
• Is not currently under active follow-up in secondary care following COVID-19 hospitalisation.
• Has persistent disabling symptoms that require specialist assessment.
• Has all of the initial investigations as specified on service referral form, within two months of the referral.
• Does not have an alternative cause for their symptoms following appropriate clinical assessment.

Please complete the referral form (below, it can also be prepopulated on EMIS) and all requested tests and email to postcovid19recovery@somerset.nhs.uk.