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ICSs will determine long Covid support to general practice, NHS England says


By Caitlin Tilley
1 August 2022

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It will be left to ICSs to decide how support general practice in dealing with the growing problem of long Covid, NHS England has said.

NHS England’s long Covid action plan, published today, announced that GP workload related to long Covid will be reduced by the introduction of local one-stop-shops and mobile clinics, intended to prevent people having to go back to their GP practice for multiple different tests.

However the plan stressed that ‘primary care will continue to be a core element of the patient pathway, often being the patient’s point of entry into long Covid care.’

And it added: ‘It will be for ICSs to determine the best way of distributing funding across the pathway of care locally including how to support general practice.’

NHS England has also published guidance for GPs on when they should refer long Covid patients to specialist services.

The guidance, co-developed by RCGP and NHS England, said the first role of GPs is to ‘exclude acute or life-threatening complications and other unrelated diagnoses’.

GPs can offer patients concerned about their symptoms an initial consultation and provide access to further assessments or care they determine patients need.

It said patients may present with a range of symptoms ‘including but not limited to: breathlessness, fatigue, chest pains, cognitive impairment or psychological symptoms’. 

Depending on the patient’s symptoms, assessment may include blood tests, chest X-rays or clinical tests, as per NICE/SIGN/RCGP guidance.

Advice, treatment or referral to the relevant acute or specialist services may be necessary.

The guidance said that symptoms at four weeks from acute Covid-19 infection are ‘common’, and for the most part ‘represent the normal tail of recovery from the acute infection’.

It said: ‘Appropriate re-assurance about the pace of recovery is likely to be helpful.’

However, if ongoing symptomatic Covid is diagnosed, from four weeks after infection, with other diagnoses ruled out, GPs should discuss the following options with patients:

  • Signposting to self-management including the online Your Covid Recovery platform.
  • Supporting self-management from the GP practice or PCN team, which could involve input from social prescribers, health and wellbeing coaches and care co-ordinators.
  • Referral to a post-Covid service any time between four weeks after the start of acute Covid illness. 

The guidance said: ‘Typically referral will not be immediate due to the need to rule out alternative diagnosis and undertake relevant investigations.’

NICE published its final guideline on long Covid in November last year, which said GPs should consider referring patients with long-term symptoms of Covid-19 to specialist clinics as soon as four weeks after acute infection after ruling out other diagnoses.

It comes as a growing number of patients in suffer with long Covid symptoms. A study published yesterday said that, worldwide, some 5% of people who have recovered from Covid may experience long-term changes to their sense of taste or smell, for example.

This story first appeared on our sister title, Pulse.

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