Clinicians within the Suffolk and North East Essex Integrated Care System (SNEE ICS) have so far treated more than 700 patients who have developed longer-term health problems after recovering from the acute phase of COVID-19 in hospital. A significant number of patients have also been managed in the community after reporting symptoms to their GPs.
Long Covid is defined by the National Institute for Health and Care Excellence (NICE) as, ‘signs and symptoms that develop during or following an infection consistent with COVID-19 which continue for more than 12 weeks and are not explained by an alternative diagnosis’.
The condition usually presents with clusters of often overlapping symptoms that may change over time and can affect any system within the body. Many people can also experience generalised pain, fatigue, persistent high temperature or mental health problems.
Patients reporting symptoms to their GP that are significantly impacting their health and wellbeing will first be assessed to rule out other potential causes and, if necessary, will be referred into Secondary Care for specialist treatment.
If after 12 weeks their symptoms have not improved, their GP will refer them into the SNELCAS screening hub. From there they will be further assessed and can be referred into a combination of other services such as physiotherapy, speech and language therapy, dietetics, mental health services and social prescribing, with further hospital treatment if necessary.
Many people with Long Covid will experience only mild symptoms such as a general loss of wellbeing or a manageable level of ongoing fatigue. Their needs are best met via the self-help route and there are several resources people can use to aid their own recovery. The Your Covid Recovery website https://www.yourcovidrecovery.nhs.uk/ contains general information on all aspects of recovering from COVID-19 including physical, emotional and psychological wellbeing. Other online services and resources available to patients with mild symptoms include:
• https://onelifesuffolk.co.uk/health-walks/ Tel: 01473 718193
Nearly 7,000 people in Suffolk and north east Essex have survived Covid-19 but the number of people who might have Long Covid is unknown. This is partly because many of those who developed COVID-19 might not have had themselves tested or sought medical attention at the time, instead choosing to manage their symptoms independently at home.
Sarah Fowler, Senior Respiratory Physiotherapist for East Suffolk and North Essex NHS Foundation Trust, said,
“While the package of care for patients with Long Covid has now been formalised, we have been treating patients suffering with the longer-term effects of COVID-19 since the summer. Across the Allied Health Professions (AHPs) we have seen an increase in the number of patients needing our care and have so far supported more than 450 patients with their recovery.
"A dedicated team of AHPs has been involved with Covid patients once they have left hospital to guide and support their recovery. This includes physical aspects of recovery as well as speech and swallowing, diet and eating, fatigue management and advice around breathlessness, memory and wellbeing. This personalised approach has allowed us to assess the needs of each individual and make sure that specialist services are involved at the right time.”
The clinical lead for the development of SNELCAS, Dr Peter Holloway, said, “It has been a huge challenge to design and construct a service from scratch in such a short time. The pathway has to be suitable for a wide range of symptoms with unpredictable numbers of patients but unfortunately a predictable increase in demand. I nevertheless believe we have established a thorough and effective core service to support and treat patients with Long Covid. The symptoms and effects of COVID-19 vary enormously in different people and so do the symptoms and effects of Long Covid. We expect to have to adapt SNELCAS in time as we understand more about the condition.”
Lee Taylor, Head of Strategy for the NHS Ipswich and East Suffolk, NHS West Suffolk and NHS North East Essex CCGs, who led on the development of SNELCAS said, “We hope that most people will be able to make a full recovery but there could be others left with more serious conditions as a result of the way COVID-19 has affected them. I am grateful to everyone who has helped to put this complex care plan together.
"We have been able to develop a model which should meet the needs of all our Long Covid patients thanks to the combined input of those in Primary and Secondary Care, our Allied Health Professionals, IT and digital specialists and our partners in the North East Essex Health and Wellbeing Alliance and the East and West Suffolk alliances.”
Richard Watson, Deputy Chief Executive Officer and Director of Transformation and Strategy for the NHS Ipswich and East Suffolk, NHS West Suffolk and NHS North East Essex CCGs, said, “Suffolk and North East Essex Integrated Care System already has strong care pathways in place for each of the individual symptoms Long Covid can cause. The team have been able to build on this solid foundation and bring these services together into a single, coordinated treatment plan which will be tailored to the needs of each individual patient, giving them access to a wide variety of relevant services. Everyone has done a great job getting SNELCAS off the ground. What we cannot predict is the level of demand on the service in the future and we expect that the initial SNELCAS model might well have to be expanded in time.”
Lianne Jongepier, Head of Neighbourhood and Alliance Transformation for the NHS North East Essex CCG said,“We know that many people with Long Covid need medical care and treatment to support them in their recovery. However, we also know that a large proportion of people with mild symptoms can recover through guided self-management and by making the necessary lifestyle changes. To support self-help and aid recovery, many websites and online tools have been developed, which may help people increase their energy levels and boost their mental health. I would urge anyone with mild symptoms to explore these and to seek advice from their GP only if their symptoms persist.”
Anonymised patient data from Long Covid patients in Suffolk and north east Essex will be collected and given to the National Institute for Health Research (NIHR). NIHR is funding studies of 10,000 patients across the country to help frontline NHS and social care workers better understand the condition and how they can best help their patients.