April 2022 update Stephanie Poulton Service Lead Kathryn McNerney Physiotherapist Aims To develop a basic understanding of service activity patient journey and outcomes To know when and how to make a referral to the Post COVID SyndromeLong COVID Services ID: 1046311
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1. City & Hackney Post COVID Assessment & Rehabilitation Services April 2022 updateStephanie Poulton – Service LeadKathryn McNerney – Physiotherapist
2. AimsTo develop a basic understanding of service activity, patient journey and outcomesTo know when and how to make a referral to the Post COVID Syndrome/Long COVID Services To know how to access and use OneContact to support the primary care consultation of a Long COVID patient To improve access to specialist input for people with Long COVID To know how to access further training around Long COVID
3. Activity Jan 2021-April 2022 370Accepted referrals254 MDT assessments (psychology and physical therapy) 1.5hrs duration 202 Clinic (medical) assessments128In active treatment currently
4. Demographics 72% femaleService data:21% Black and Minority Ethnic Groups65% White17% Not knownEthnicity: City & Hackney population data (nomis 2021):38% Black and Minority Ethnic groups 62% White British
5. Presented with multiple symptoms and complex needs requiring multi-discipline approachDiscipline specific treatment staggered to allow full engagement at each stageFelt confident managing symptoms independentlyPatient journey & timelines:Presented with breathlessness and fatigueDelay in FU due to patient UTABreathlessness improved with strategiesFatigue limiting return to studies so OT commencedAble to sustain a new routine engaging with studies
6. Outcome measures80% improved in one or more standardised outcome measure 93% Report improved ability to do things that are important to them93% Report increased confidence in managing symptoms 97% would recommend the group programme
7. Patient experienceI really want to tell everyone starting out with CoRe to trust in the process – it really works!“Don’t be frustrated that this might not take the Long Covid away. Listen to the science, be open, turn up even when you don’t want to, don’t expect a quick fix but more of a slow awakening. The group will challenge your entrenched beliefs but those need to be challenged as they are keeping you sick.”“Expect to be supported and understood and actually have positive suggestions to overcome the long covid symptoms”“Join with an open mind and heart and it will have a good and huge impact in your life.”
8. Slido
9. Referrals process:Successes
10. 1. Awareness2. Clinical requirement for multiple tests and questionnaires3. Referral ProcessDigital – e-RS, EMIS, OneContactData requirement on referral form Referral challenges:
11. Referral challenges:AwarenessTherapy-led team, end-to-end pathway EligibilityUnmet need?Expectations
12. 2. Clinical requirement for multiple tests: case examples for rationaleHighlights importance of thorough primary care Ax/investigationsRequires urgent malnutrition pathwayRefer to Neurology directly from primary carePt referred with shortness of breath, fatigue and chest pain. Collapsed in the waiting room at STL and taken to A+E – diagnosed with MI, taken to Barts for treatment Patient presented with significant weight loss (>30% of their body weight). BMI was 16 at the time of referral to Post COVID servicesBilateral upper limb numbness in GP appointment. No cardio-resp Sx. Referred to Post COVID services, expectation of onward referral to neurology
13. 3. Referral process: Digital Challenges
14. So, how do I refer? Make a clinical diagnosis of Post COVID Syndrome involving the following: Conduct a face-to-face assessment (bedside obs and history)Necessary blood tests ordered and reviewed (these will be automatically pulled and populated to the referral form) CXR/ECG or other depending on clinical presentation2. Email/text the patient with questionnaires via OneContact3. Open referral form on EMIS – fill out brief clinical history including date of infection, current symptoms (will self-populate with recent test results)4. Find service on e-RS and attach all of the above
15. Future considerations…Primary care assessment becomes even more importantUnmet needEngagement lead role and partnership project Sustainable support
16. Come and work with us!
17. Slido
18. Where can I learn more about Long COVID?NEL Community of Practice: