Referral Update October 2021
Kind Reminder: Use of the UHCW Long Covid Assessment Clinic
UHCW colleagues continue to work actively to manage the waiting times for Long / Post-covid screenings and assessments, including for GP clinic referrals.
They have noted that a small, but growing, number of GP referrals are now presenting where Long Covid is not the primary indication eg referral seeking to gain quicker access to rheumatology review.
The Long Covid Assessment Clinic is only for suspected Long Covid cases where other possible causes have reasonably been excluded. The Assessment Clinic has reasonable access to a Respiratory Consultant but is otherwise delivered by an MDT of therapists with Psychology support.
Referrals for other reasons will likely simply add unnecessary delay and inconvenience to the patient’s experience.
If useful, the Advice and Guidance function remains an option – see the Long Covid section of the GP Gateway
Post COVID Syndrome – Suspected or confirmed COVID-19 with persistent respiratory symptoms AFTER 12 WEEKS
Most patients with COVID 19 will fully recover, but some patients may go on to have a variety of persistent symptoms.
Long COVID / COVID Syndrome is defined as presence of ongoing symptoms after COVID 19 not explained by other reasons 12 weeks after the initial infection.
Common symptoms:
Shortness of breath
Fatigue and tiredness
Mental health issues
UHCW Post COVID MDT Assessment Clinic
The assessment clinic is delivered by therapists with access to psychology support.
Following assessment patients will, as relevant to their Long COVID presentation, be given self-management advice and/or referred on directly to relevant services such as Cardiology, Physiotherapy, Occupational Therapy, Pulmonary Maintenance Exercise Programme and IAPT.
To note: UHCW follow-up (local patients who were admitted with acute COVID-19) at around 6 weeks post-discharge for assessment, management and onward referral as required.
The following guidance is therefore particularly for local patients with suspected Post COVID Syndrome not known to UHCW.
Inclusion Criteria
History of persistent symptoms 12+ weeks after onset, compatible with suspected COVID 19. In exceptional circumstances the clinic will accept referrals after 4 weeks if symptoms are very severe.
Primary Care Assessment and Referral
This guidance is particularly for patients with suspected Post COVID Syndrome not known to UHCW.
Inclusion Criteria
History of persistent symptoms 12+ weeks after onset, compatible with suspected COVID 19
Chest X-ray
COVID antibodies test if no vaccination or previous confirmed swab – (Yellow topped bottle)
If COVID is confirmed (previous swab or antibody test) request bloods:
- Full blood count
- U&Es
- Liver Function Tests
- Vitamin B12
- Folic Acid
- Ferritin
- Vitamin D
- TSH
- BNP
- HbA1c
Urgency of Referral
| Patients with confirmed COVID 19 swab or positive antibodies and persistent CXR changes e.g. consolidation / interstitial lung disease / fibrosis | Urgent MDT referral |
| Patients with positive antibodies and normal CXR | Routine MDT referral |
| Patients with negative antibodies and normal CXR | Consider A&G or routine Respiratory Medicine referral |
Referral Letter Information
Please refer through Referral Support Service (RSS)
Include the following and send with the MDT referral letter:
- CXR report
- COVID antibody or previous positive swab result
- Bloods: Full blood count, Urea and electrolytes, Liver Function test, Vitamin B12, Folic Acid, Ferritin, Vitamin D, TSH, BNP, HbA1C
Click on image below or link on RIGHT for downloadable referral form
MDT Clinics & Patient Choice
Post COVID-19 appointments will be mostly face-to-face but patient or clinical need might indicate the need for other forms of clinical review, e.g telephone or video call.
If patient would prefer not to come to hospital for first consultation please add this information in your referral in order for us to arrange a phone consultation.
Please make your patients aware of the following information:
They may receive multiple letters including;
- Respiratory physiology (breathing test)
Radiology (CT scan)
Clinic appointment (if they are booked at short-notice our team will phone them) - We will book a blood test on the same day of their appointment in clinic if further tests are needed. They will be given the forms on arrival to clinic or by post.
- Invitation to participate in clinical trials.
- Referral to other specialities if needed, e.g cardiology, rheumatology, psychology, neurology.
Advice and Guidance
Please send any A&G requests for the attention of Dr B Lara or Dr A Ali.
See links
Follow image above for link to Post Covid Pathway GP Gateway Page including:
Referral form
IAPT information for GPs inc new virtual/remote offer
IAPT information for patients
Patient leaflets:
– Breathing
– Breathlessness
– Cough suppression
– Nutrition
– Prone position
– Voice recovery
Long Covid Support Group
The aim of this group is to provide emotional and wellbeing support and it is not to offer medical advice.
We will be offering room for participants to explore with others the feelings and adjustments necessary for them at this time
Long Covid: Hope Supported Self-management Programmes 2023
Please see attached details of the 8-week support programmes available to Coventry and Warwickshire residents across 2023 – start dates:
- 19th January
- 13th April
- 22nd June
- 14th September
Click on this link for Warwickshire Long Covid Support Group information
Please find attached the welcome pack which will be given to participants once referred as shares some details about the group.
Advice for Health Professionals on Returning to Work
For review soon
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Coventry
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