NHS England: National guidance for post-COVID syndrome assessment clinics (November 2020)
Published on the 6th November, 2020. https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/11/C0840-national-guidance-for-post-covid-syndrome-assesment-clinics-111220.pdf
NHS England recently invested £20 million in setting up 40 Long COVID clinics to assess and manage these individuals. They have recommended the use of C19-YRS as an outcome measure to be used at first assessment, 6 weeks and 6 months to monitor progress.
The purpose of this document is to provide commissioning guidance on the development of a specification to assist local healthcare systems to establish post-COVID assessment clinics for patients experiencing long-term health effects following COVID-19 infection. Clinics will offer physical, cognitive and psychological assessments with the aim of providing consistent post-COVID syndrome services for all who need them, whether they were hospitalised or not and regardless of whether clinically diagnosed or by a SARS-CoV- 2 test.
It will be critical to gather and analyse data, participate in shared learning and use this information to inform future practice and reduce unwarranted variation in the management and subsequent outcomes of patients with post-COVID syndrome symptoms. The data will be used to inform the management of patients, as well as informing service providers and commissioners in resource planning to maximise resource and service resilience.
NHS England and NHS Improvement London has reviewed the instruments available to monitor patient recovery trajectories and the impact of symptoms on an individual’s functional status. Based on this review the use of two validated tools for routine collection are recommended:
- The COVID-19 Yorkshire Rehab Screening Tool (C19-YRS) is a comprehensive multi-system telephone tool which has been developed by multi-disciplinary rehabilitation teams from Leeds, Airedale and Hull NHS Trusts to assess and capture symptoms and guide rehabilitation interventions. The tool can be found in appendix C.
- The post COVID-19 Functional Status Tool is an ordinal, 6-point tool used to measure a variety of functional outcomes during recovery from COVID-19. The scale which has steps ranging from no symptoms to death can be used to measure the impact of symptoms on functional performance and the effect of interventions on the recovery trajectory. The post COVID-19 Functional Status Tool is intended to be used at a number of different time points during a patient’s recovery in order to measure change in status and support an understanding of the patient’s recovery trajectory. It may be completed either by clinical professionals or by the patient themselves with the use of the flowchart. If the patient has cognitive or other limitations which prevents them from providing responses, the tool is suitable for a family member or carer to respond on their behalf. The tool can be found in appendix D