Supporting NHS staff with Post COVID-19 Syndrome (Long Covid)
The gift many had been waiting for (alongside the vaccine!) has arrived; the NICE COVID-19 rapid guideline: managing the long-term effects of COVID-19 (hyperlink to document https://www.nice.org.uk/guidance/ng188).It provides clear definitions for Acute COVID-19 (signs and symptoms up to 4 weeks), Ongoing symptomatic COVID-19 (4-12 weeks) and Post COVID-19 syndrome (more than 12 weeks). This clarity will help healthcare professionals collect data and offer a stepped care approach to return to work interventions as for many people, their symptoms will resolve within 12 weeks. So, what does this mean for NHS staff now who are struggling to return to work after COVID-19?
The NICE guidelines state that crucial in the earlier stages is assessment, offering advice and written information about possible fluctuating symptoms and self-management. How the symptoms affect the person’s life and activities such as work should start at the assessment stage. Introductory advice is offered inYour Covid Recovery(hyper link to site https://www.yourcovidrecovery.nhs.uk/your-road-to-recovery/returning-to-work/)
Ongoing symptomatic and Post COVID-19 syndrome
If people develop longer term symptoms, the guidelines indicate that they may require a greater level of multidisciplinary assessment, support and rehabilitation to return to work. This would include using shared decision making to set realistic goals, treating fatigue and respiratory symptoms, and supporting people in discussions with the employer about what a phased return to work would look like. The use of graded activity, problem solving and worksite assessments will be key. It is hoped that this group of people will also be able to benefit from new sections in Your Covid Recovery that will provide more in-depth return to work advice.
Your Covid Recovery Group
So, can this be put into practice with potentially larger groups of employees with Long Covid in the NHS? Occupational therapists working in NHS Occupational Health have been doing just this offering both group and individual interventions.
Sara McGinness from Liverpool University Hospitals Foundation Trust has set up the “Your Covid Recovery” group which starts with a screening telephone appointment and is offered to NHS staff experiencing symptoms that significantly impact on their daily function and ability to work. The group runs for one hour a week for six weeks and uses the Work and Social Adjustment Scale (WSAS) and Warwick and Edinburgh Mental Wellbeing Scale (WEMWBS) as outcome measures. The main topics cover – what Long Covid is, fatigue and respiratory management, returning to physical activity, cognitive dysfunction, acceptance and mental wellbeing.
Early results show improvements on both measures, particularly the WEMWBS. The group have also started their own WhatsApp group for ongoing peer support and are offered monthly group catch ups for 6 months. This focuses on ongoing symptom management and building on goals. They are also offered individual reviews with the occupational therapist for more tailored advice and intervention. The group is proving to be a life line for many, who would otherwise fall out of the work place. Interpreting and implementing the NICE guidance in this way may be critical in helping our workforce get back on its feet after the worst pandemic our country has seen.
Royal College of Occupational Therapists