Warning issued over staffing pressures on new 'long Covid' units

The British Thoracic Society (BTS) has welcomed NHS plans to open 43 specialist ‘long Covid’ units in England ‘within weeks’ – but raised questions over implementation plans.

The BTS, a charity with more than 3,000 members – some of whom are physiotherapists – was responding to news that NHS England has earmarked £10 million to fund the clinics.

60,000 people affected by 'long Covid'

The clinics will treat patients who have been hospitalised, officially diagnosed after a test, or who ‘reasonably believe’ they have the condition.

‘Long Covid’, which is thought to affect more than 60,000 people in the UK, can cause continuing fatigue, ‘brain fog’, breathlessness and pain.

Ten sites are planned for the Midlands, seven in the north east, five in London and three in the north west. Meanwhile, the east of England, the south west and south east will each host six.

Specialist staffing 

In a statement, the BTS said that, as well as funding, the services would also need infrastructure and specialist staffing – both of which are currently in ‘short supply’. 

It called for respiratory professionals to be involved at the ‘highest level from the start’ in designing care systems.

‘Creativity and innovation are key strengths of the respiratory workforce which should be harnessed to ensure that these initiatives deliver the best possible outcomes.’

Jon Bennett, he BTS chair, said: ‘Respiratory specialists at all levels have been caring for patients in hospital, but have also been running post-Covid (including long-Covid) clinics throughout the country since the peak of the pandemic.’

There has been too little consultation with the specialty, even if it’s going to be the one in charge of care for patients with Covid-19 [Prof Jon Bennett, BTS]

The respiratory workforce – including physiotherapists and other allied health professionals – had shown ‘great leadership and invention’ in its response to the pandemic, Professor Bennett said.

‘But their numbers and time are limited and increasingly stretched across all these services.

‘They should not just be expected to find a way to deliver these new clinics, which realistically, might only be possible at the expense of other services.

‘There has been too little consultation with the specialty, even if it’s going to be the one in charge of care for patients with Covid-19.’

Winter looms

According to the BTS, 15 per cent of those hospitalised with the virus need intensive care treatment, while the rest go to respiratory and general wards – where respiratory professionals play a crucial role in their care.

Admissions for respiratory illnesses are about to surge as the weather cools, the BTS predicts, and respiratory specialists will have to deal with both these extra patients and Covid-19’s second wave.

The extra pressure on respiratory wards must be taken into account when planning the long-Covid and any new Covid-19 service announced by the NHS, it stressed.

Taskforce launched

The NHS has also launched a new taskforce, with patients, charities, researchers and clinicians, to help manage the NHS approach to ‘long Covid’ and produce information and support materials for patients and healthcare professionals to develop a wider understanding of the condition.

NHS chief executive Sir Simon Stevens said: ‘These pioneering “long Covid” clinics will help address the very real problems being faced by patients today while the taskforce will help the NHS develop a greater understanding of the lasting effects of coronavirus.’

Recent evidence shoes that ‘long Covid’ can be categorised into four syndromes: post intensive care syndrome, post-viral fatigue syndrome, permanent organ damage and long-term Covid syndrome.

NHS announcement: https://www.england.nhs.uk/2020/11/nhs-launches-40-long-covid-clinics-to-tackle-persistent-symptoms/

BTS announcement: https://www.brit-thoracic.org.uk/about-us/pressmedia/2020/bts-response-to-nhsei-long-covid-clinics-announcement/