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Publish date: 28 May 2021
UCLH’s post-COVID service has won the award for excellence in times of crisis at the Royal College of Physicians 2021 Excellence in Patient Care Awards. This was a new category, created in response to the pandemic.
What stood out to the judges was the speed at which the service was established in urgent response to the gap in healthcare provision for this patient cohort early in the pandemic. Also, how the early clinical experience and academic collaboration of the multidisciplinary team at UCLH fed important insights into the work of NHS England and NHS Improvement (NHSEI) and the National Institute for Health and Care Excellence (NICE) in defining post-COVID-19 syndrome and in developing appropriate pathways of care.
At the time of judging, UCLH’s multi-specialty, multi-professional post-COVID service had assessed and managed 1,200 patients with persistent symptoms after COVID and delivered over 2,000 appointments since the clinic opened in May 2020. To date, more than 2,600 appointments have taken place.
Dr Melissa Heightman, respiratory physician and clinical lead for the post-COVID service, said: “We are delighted to be recognised by the Royal College of Physicians. It took phenomenal effort on the part of so many colleagues across multiple specialties and professions at UCLH to establish the clinics so quickly to respond to the huge demand from patients.”
“Right from the start we identified that patients needed a multi-professional assessment with access to advice from multiple specialties, such as infectious diseases, cardiology, neurology, gastroenterology and rheumatology. This has been delivered through weekly virtual multidisciplinary team meetings (MDT) as well via dedicated clinics in post-COVID neurology and cardiology.
“The physiotherapy and occupational therapy team, led by Rebecca Livingston, have played a crucial role in assessment and treatment of patients. We are also delighted to be integrating psychology support for patients struggling with difficult symptoms. Our digital health record system EPIC has been fundamental to developing tools for consistent assessment and coping with the capacity demands.”
“We are now the lead provider for north central London and have formed a post-COVID network with pathways co-designed with primary and community services and linking in with other acute trusts. The aim of this network is to improve equity of access for patients with long COVID to a consistent community-based assessment and more rapid access to recovery support and further specialist investigation and treatment where necessary. We have weekly MDTs with the five borough teams and are contributing to the training and upskilling of the wider workforce in post-COVID medicine, a rapidly expanding field.”
The clinical need for a post-COVID service was identified soon after the announcement of the national lockdown in England on the 23rd March 2020. The initial screening of patients following hospital admission started two weeks later. Planning of the post-COVID service, and identification of staff and physical space to carry out consultations took around four weeks. The clinic started operating from the Find and Treat mobile X-ray unit on 11th May 2020.
UCLH’s post-COVID service now has three clinics. The main clinic is led by Dr Heightman and team (Dr Toby Hillman, Dr Kay Roy, Dr Emma Wall and infectious diseases colleagues), and there is a dedicated post-COVID cardiology list led by cardiologist Dr Rob Bell. A second COVID neurology clinic at the NHNN, is led by consultant neurologists Dr Patricia McNamara, Dr Mike Zandi and Dr Hadi Manji, and the anosmia clinic at the Royal National ENT and Eastman Dental Hospitals is led by consultant rhinologist Dr Peter Andrews.
Collectively, the teams now deliver eight lists weekly and continue to offer over 100 consultations (both face to face and via telephone) per week.
This service was highlighted in September 2020 as being the only true long COVID clinic operating in the UK. As such, members of the service have been influential in the development of local, regional and national policy on the nature and structure of post-COVID follow up, and in raising the profile of this new condition.
Members of the team were on the expert panel which drafted the first rapid guideline on the assessment and management of the long-term effects of COVID. The summary paper of this guidance, published in the BMJ, has now been viewed over 21,000 times.
Members of the core and wider post-COVID service have engaged proactively with mainstream media, appearing in multiple newspaper, radio and television pieces and articles. The service has also responded to many calls for assistance in the commissioning and shaping of post COVID services across the UK and continue to engage with NHSEI through their long COVID taskforce.
