The Post COVID Assessment and Management Service (PCAMS) provides holistic care for patients who have suffered from COVID-19 and continue to have symptoms 12 weeks or more after the start of the infection.

The Post COVID Assessment and Management Service takes a multi-disciplinary approach to caring for patients and involves input from a range of specialities, including:

  • Neuro-rehabilitation
  • Respiratory
  • Cardiology
  • Long COVID Clinical Lead GPs
  • Physiotherapy
  • IAPT
  • Social Prescribers
  • Health Coaches

GPs will continue to follow existing referral routes for specific speciality referrals, and some patients referred into the PCAMS service may be referred into speciality clinics, if this is felt to be appropriate.

If patients are seen in specialist clinics, and felt to be suitable for the PCAMS service, a referral should be sent by the relevant specialist via the process described below.

If patients referred into specialist clinics are identified, at triage, as potentially being more appropriate for the PCAMS service, they should be declined with advice for their GP to refer to PCAMS.

Symptoms following COVID-19

Symptoms after acute COVID-19 are variable and wide ranging. The most commonly reported symptoms include:

  • Generalised symptoms: fatigue, fever, pain.
  • Respiratory: breathlessness, cough.
  • Cardiovascular: chest tightness, chest pain, palpitations.
  • Neurological: cognitive impairment such as loss of concentration and memory issues, headache, sleep disturbance, peripheral neuropathy including Paraesthesia and numbness, dizziness, delirium (in older people).
  • Gastrointestinal: abdominal pain, Nausea, diarrhoea, anorexia and reduced appetite (in older people).
  • Musculoskeletal: joint and muscle pains.
  • Psychological: depression and anxiety.
  • Ear, nose, and throat: Tinnitus, ear ache, Sore throat, Loss of taste and/or smell.
  • Dermatological: Skin rashes.

Who should be referred to the service?

Patients who have had confirmed or suspected COVID-19 and are still having multiple symptoms 12 weeks or more after infection. These patients will likely have complex needs that would benefit from assessment from the Post COVID Assessment and Management Service.

The patient does not need to have had a confirmed diagnosis of COVID-19 or to have been admitted to hospital as long as they are suffering from multiple symptoms post COVID and would benefit from an assessment.

Patients with only one symptom can still be referred to other specialities through normal processes, or if it is considered that an MDT assessment would not be beneficial.

Who NOT to refer to the service

Patients who are:

  • Acutely unwell
  • Have oxygen Saturation <92% (unless COPD patients with known low oxygen saturation)
  • Have cardiac chest pain, suspected ACS or angina
  • Have severe mental health symptoms with risk of suicide or self-harm
  • How to refer to the Post COVID Assessment and Management Service

The referring clinician must complete the referral form. This should then be sent to the Post COVID Assessment and Management Service via email at stsft.longcovidclinicreferrals@nhs.net.

Clinicians are asked to carry out a physical examination and ensure the following investigations have been undertaken prior to referral:

  • Bloods, including FBC, Ferritin, TFTs, U&Es, LFTs.
  • Patients with ongoing dyspnea should also include BNP, ECG and CXR.
  • What happens after referral?

The patient will be assessed by the Post COVID Assessment and Management Service Clinical Lead GP and information gathered. This will then be discussed by the MDT and a management plan agreed.

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