Critical care
Patient feedback
‘ It just feels so nice to be able to talk to someone who understands all the different problems I ’ ve had from Covid .’
‘ I feel reassured to know someone is looking out for me and looking after me since I was discharged .’
‘ Having a video call is so much easier for me . I found it hard to go to hospital appointments and also I was scared of going out because of Covid .’
‘ I am so grateful to this clinic for organising the further therapy for my mum , we didn ’ t know what to do after she was discharged ( by reablement ) and the GP said we had already had physiotherapy .’
‘ It completely changed my life and I have a lot more confidence to do things . I can use my hands again . I wouldn ’ t have been able to get the specialist [ neuro ] rehab I needed without the clinic .’
and other community organisations . Interestingly , those who were not intubated seemed to be more likely to have had traumatic experiences from being conscious in ITU during the peak . This was another reminder that care really does not just end on hospital discharge , particularly from the acute perspective .
Having a therapist also appeared to support continuity of care , serving as a link between inpatient and outpatient / community services and ensuring the patient ’ s wide-ranging needs are addressed holistically in their aftercare .
We found it beneficial to review patients at least two to three months after discharge , rather than earlier , as it allowed us to identify and target more significant and longer-lasting symptoms beyond spontaneous recovery .
The clinic aimed to help address some of the inequalities faced by the specific patient cohort in terms of their impairments and struggles after COVID-19 critical care admission . However , it also revealed ongoing inequalities .
Nevertheless , as with many services since the pandemic , it was an opportune moment to explore virtual working .
It was an invaluable experience for me , personally , as a different way of working and communication , inspiring more creative service delivery .
This project helped to develop a more permanent therapy presence in critical care clinics , support potential funding and address the unmet need to establish best practice pathways across the trust to build a sustainable and equitable model for future follow up clinics , alongside many other developments .
Faculty of Intensive Care Medicine ( 2019 ) Guidelines for the provision of intensive care services ( GPICS ) ( 2nd edition ). Available online : www . ficm . ac . uk / sites / default / files / gpics-v2 . pdf [ accessed 11 October 2021 ]
National Health Service ( 2021 ) Long Covid : the NHS plan for 2021 / 22 . Available online : www . england . nhs . uk / coronavirus / publication / longcovid-the-nhs-plan-for-2021-22 / [ accessed 11 October 2021 ]
National Institute for Health and Care Excellence ( 2021 ) COVID-19 rapid guideline : managing the long-term effects of COVID-19 . Available online : www . nice . org . uk / guidance / ng188 [ accessed 11 October 2021 ]
National Institute for Health and Care Excellence ( 2017 ) Development of a multidisciplinary post critical care clinic at Guy ’ s and St Thomas ’ NHS Foundation Trust . Available online : https :// bit . ly / 3KtqqVZ [ accessed 11 October 2021 ]
National Institute for Health and Care Excellence ( 2021 ) Rehabilitation after critical illness in adults . Available online : https :// bit . ly / 37dH4ua [ accessed 11 October 2021 ]
Royal College of Occupational Therapists ( 2021 ) RCOT Informed View : Long Covid . Available online : www . rcot . co . uk / post-covid-syndromelong-covid [ accessed 11 October 2021 ]
Words NICHOLE YAM , Occupational Therapist , Barts Health NHS Trust , Follow on @ nicholeyam
Acknowledgements and thanks go to all the consultants , therapists , nurses , and administrators who helped to make this clinic a success , with special thanks to Specialist Respiratory Physiotherapist Rebecca Allen for her support and joint contributions to this project
April 2022 OTnews 27