One of the first teams to offer post- COVID support has proven a success due to its therapy-led approach .

NHS Tayside ’ s COVID-Related Advice on Rehabilitation , Enablement and Support ( CARES ) team started work last July , staffed with the working time equivalent of 1.5 occupational therapists and one physiotherapist , created from existing budgets . By December , the team received 200 referrals .

‘ My manager came up with the idea last May ,’ says Vicky Fyffe , an occupational therapist on the team . ‘ She thought people who had COVID would need further rehab , but people wouldn ’ t fit into the categories of existing services .’

Initially the team targeted people coming out of hospital , but with the July start date coming after the end of the first

Vicky Fyffe

some reassurance and validation of what they were experiencing . That first hour is really important for people to tell their story .’

The team can then offer support for common symptoms , such as fatigue , breathlessness , sleep issues , COVID-related anxiety , difficulty managing activities of daily living , new cognitive difficulties and issues around returning to work .

Signposting is also really important because of the diverse nature of COVID ’ s symptoms . The team has made 95 referrals so far , with speech and language therapy , nutrition advice and dietetics , and computerised cognitive behavioural therapy topping the list of destinations . Health psychologists have also proven really important , as have respiratory and cardiology services .

‘ You can ’ t support people from a single discipline with prolonged COVID

wave , there wasn ’ t a huge rush at first . It was when they turned to GP referrals and social media , particularly a post by NHS Tayside on its Facebook page , that more referrals started to come in .

As a result , just over half of people who have used the service self-referred , with GPs also a big source of referrals and a few passed on by hospital COVID teams .

Over half are key workers , and a quarter work for the NHS , with an average age of 51 . A high percentage have either not managed to return to work , or are struggling to remain in work due to ongoing symptoms .

Patients have typically had symptoms for seven months ; less than half had never received a positive test , or had not been tested , and a further one in six had negative tests , demonstrating the huge depth of need out there for support .

In terms of support offered , the team start with a telephone or Near Me video call to conduct a holistic assessment , typically lasting an hour .

‘ When we took our first patients we didn ’ t know what to expect ,’ says Vicky . ‘ But we quickly learnt that people needed

symptoms ,’ says Vicky . ‘ We ’ ve worked in a case management approach , providing that initial assessment and then working out where is the best place for them .’

While some patients just require a few sessions , only a third of patients have finished with the service , reflecting the complexity of COVID .

The team is now working on a peer support group , fatigue management programmes , and improved triaging of patient referrals , as well as the use of screening tools for specialist assessment , with new ideas partly being trialled to make sure the service is sustainable in the face of overwhelming demand .

‘ Having a holistic assessment to look at the impact of the condition on a person ’ s life , especially from a functional point of view , is why it ’ s important for occupational therapists to be involved ,’ says Vicky . ‘ It can be quite challenging work , as we ’ re not just working as occupational therapists but taking a case management approach , but patients have said it ’ s really helpful to have us to refer back to .’