Community and primary care services helping to treat people with long-covid across Wales

A programme aimed at helping those suffering from long-covid to treat and manage their symptoms has been accessed by more than 2,200 people across Wales.

The £5m Adferiad (Recovery) programme was set up to diagnose, rehabilitate and support those suffering from long-Covid in Wales.

Long-covid is defined as covid-19 symptoms, which persist for more than 12 weeks and are not explained by an alternative diagnosis.

All health boards in Wales provide integrated, multi-professional rehabilitation services for people with long-Covid and refer people to specialist care services wherever needed.

The review of the programme assessed information provided by health boards and feedback from almost 600 people who had accessed long-Covid services in Wales. It found:

• Of the 2,431 recorded cases of people with long-Covid via GP systems in Wales, 2,226 have accessed Adferiad services.
• Around 3.5 per cent of people with long-Covid were referred to secondary care services.
• Less than 27 per cent of people with long-Covid had been hospitalised with Covid-19.
• The Covid Recovery App has been an effective digital tool to help people manage their condition.
• The majority of people who took part in the review said they felt their concerns were listened to and they were supported to get the help and information they needed.
• More than 70 per cent rated their experience of the service above average and more than 87% would recommend the service.
• People responding to the national patient evaluation, undertaken by CEDAR who used long-Covid services, reported an improvement in their health outcomes and were satisfied with their experience.
• A long-Covid expert group has been set up to consider the impacts of the condition, treatments and referral methods.

One person who has accessed the service since its launch is 59-year-old Mr R, who developed Covid-19 in January 2021.

He was admitted to intensive care in his local hospital as a result of this illness. He was ventilated for 57 days and discharged three months later. He was referred to the long-Covid service by pulmonary rehabilitation team.

Mr R has been on sick leave from his physically-demanding job since his acute Covid-19 infection almost 12 months ago and he is still unable to return to his role.

He is only able to walk for short distances and although managing most tasks of daily living (with support from his adult children who live locally); he is significantly impaired by fatigue and cannot manage tasks without considerable rest periods.

Mr R says he feels his “low mood and difficulties with motivation” are a consequence of his struggles with fatigue and sleep. He reports that his low mood, anxiety and experience of psychological trauma impacts on his motivation to engage in social connection.

Mr R participated in a comprehensive multi-professional assessment. He requires the professional expertise of psychology, physiotherapy and a GP.

His treatment includes psycho-education and support for the impact of long-Covid on mind and body; fatigue management, pacing and post-exertional malaise; sleep hygiene. acceptance and commitment therapy (ACT) and a therapeutic programme to improve mood, reduce anxiety and psychological trauma; B12 injections and medication review; education and support for breathing pattern disorder, fatigue management and pacing.

Minister for Health and Social Services Eluned Morgan said: “In Wales we are committed to ensuring every person suffering from long- Covid receives support and care tailored to their particular needs and symptoms rather than a one-size-fits-all approach, as close to home as possible.

“It’s great to see the results of this review, which show people are receiving the right care they need for them and positive health outcomes are being maximised.

“We know it affects everyone differently. By following the primary care model we have ensured people are treated by the most appropriate specialists for their symptoms. Not everyone suffering from long-Covid will need to see a specialist and this model will stop people waiting a long time for treatment.

“We are still learning about long-Covid and this review will help us improve services further. We will continue to monitor the support required and adapt accordingly as we learn more to ensure services are available to all those who need support.”

Every person who seeks help for long-Covid receives a comprehensive assessment of their symptoms so they can be treated for their specific concerns and receive tailored support.