GP practices will have until 31 July to sign up to the new long Covid enhanced service (ES), which will pay just under 50p per registered patient.
The ES, which is worth a total of £30m and expected to run until at least 31 March 2022, is ‘for GP practices to plan their workforce set up, training needs and infrastructure in order to support patients with this new condition’, the specification said.
It said the ES was created because long Covid is ‘complex, and ‘will require professional education, consistent coding of patients, planning of practice clinical pathways to assess and support patients and consideration of measures to reduce the risk of inequity of access to support’.
Practices will be paid, in monthly instalments, £0.371 per registered patient (75% of payment) upon sign-up, and the remaining £0.124 per registered patient (25%) ‘upon commissioner confirmation that the self-assessment set out above has been completed by 31 March 2022’.
The document stressed this funding is ‘in addition to the funding already available to practices through global sum which reflects their core contractual responsibility for the provision of essential services to this cohort of patients’.
The initial role of ‘the general practice clinician’ is to ‘exclude acute or life-threatening complications and other unrelated diagnoses’ when patients with previously confirmed or suspected Covid-19 presents with ‘a wide range of symptoms including breathlessness, fatigue, chest pains, cognitive impairment or psychological symptoms’, the specification stated.
GP assessment may include ‘blood tests, chest X-rays or clinical tests, including sit-to-stand or lying and standing blood pressure, depending on the person’s signs and symptoms (as per NICE/SIGN/RCGP guidance)’, the document said, adding that ‘advice, treatment or referral to the relevant acute or specialist services may be required’.
Patients included under the ES include those who have ongoing symptomatic Covid from 4-12 weeks after the initial infection; as well as those with post-Covid syndrome, i.e. Covid symptoms that ‘continue for more than 12 weeks and are not explained by an alternative diagnosis’.
According to the latest data from the Office for National Statistics (ONS), long Covid is still affecting about a million people in the UK, with the number of patients living with symptoms for many months on the rise.
Options for treatment include:
- Signposting to self-management support including the online platform Your COVID Recovery (YCR) Phase 1 https://www.yourcovidrecovery.nhs.uk/
- Supported self-management from the practice or primary care network team; this may include input from social prescribers, health and wellbeing coaches and care coordinators with linking into community groups or other existing community services as appropriate
- Referral into a Post COVID assessment clinic if self-management alone is not appropriate and if further investigations or support are required.
Source: NHS England