I’m not surprised that more than one in ten GP referrals to Long Covid clinics are rejected. And, frankly, I don’t care.
Not surprised, because having only 10% of referrals bounced back in these days of pandemic box-ticking and mandated A&G is a bit of a result.
And don’t really care because, in all honesty, a more logical rejection rate would be 100%. By which I mean that these clinics seem to be an exercise in futility.
This was brought home to me recently by one of the few patients I have actually sent to a Long Covid clinic. After the obligatory and labyrinthine pre-referral polyinvestogram hoop-jumping exercise, he was distinctly unimpressed by his eventual assessment and treatment, which apparently amounted to a phone-call, an emailed PowerPoint and a weblink.
This is definitely not the fault of the Long Covid clinic. We’re dealing here with a disease with no clear definition, no diagnostic test and no specific treatment. Try running a clinic on that basis.
Plus, of course, there’s the thorny issue of self-selection. Such diagnostic criteria as there are pretty much amount to, ‘I think I’ve had Covid and I now think I have Long Covid’. And while there is clearly a cohort of patients who don’t have a demonstrable post-Covid complication but do have some form of debilitating post-viral syndrome, there also exists a significant number of TATT chancers delighted to latch onto a zeitgeisty label to validate their symptoms, with a view to pursuing any number of possible agendas.
All of which means, I think, that Long Covid clinics are a waste of time, money and energy, resources which the NHS is already creakingly short of. Besides, I suspect these clinics were set up largely to act as a conscience-salving penance for a Government feeling guilty about mid-Covid cock-ups rather than to actually help Coviddy patients.
The result is a service which is over-sold to the public and set up to fail. It needs scrapping. So long, Long Covid clinics.
READERS' COMMENTS [9]
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Long covid clinics are a brief resting place for fibromylagia
Imagine if I said coding you for Long Covid will increase your future insurance premium by 20%.
Imagine.
This would all stop then, like the rest of the nannying charard.
“We’re dealing here with a disease with no clear definition, no diagnostic test and no specific treatment. Try running a clinic on that basis.’ Well said. We’re supposed to be a science based profession! I hate to say it but doctors should get sued for missing psychosomatic illnesses and instead inventing physical diagnoses. We create the fat files not the patients.
Perhaps send patients to Germany? They don’t seem to have Long Covid in Deutschland; perhaps something in the water?
Well said. There are many “diseases” created that only exists in Britain, all for the benefit of the benefit cheats and attracting others to come for this. The USA in the 80s and now attracted the cream of the crop from around the world with attractive terms. Look at what we are attracting. Really sad.
I too was brought up to sneer at ME and CFS patients, but its time to reconsider.
Long Covid is real, its probably more than one syndrome, its new to medicine , there is research happening across the world (the WHO esimate and treatments being tried. The idea that you would all just give up on these people, dismiss them, cancel the clinics, poor as they are, that are their only hope? That is NOT what any doctor should be doing with any disease, least of all one that disables more then 2 million people, both adults and children in this country. Patients are comitting suicide (including at least one doctor) because of the lack of care or help offered. There are several doctors that talk openly about suffering Long Covid, post viral sydromes. Put your prejudices aside and really try to help these people, thats our job, thats what we are supposed to do! Listen and help, not sneer and dismiss.
Long Covid is real but different to anything precceding. We need specialists focussing on it to start to find effective treatments. In some cases, tests are emerging. I have had severe post-Covid chest pain since April 2020 and having been told ‘all tests are normal, perhaps it’s the menopause?’ I eventually tracked down two specialists who actually got to the bottom of it and found a (missed) cardiac scar on my PET scan. I am now on methotrexate, off opiates and able to function much better (no benefits involved!). Hopefully, diagnostic and treatment pathways will become clarified by the work of these clinics for at least some patients shoved into the ‘CFS’ group.
Re Lise Hertel – these are excellent valid points you make. But GP cynicism is based on 2 major issues.
Firstly, LCovid patients are a huge heterogeneous group. Yes, some are previously healthy people struck down by a virus they never fully recover from, but let’s be honest, many are the Usual Suspects that GPs could have predicted would develop LCovid a mile away.
Secondly, LCovid clinics are perceived by GPs as a work intensive exercise in futility. Extensive pre-referral investigations (many of dubious value clogging up an already overloaded system), lengthy compulsory time-stealing referral forms, frequent infuriating bounce-backs and re-referral, lengthy waits, then eventually…..hallelujah!….. an LCovid diagnosis.
With no effective treatment, and frustrated patients returning to their GP disappointed and looking for a non-existent Plan B.
It’s an extraordinarily expensive time-devouring pointless circular journey back to the GP. If there are no effective treatments we should be honest with the patient, make the LCovid diagnosis ourselves, and follow latest guidelines on self-help, exercise, diet, support groups etc as we have done with postviral patients for years.
This is not ignorance or prejudice, it’s hard-headed real-world pragmatism. And most patients accept and appreciate that honesty.
…we should be honest with the patient…
Says it all!