GP and newly elected MSP Sandesh Gulhane says new clinics must be rolled out immediately for long covid patients who ‘cannot afford’ to wait any longer for help.

As many as 110,000 Scots are thought to have long covid – including some children – which can leave individuals struggling with fatigue, dizziness, poorer mental health, joint pain and many other symptoms.

Elected to Holyrood in May of this year, Conservative MSP Dr Sandesh Gulhane is pressing the government hard on the issue of treatment and support for long covid. He wants an approach that has become known as the Hertfordshire model rolled out across Scotland.

Specialist covid clinics staffed by GPs, physiotherapists and occupational therapists (OTs) that patients can be referred to are already operating in parts of England, with the UK government committing £34m for their roll out.

For the 1.9% of the Scottish population already thought to be suffering from long covid, and the many more people researchers expect to be diagnosed with in in the future, Dr Gulhane wants to see specialist long covid clinics set up over the course of the next few weeks and months, rather than waiting until further research is carried out into the condition.

“The SNP government’s response has been initially to say that we don’t know enough about this need to do some research,” Dr Gulhane told healthandcare.scot, “but research takes between 18 months and three years to complete and then action, and my patients cannot forward to wait that long.

“I have a patient who used to run five to ten kilometres a day but now, after having covid, can’t make it to the toilet without feeling breathless. People are having to leave their jobs because they can’t think clearly and keep up with what’s going on.

“What I want is the Hertfordshire model - that would be having a small clinic with a GP and occupational therapist and a physiotherapist. They take over the responsibility for care and support patients who are referred in and they can refer to specialities like radiology or the respiratory team.”

Earlier this week a group of Scottish academics called for urgent government funding for long covid assessment, treatment and rehabilitation. They issued a warning over a lack of universal support services and said many professionals were unaware of what help was available.

The first UK guidelines for long covid were published in December, when it was estimated around 80% of people who contracted the virus experienced mild to moderate symptoms, with the remaining 20% enduring more serious problems such as heart, lung and kidney issues.

In recent weeks researchers from the University of the West of Scotland received funding to examine whether a long-standing approach to helping people with ME manage their symptoms could help long covid sufferers struggling with extreme fatigue.

In a paper he wrote and published recently, Dr Gulhane says opening long covid specific clinics would mean existing services would escape being “devastated” or overwhelmed by the substantial number of Scots dealing with the condition, and mean existing services would be better used.

“A patient attending a long covid clinic could then be seen by a respiratory consultant and once they have done all they can, then be referred back to the clinic and the same GP can continue their care.

“What we see with this way of doing things is that we treat the patient holistically, intervening to support their mental and physical health. Physiotherapists and the OTs can get patients moving, but the OT also has a dual mental and physical health approach.

“We can and need to do so much of this on the phone or remotely, because patients are shattered; they can’t physically make it into clinics much of the time.”

A return to work is also proving difficult for many who have long covid, but getting people back – particularly young people – needs to be a priority he says:

“No matter how much, as a doctor, I want to say health is the most important thing, without money we can’t do health so what we need is for those patients – particularly the 18 to 35-year-olds who are affected but are prime workers who pay taxes and put money into the economy – to get back to work.

“Our traditional model of getting patients back to work covers a four-week return plan, but that isn’t right for long covid. Patients end up going backwards if you try to, so we need a slower model and that’s what a clinic with GPs, physiotherapists and OTs would be able to do – they would be able to give patients a bespoke plan of how to return to work.

“I have had a lot of meetings with the Royal College of Occupational Therapists, the Royal Pharmaceutical Society, the Chartered Society of Physiotherapy, and the Hertfordshire team themselves, and I’ve been to a long covid summit.

“What is overwhelmingly coming out is patients feeling as though they are being left alone and not being cared for – they want to have that clinic and coordination of care. But that is something GPs right now can’t do with the time constraints they are under and without anywhere to send them.

“We don’t have the pathways. And if there are some in the service, we don’t know about them which means there is no point having them if we don’t know they are there.”

Following a question yesterday from Labour MSP Jackie Baillie on long covid, First Minister Nicola Sturgeon reiterated that “significant sums of money” were being allocated to understanding long covid:

“It is important to ensure that we have the right specialist provision in place, and that we build it on the basis of the best understanding.

“Our understanding will obviously develop as our research develops, but we should build from an evidential base, and we should do it properly, rather than me saying, “Here’s £3m”, knowing that it will not deliver many specialist clinics.

“We need proper investment and proper development of understanding to ensure that specialist provision does what we require it to do.”

 

Read more: Researchers: ‘Time to embrace’ action on long covid; Clinical guidelines crucial in treating long covid; Insight: Mapping pathways to transform the NHS; ME support could be tailored to long covid patients

Sign up to our bulletin for key health & social care updates straight to your inbox.