Post-COVID assessment service

Our Service is for people with symptoms consistent with Post-COVID Syndrome, which continue for more than eight weeks and cannot be explained by an alternative diagnosis. Lasting symptoms of COVID-19 can include fatigue and breathlessness, anxiety and low mood, joint or muscle pain, chest pains, and cognitive changes. Post-COVID Syndrome is often called 'Long COVID'. 

Everyone will vary in which symptoms they have. As a diagnosis by exclusion, your GP will rule out any other possible causes of your symptoms before you are referred to the service. Some common symptoms of Post-COVID Syndrome include: 

• Managing breathlessness and cough
• Cardiac and chest symptoms
• Fatigue management, such as pacing
• Managing brain fog and cognition
• Altered taste and smell
• Changes to voice, speech and swallowing
• Nutritional advice
• Wellbeing advice, including stress, anxiety, low mood, and sleep
• Dizziness
• Hearing and tinnitus
• Physical activity
• Getting back to work/occupations
• Pain advice
• Other post covid symptoms

Our multi-disciplinary team includes:

• nurses
• physiotherapists
• clinical psychologists
• dieticians
• occupational therapists
• assistant practitioners
• speech and language therapists
• medical consultants

 

 

Referrals to the Post-COVID Assessment Service can be made by your GP or another healthcare professional.

Before referring, they must complete the required tests in line with the referral criteria (see referral form).

For health professionals:

• Referral - Adult
• Referral - Child

Once a referral is received, our clinicians will review and assess it to decide the most appropriate next steps.

• If you need any adjustments to help you access our service, or if you don't have internet access, please let us know as early as you can so we can do our best to accommodate you.
• We encourage you to attend all scheduled appointments, and to stay in touch with us throughout your care. If you're unable to attend an appointment, please let us know as soon as possible so we can offer that time to another patient in need.  To make sure our service remains fair and accessible to everyone, please note: if you miss an appointment without giving at least 24 hours' notice, or if you cancel two appointments, you may be discharged from the service and your GP will be informed.
• We ask that you actively take part in your treatment plan and follow the advice provided to help manage your Post-COVID symptoms.
• You may meet different members of our team during your care. Each clinician brings different expertise, and they will always review your notes beforehand to ensure continuity in your care.
• Not every patient requires a follow-up appointment. If your symptoms change or you feel ready to take the next step in your recovery, you're welcome to get in touch with us. This is part of what we call a patient-initiated follow-up, where you can request further support when you need it.
• If you have any questions about your treatment or care pathway, please don't hesitate to contact us-we're here to help.
• If your symptoms suddenly worsen or you develop new, severe symptoms, please contact your GP, NHS 111, or call 999 in an emergency. Please note that we are not able to offer crisis mental health support or prescribe medications.
• To maintain a safe and respectful environment for everyone, we're unable to continue care for patients who behave in ways that are physically aggressive, threatening, verbally abusive, or otherwise inappropriate toward staff or property.

Watch a video explainer of what you can expect: 

PCAS and Me

You will need to complete a questionnaire which will be sent to you electronically via email. This questionnaire will be reviewed by a clinician, and our admin team will contact you with an appointment. It is important that you complete this questionnaire as soon as possible, as its receipt will trigger the scheduling of your appointment.

If the questionnaire is not completed, you will not be offered an appointment. If there is a reason you cannot complete the questionnaire, please let us know.

Please read the information provided in the attached service leaflet to learn more about the service and find links to helpful websites. This will help you prepare for the next steps in your care.

Please visit the NHS Long Covid webpage for basic advice on managing your Long Covid.

If you need any reasonable adjustments, please let us know as soon as possible so we can plan for these. NHS England » Reasonable adjustments

• Your first appointment will be over the telephone. During this appointment, the clinician will gather some information about you, including your past medical history, current medications, and any other relevant details to help manage your post-COVID symptoms. You will have the opportunity to discuss your post-COVID experience and symptoms.

• We will offer you a choice of symptom-focused webinars and educational/support sessions that are appropriate to your symptoms and goals. We will ask you to set a small, achievable goal/target and discuss what advice and/or resources you might need to help you with this.

• You will be required to attend an observation appointment, where we will see you in clinic and carry out some basic tests (such as blood pressure and oxygen saturation).

• Where necessary, you will be offered specialist support for individual symptoms and may discuss your care at our multi-disciplinary team (MDT) meeting to ensure we provide the best possible support.

• Our service will help you understand the approach that best suits you and your circumstances. Different strategies are used at various stages of recovery, depending on each individual's needs and situation.

• You may be offered group workshop sessions focused on symptom management. Each group and session is tailored to the participants, but common themes include:

  • Reflecting on your symptom triggers
  • Creating conditions for change
  • Recognising and managing setbacks
  • Setting personal goals

• Recovering from long COVID can be a challenging experience. Sharing your feelings with others in similar situations can be helpful. However, if group sessions don't feel right for you, we will consider your individual needs and discuss alternative options with your clinician.

• There is currently no diagnostic test available for Post-COVID Syndrome/Long COVID. Without testing, post-COVID can be difficult to distinguish from other health conditions. However, this does not prevent you from receiving care if you have a clinical need or from accessing other support you may need.
• We require certain blood tests and other investigations to be carried out prior to a referral to us. This will help ensure that no other causes of your symptoms have been missed. You should have already had these tests, and further tests, such as basic observations, may be offered by our service.
• You will receive an initial phone appointment, which provides an assessment to ascertain whether this service is right for you. If, after reading this information, you feel that this is not the right service for you, please let us know.
• Where needed, and when appropriate, we will be able to state that you have had a thorough assessment and that your symptoms are consistent with Post-COVID Syndrome, and we can inform the relevant people that you are being supported by the Post-COVID Assessment Service. This has been accepted by multiple statutory organisations. 

The NICE guidelines on managing the long-term effects of COVID-19 focuses on holistic, person-centred assessment and multidisciplinary rehabilitation, with strong emphasis on self-management strategies. There is no single "cure" for long COVID, so management is aimed at symptom relief and improving quality of life. 

Recovery time is different for everyone, and symptoms can fluctuate. The guidance emphasizes that the likelihood of developing long COVID is not linked to the severity of the initial illness, and even those with mild initial symptoms can be affected. 

For further information and resources, patients can consult the NHS Long COVID website & https://www.nice.org.uk/guidance/ng188

Peer support occurs when people with similar long-term conditions or health experiences come together to support each other, either on a one-to-one or group basis. Peer support is enabled through relationships that build mutual acceptance and understanding. 

Health coaching focuses on supporting people to make more informed and conscious choices about their health. It enables people to develop the knowledge, skills, and confidence to take opportunities to become active participants in their care. Our clinicians will support you to self-manage your post-Covid symptoms. This means that there will be actions you need to take, and these will require your full commitment to optimise the management of your symptoms. 

You will need access to the internet to use many of the resources we offer. If you do not have internet access, you can get support at your local library or with the help of a friend or family member. If you are unable to access the internet in any way, please let us know as soon as possible so we can find a way to support you. 

There is currently no medical treatment or cure for Post-COVID Syndrome. We work closely with the research team at Norfolk Community Health and Care NHS Trust, and we are keen to be involved in as many trials and projects as possible. 

Criteria for vaccination from Autumn 2025

The Post-COVID Assessment Service is not involved in vaccine eligibility decisions. The list below shows the current criteria for vaccination:

• adults aged 75 years and over
• residents in a care home for older adults
• individuals aged 6 months and over who are immunosuppressed

Post-COVID Syndrome is not a specific criterion for the Autumn 2025 vaccine.

If you have questions about whether you qualify, particularly if you believe you are immunosuppressed, please contact your GP to discuss your individual circumstances.  You can also find out more by clicking on the following link https://www.nhs.uk/vaccinations/covid-19-vaccine/

Patient Initiated Follow-Up (PIFU) means you can arrange a follow-up appointment when you feel you need one, based on your symptoms and personal circumstances. Instead of having routine appointments booked automatically, you are in control of when to reach out.

This approach empowers you to manage your condition and supports shared decision-making in line with the NHS personalised care agenda.

PIFU is sometimes called open access follow-up, patient-led follow-up, or self-managed follow-up.

Does this mean my care is ending?

Not at all. We are simply closing this active episode of care, but you remain in our system. If anything changes or you need support, you can contact us to book a follow-up appointment without going back to your GP. You are in control.

The current guidance from the National Institute of Clinical Excellence (NICE) recommends a self-management approach to support patients with post-Covid.

Supported self-management means increasing the knowledge, skills and confidence a person has in managing their own health and care by putting in place interventions such as peer support, self-management education, and health coaching.

Self-management education is any form of formal education or training for people with long-term conditions focused on helping them to develop the knowledge, skills and confidence they need to manage their own health care effectively. We offer webinars and education/support sessions for the most common symptoms of post-COVID. 

 

• Living with a lung condition - Asthma and Lung UK
• Physiotherapy for Breathing Pattern Disorder - Physio for BPD

• PoTS UK

ACAS - Advisory, Conciliation and Arbitration Service

For free employment-related support and advice to both employees and employers 

www.acas.org.uk/index.aspx?articleid=2042

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Access to Work

Access to Work is a specialist disability service which gives practical advice and support to disabled people, whether they are working, self-employed or looking for employment 

https://www.gov.uk/access-to-work/overview

• Lift up your everyday - managing energy - The Royal College of Occupational Therapists

• Norfolk & Waveney Talking Therapy - https://www.nandwtalkingtherapies.org.uk/
• Call Samaritans - 116 123 (24 hours) https://www.samaritans.org/
• Call 111 option 2 for NHS Mental Health Support (24 hours). This is a Crisis Response Service.
• Text SHOUT 85258 for a confidential 24/7 text service. https://giveusashout.org/get-help/
• Campaign Against Living Miserably (CALM) 0800 58 58 58 open 5pm - midnight. Free, confidential and anonymous. https://www.thecalmzone.net/ They also have live chat and WhatsApp options.
• SOS Silence of Suicide (8pm - midnight Monday to Friday, 4pm to midnight Saturday and Sunday) 0808 115 1505 https://silenceofsuicidesos.org.uk 
• MIND Support Line 0300 102 1234 to access emotional support. They do not provide a crisis service. Or call their Info Line on 0300 123 3393 for information about mental health problems, where to get help and treatment and advocacy services. https://www.mind.org.uk/information-support/helplines/
• SANE line 0300 304 7000 (Every day 4:30pm - 10:30pm) https://www.sane.org.uk/how-we-help/emotional-support/saneline-services
• Nuffield Health - COVID-19 Rehabilitation Programme
• NHS Five ways to wellbeing guide - 5 steps to mental wellbeing - NHS

A Guide to Long COVID and Mental Health - produced by University College London

Download

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NHS Long COVID website 

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COVID recovery - Guy's and St Thomas' NHS Foundation Trust 

10 films that provide practical advice to help you recover from COVID-19. You can use them as self-management guides. 

Watch these films in any order and try to use some of the suggestions in your own personal recovery plan. Focus on the symptoms that affect you the most. 

• Long Covid and diet - British Dietetic Association
• Myalgic Encephalomyelitis (or Encephalopathy) / Chronic Fatigue Syndrome (ME/CFS) - British Dietetic Association
• The Eatwell Guide - NHS

https://www.paintoolkit.org/

https://livewellwithpain.co.uk - particularly the self-help resources under the 'resources' tab.

• https://www.nhs.uk/symptoms/lost-or-changed-sense-smell/

• Royal College of Speech & Language Therapists 
• Information written by speech and language therapists (SLTs) as a guide for individuals, and their carers/families, living with the aftereffects of COVID-19 infection: 
  • Long COVID Overview - Patient Handbook 
  • Brain fog and communication
  • Reflux
  • Swallowing
  • Throat changes after COVID-19
  • Voice
  • Stammering