Five things we have learnt from COVID-19 that can help us design new services in a different way – starting with Long COVID

Mike Farrar

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Long COVID is an unpredictable and extremely disruptive and challenging condition which can bring severe ongoing discomfort and difficulty for its sufferers. Early indications suggest it is hard to predict which people go on from experiencing COVID-19 to have this condition on a chronic basis but as our understanding of the problem grows it is undisputed that patients with it can suffer greatly for many months and possibly years.

The emergence of this condition has coincided with a system under severe strain with pressure to recover the access standards to care for non COVID patients, the ongoing challenge of vaccinations and the continuing management of COVID-19 with its sustained impact on a baseline level of hospitalisation and then, the longer lasting consequences for some patients. Estimates of patients waiting over 52 weeks is currently 388,000 and the number of people suffering from Long COVID standing at over 1 million people.  

Trying to design services for a new, emerging and previously unknown condition has often proved challenging for the NHS and care system in the past, and typically it can take many months before a standard pathway emerges. But with the experience of responding to COVID-19 over the past 18 months, there may be a means now to show that we have learnt a thing a two about rapid service design.

I would argue that we have demonstrated over this recent 18 month period a number of significant learning points –

  1. the importance of putting the patient at the centre of care
  2. the ability to provide services using digital and remote connections
  3. the need for data and ongoing monitoring to inform both personal behaviours, service interventions based on actual need and how to frame national policy accordingly
  4. targeting and empowering vulnerable patients enables support networks to emerge that can be connected to complement the state’s statutory service offer
  5. health and care staff are tired and experiencing their own health problems which coming on top of an existing workforce shortage requires us to trust and invest more in shared care

In this sense, the design of a pathway for long COVID and the ongoing management of the condition needs to be built on these key learning points.

Crucially by using remote monitoring and condition management, the service can assess referrals easily, help the patient identify and manage the periodic acute episodes of the condition, and alert the clinical staff to any significant deterioration that warrants a higher level of intervention. It also, subject to patient permission, allows for the possibility of real time research on the condition as a means to help predict acute phases and develop new treatment and interventions

This is why the work of ADI Health and the MyPathway approach is very interesting as it’s patient centred remote and ongoing evidence based monitoring looks highly suited to the task. Their solution gives you an indication of how straightforward the service can be when the patients are connected using the software. It also has the ability to minimise the use of clinical time until it is really needed if, as, or when, there is deterioration in the patients condition.

Long COVID may be a lasting consequence of an awful virus that we will need to live with for many years. If we are smart however, and put into practice, the learning we have had over the last 18 months we may be able to mitigate its impact, improve patient outcomes and show us a way forward for designing new service in the future.