The limited evidence described different models of rehabilitation services. The panel agreed that some of the common elements, such as integration and multidisciplinary team working, would help provide effective, well-organised care for people with ongoing symptomatic COVID‑19 and post‑COVID‑19 syndrome.
Because symptoms are so wide-ranging, many other areas of expertise could also be added as needed and examples of these have been added for the November 2021 update as an additional remark to the recommendation.
As well as ensuring the right breadth of expertise, having a multidisciplinary team with input from other services and clear referral pathways can help prevent disjointed care and people waiting a long time for appointments with multiple specialists. This was supported by the patient experience evidence, which described the challenges of getting support for such a wide range of symptoms and a lack of co-ordinated care.
The panel agreed the core expertise that a multidisciplinary team could include. Because symptoms are so wide ranging, many other areas of expertise could also be added as needed, for example rheumatology, neurology rehabilitation, cardiology, paediatrics, dietetics, speech and language therapy, nursing and pharmacy.
Different regional and geographical challenges meant that areas have different service needs and resources, so the panel agreed that one model would not fit all areas. However, the panel agreed a multidisciplinary service for assessment could avoid multiple referrals and would provide a single point for care. This could be a ‘one-stop’ clinic to help keep appointments to a minimum, although this might not be feasible for all services or wanted by all patients.
Based on their experience, the panel wanted to encourage different services to share knowledge and expertise with each other, to help expand the choice of tests and interventions available in the community. This could be done through local clinical networks or clinical hubs.