Coronavirus patients will need to be monitored for a year

Coronavirus patients will be monitored for up to a year, one hospital trust has revealed, amid concern over further pressure on the NHS to provide after care. 

Emphasis has been placed on discharging patients rather than providing long term rehabilitation, meaning some are unlikely to make a full recovery, charities and health unions have warned.

Patients have suffered with coronavirus symptoms for months after testing positive, with some even losing the ability to walk after spending weeks in hospital, doctors said.

Dr Matthew Knight, Consultant Respiratory Physician at West Hertfordshire Hospital, said seven weeks on some of his patients are still experiencing breathlessness, fatigue and the “sensation of temperature”.

“Some of these poor people can’t walk, they’ve lost all their muscle mass and they really are starting from a very low base physically,” Dr Andrew Barlow, Clinical Lead for Respiratory Medicine at West Hertfordshire Hospitals NHS Trust, said.

West Herts Hospital has launched its own aftercare pathway for recovering patients, in lieu of official NHS guidance which was due to be released at the end of April.

Dr Barlow said they have agreed with their local NHS Clinical Commissioning Group that patients who were severely ill with the virus will now be monitored for up to a year, including regular checkups for lung function and cardiac health, he said.

But without an established rehabilitation pathway from the NHS patients are unlikely to fully recover and could end up back in hospital, a leading healthworker’s union warned.

Ruth ten Hove, head of development and research at the Chartered Society of Physiotherapy, said the NHS has “hasn't really thought” about how it will meet the needs of recovering patients, as it has “focused on discharging people from hospital” instead.

“It's a really tough recovery pathway for people” and it is “critical” to have one in place so they can get “back on track" to their pre-Covid health, she said.

Neil Tester, director of the Richmond Group - a coalition of 14 leading health and care charities including Age UK and The British Heart Foundation - said it’s inevitable the NHS is focusing on the “current emergency”.

But he said “impetus” must be placed behind “longer-term planning”, or else it could lead to “worse outcomes and pressures on services in future”.

Mr Tester added the NHS must remember that recovering patients are dealing with mental, as well as physical, problems so a “wide range of rehabilitation needs” must be considered.

Recovery will be a “long haul”, but it will be even “longer and harder if people’s individual situations aren’t considered in the round from the start”, he added.

But traditional aftercare will need to be adapted, as patients are so frightened of the virus they are refusing to let people into their homes, Ms ten Hove said.

Health workers are “ready and willing” to go into homes, but “an enormous fear factor exists… when you know they may be bringing new infection”.

She added it may not be time to go "back to normal”, but a balance must be made between “risk and perspective” when it comes to health workers.

“It's complex, but there isn't any clear plan from the Government yet,” she said.

NHS England did not provide a date for when the rehabilitation guidance will be published when contacted for this story.

Following publication, a NHS spokesperson said: “This coronavirus pandemic is a once in a generation healthcare challenge which will have a lasting impact on patients, their families and the NHS, which is why the NHS is now scaling up rehab and other community care services as part of the next phase of our response to the virus, including recently opening the first new Seacole centre for covid-19 rehab treatment centre."