A national survey of community rehabilitation service provision for people with long Covid in Scotland

Background: Over 50 million cases of COVID-19 have been confirmed globally as of November 2020. Evidence is rapidly emerging on the epidemiology of COVID-19, and its impact on individuals and potential burden on health services and society. Between 10–35% of people with COVID-19 may experience post-acute long Covid. This currently equates to between 8,129 and 28,453 people in Scotland. Some of these people will require rehabilitation to support their recovery. Currently, we do not know how to optimally configure community rehabilitation services for people with long Covid. Methods: This national survey aimed to provide a detailed description of current community rehabilitation provision for people with long Covid in Scotland. We developed, piloted, and conducted a national electronic survey of current community rehabilitation service provision for people presenting with long Covid symptomatology. Our sample were the Allied Health Professions Directors of all 14 territorial NHS Health Boards in Scotland. Fixed response and narrative data were analysed descriptively. Results: Responses were received from all respondents (14/14), enabling a national picture to be gained. Almost all Health Boards (13/14) currently deliver rehabilitation for people with long Covid within pre-existing services. Fatigue (11/14) and respiratory conditions (9/14) were the two most common presenting problems of patients. Most long Covid community rehabilitation services are delivered through a combination of face-to-face and digital contact (13/14). Conclusions: Community rehabilitation for people with long Covid is an emerging reality. This survey provides a national picture of current community rehabilitation for people with long Covid. We do not know how community rehabilitation can be optimally delivered for this population. This is vital as community rehabilitation services were already under pressure prior to the emergence of COVID-19. Further research is urgently required to investigate the implementation, outcomes and cost-effectiveness of differing models of community rehabilitation for this patient population.[Version 2; peer review: 2 approved

Witnesses to Inspiration

Introductory essays by Jennifer Abod, Eve Oishi, and Holly Smith, the editors of a Special Issue of the Journal of International Women’s Studies dedicated to pioneering Black Lesbian Feminist scholar, activist, artist, teacher Angela Bowen, Ph.D. (1936-2018.) Also included is a piece by Lore/tta LeMaster, a former student of Bowen’s and M. Jacqui Alexander, a close friend and co-conspirator. These essays describe the authors’ personal and professional connections with Bowen and situate the special issue in relation to their fields of expertise, including International Women’s and Gender Studies and Black Archival Feminist Practice

Perceptions and experiences of different Long COVID community rehabilitation service models from the perspectives of people living with Long COVID and healthcare professionals

Objectives: To explore the perceptions and experiences of barriers and facilitators to accessing Long COVID community rehabilitation.Design: We used a qualitative descriptive design over two rounds of data collection with three participant groups: i) people with experience of rehabilitation for Long COVID (PwLC), ii) NHS staff delivering and/or managing community rehabilitation services (allied health professionals (AHPs)), and iii) NHS staff involved in strategic planning around Long COVID in their health board (Long COVID leads).Setting: Four NHS Scotland territorial health boards. Participants: 51 interviews: eight Long COVID leads (11 interviews), 15 AHPs (25 interviews), and 15 PwLC (15 interviews).Results: Three key themes were identified: i) Accessing care for PwLC, ii) Understanding Long COVID and its management, and iii) Strengths and limitations of existing Long COVID rehabilitation services.Conclusions: Organisational delivery of Long COVID community rehabilitation is complex and presents multiple challenges. In addition, access to Long COVID community rehabilitation can be challenging. When accessed, these services are valued by PwLC but require adequate planning, publicity, and resource. The findings presented here can be used by those developing and delivering services for people with Long COVID

Perceptions and experiences of different Long COVID community rehabilitation service models from the perspectives of people living with Long COVID and healthcare professionals.

To explore the perceptions and experiences of barriers and facilitators to accessing Long COVID community rehabilitation. We used a qualitative descriptive design over two rounds of data collection with three participant groups: i) people with experience of rehabilitation for Long COVID (PwLC), ii) NHS staff delivering and/or managing community rehabilitation services (allied health professionals (AHPs)), and iii) NHS staff involved in strategic planning around Long COVID in their health board (Long COVID leads). Four NHS Scotland territorial health boards. 51 interviews were undertaken, eight Long COVID leads (11 interviews), 15 AHPs (25 interviews), and 15 PwLC (15 interviews). Three key themes were identified: i) Accessing care for PwLC, ii) Understanding Long COVID and its management, and iii) Strengths and limitations of existing Long COVID rehabilitation services. Organisational delivery of Long COVID community rehabilitation is complex and presents multiple challenges. In addition, access to Long COVID community rehabilitation can be challenging. When accessed, these services are valued by PwLC but require adequate planning, publicity, and resource. The findings presented here can be used by those developing and delivering services for people with Long COVID

Investigating Scottish Long COVID community rehabilitation service models from the perspectives of people living with Long COVID and healthcare professionals:a qualitative descriptive study

Objectives:This study aimed to explore the perceptions and experiences of barriers and facilitators to accessing Long COVID community rehabilitation.Design:We used a qualitative descriptive design over two rounds of data collection with three participant groups: (1) people with experience of rehabilitation for Long COVID (PwLC); (2) National Health Service (NHS) staff delivering and/or managing community rehabilitation services (allied health professionals (AHPs)); and (3) NHS staff involved in strategic planning around Long COVID in their health board (Long COVID leads).Setting:Four NHS Scotland territorial health boards.Participants:51 interviews: eight Long COVID leads (11 interviews); 15 AHPs (25 interviews) and 15 PwLC (15 interviews).Results:Three key themes were identified: (1) accessing care for PwLC, (2) understanding Long COVID and its management, and (3) strengths and limitations of existing Long COVID rehabilitation services.Conclusions:Organisational delivery of Long COVID community rehabilitation is complex and presents multiple challenges. In addition, access to Long COVID community rehabilitation can be challenging. When accessed, these services are valued by PwLC but require adequate planning, publicity, and resource. The findings presented here can be used by those developing and delivering services for people with Long COVID.<br/

Investigating Scottish Long COVID community rehabilitation service models from the perspectives of people living with Long COVID and healthcare professionals:a qualitative descriptive study

Objectives:This study aimed to explore the perceptions and experiences of barriers and facilitators to accessing Long COVID community rehabilitation.Design:We used a qualitative descriptive design over two rounds of data collection with three participant groups: (1) people with experience of rehabilitation for Long COVID (PwLC); (2) National Health Service (NHS) staff delivering and/or managing community rehabilitation services (allied health professionals (AHPs)); and (3) NHS staff involved in strategic planning around Long COVID in their health board (Long COVID leads).Setting:Four NHS Scotland territorial health boards.Participants:51 interviews: eight Long COVID leads (11 interviews); 15 AHPs (25 interviews) and 15 PwLC (15 interviews).Results:Three key themes were identified: (1) accessing care for PwLC, (2) understanding Long COVID and its management, and (3) strengths and limitations of existing Long COVID rehabilitation services.Conclusions:Organisational delivery of Long COVID community rehabilitation is complex and presents multiple challenges. In addition, access to Long COVID community rehabilitation can be challenging. When accessed, these services are valued by PwLC but require adequate planning, publicity, and resource. The findings presented here can be used by those developing and delivering services for people with Long COVID.<br/

Investigating Scottish long COVID community rehabilitation service models from the perspectives of people living with long COVID and healthcare professionals: a qualitative descriptive study.

This study aimed to explore the perceptions and experiences of barriers and facilitators to accessing Long COVID community rehabilitation. We used a qualitative descriptive design over two rounds of data collection with three participant groups: (1) people with experience of rehabilitation for Long COVID (PwLC); (2) National Health Service (NHS) staff delivering and/or managing community rehabilitation services (allied health professionals (AHPs)) and (3) NHS staff involved in strategic planning around Long COVID in their health board (Long COVID leads). The study was based in four NHS Scotland territorial health boards. It involved 51 participant interviews: eight Long COVID leads (11 interviews); 15 AHPs (25 interviews) and 15 PwLC (15 interviews). Three key themes were identified: (1) accessing care for PwLC, (2) understanding Long COVID and its management and (3) strengths and limitations of existing Long COVID rehabilitation services. The study concluded that organisational delivery of Long COVID community rehabilitation is complex and presents multiple challenges. In addition, access to Long COVID community rehabilitation can be challenging. When accessed, these services are valued by PwLC but require adequate planning, publicity and resource. The findings presented here can be used by those developing and delivering services for people with Long COVID

Exploring the perceptions and experiences of community rehabilitation for Long COVID from the perspectives of Scottish general practitioners' and people living with Long COVID:a qualitative study

OBJECTIVES: To explore the experience of accessing Long COVID community rehabilitation from the perspectives of people with Long COVID and general practitioners (GPs).DESIGN: Qualitative descriptive study employing one-to-one semistructured virtual interviews analysed using the framework method.SETTING: Four National Health Service Scotland territorial health boards.PARTICIPANTS: 11 people with Long COVID (1 male, 10 female; aged 40-65 (mean 53) and 13 GPs (5 male, 8 female).RESULTS: Four key themes were identified: (1) The lived experience of Long COVID, describing the negative impact of Long COVID on participants' health and quality of life; (2) The challenges of an emergent and complex chronic condition, including uncertainties related to diagnosis and management; (3) Systemic challenges for Long COVID service delivery, including lack of clear pathways for access and referral, siloed services, limited resource and a perceived lack of holistic care, and (4) Perceptions and experiences of Long COVID and its management, including rehabilitation. In this theme, a lack of knowledge by GPs and people with Long COVID on the potential role of community rehabilitation for Long COVID was identified. Having prior knowledge of rehabilitation or being a healthcare professional appeared to facilitate access to community rehabilitation. Finally, people with Long COVID who had received rehabilitation had generally found it beneficial.CONCLUSIONS: There are several patient, GP and service-level barriers to accessing community rehabilitation for Long COVID. There is a need for greater understanding by the public, GPs and other potential referrers of the role of community rehabilitation professionals in the management of Long COVID. There is also a need for community rehabilitation services to be well promoted and accessible to the people with Long COVID for whom they may be appropriate. The findings of this study can be used by those (re)designing community rehabilitation services for people with Long COVID.</p

Exploring the perceptions and experiences of community rehabilitation for long COVID from the perspectives of Scottish General Practitioners and people living with long COVID: a qualitative study.

The objective of this study was to explore the experience of accessing Long COVID community rehabilitation from the perspectives of people with Long COVID and General Practitioners (GPs). This was a qualitative descriptive study, employing one-to-one semi-structured virtual interviews that were analysed using the framework method. The study focused on four NHS Scotland territorial health boards. Participants included eleven people with Long COVID (1 male, 10 female; aged 40-65 [mean 53]), and 13 GPs (5 male, 8 female). Four key themes were identified: i) The lived experience of Long COVID; ii) The challenges of an emergent and complex chronic condition; iii) Systemic challenges for Long COVID service delivery, and iv) Perceptions and experiences of Long COVID and its management, including rehabilitation. The study concluded that there are several patient, GP, and service-level barriers to accessing community rehabilitation for Long COVID. There is a need for greater understanding by the public, GPs, and other potential referrers of the role of community rehabilitation professionals in the management of Long COVID. There is also a need for community rehabilitation services to be well promoted and accessible to the people with Long COVID for whom they may be appropriate. Service providers need to consider availability and accessibility of Long COVID rehabilitation and ensure adequate interprofessional communication and collaboration to enhance the experience for people with Long COVID