Learning from long COVID: integrated care for multiple long-term conditions

Long COVID is a multisystem condition requiring a range of medical, therapeutic, and psychological inputs. Given the complexity of the illness affecting multiple organ systems, often impacting physical and mental health, individuals can be heavy healthcare users across primary, secondary, and emergency services. The long COVID clinics commissioned in England1 have provided an opportunity to innovate within a complex care pathway, bringing multiple providers together to meet needs broader than has been historically possible for many other complex conditions. Designing these new services from a blank page has enabled teams to co-create services with patient groups and work more effectively in an integrated way. Significant benefits have been seen, including skills transference between professions. Long COVID services have enabled closer working between primary and specialist care by working across boundaries, and they have helped a broader multidisciplinary team (MDT) to be involved in complex care decision making to meet therapeutic needs. There is a need for a critical evaluation of long COVID clinics to determine how these improve outcomes and meet patient needs, including a critical analysis of patient outcomes, the availability of services, and the economic costs of MDT services, such as long COVID clinics themselves. This is ongoing in the context of the STIMULATE- ICP- Delphi study,2 and the following relevant factors have been identified: