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Occupational Health Long COVID Service

What is the Long Covid Service ?

The Occupational Health Long Covid Service provides support, advice and rehabilitation for NHS Greater Glasgow & Clyde employees who continue to be affected by ongoing symptoms related to Covid-19 infection that have lasted more than 12 weeks  and impacts on their performance or attendance at work.

Service Criteria

  • Off work for at least 12 weeks with Covid 19
  • Sick line with covid as a diagnosis
  • Support for staff members presenting with emotional, cognitive, and physical issues that influences their ability to engage in everyday activities including work as a result of their long covid symptoms.

The Long Covid service is made up of: a specialist Physiotherapist, two Occupational therapists, an Occupational Health Nurse and a Psychologist with access to support from the wider Occupational Health team. The aim of the service is to support employees to improve their health, functional capabilities and quality of life, leading wherever possible to a return to work.

This may be through supporting employees to access self – management tools to assist in their understanding of their condition and aid their recovery, return to work advice and access to a rehabilitation treatment programme for those with more complex symptoms if they meet our inclusion criteria. Access to the service is currently through management referral.

We are based within the Occupational Health Service on the 6th Floor, West Glasgow ACH, Dalnair Street, Glasgow, G3 8SJ and can be contacted on 0141 201 0600.

How to Access the Service

In line with the Long Covid HR support Process and as part of the Attendance Management
discussions with the employee consideration should be given to submitting a management referral
to Occupational Health (OH) where there has not been sufficient improvement in the employees Long
Covid-19 symptoms to facilitate a return to work and they have been absent for more than 12
weeks. Please note that not every employee who is absent will require a referral to OH and this
should be considered on a case by case basis.


Where a referral is required, this should be discussed with the employee prior to a management
referral being submitted. At this point the Manager should also advise the employee that an
assessment questionnaire will need completed by the employee and returned directly to
Occupational Health before they can be accepted into the rehabilitation programme. The
questionnaire helps the Long Covid multidisciplinary team to make decisions about how best to
address each individual’s needs.

Management referrals should include all relevant information with regards to the employee’s
Covid related absence and details of the following:

  • Confirmation of absence related to ongoing Covid-19 symptoms (even if provisional diagnosis) by GP/Hospital/specialist.
  • As much factual background information as known regarding history, symptoms reported
  • and advice/treatment received to date (if known).
  • Any other relevant health matters which be impacting on recovery/return to work.
  • Details of any adjustments or support measures which have been considered prior to
  • referral.

The assessment questionnaire is available here and can either be sent to the employee by their manager with instructions to complete and return directly by the employee or manager to occhealth@ggc.scot.nhs.uk

If the manager has further questions prior to submitting a referral they can contact
Occupational Health on 0141 201 0594 or via HR.Support@ggc.scot.nhs.uk for further advice.

Occupational Health Process
  • The Occupational Health Service will consider an appointment with the Long Covid Team for further assessment, advice or treatment when a Management referral has been received that meets the service criteria.
  • An assessment questionnaire will be sent to the manager to share with their employee for completion and return to the Long Covid Service prior to an appointment being issued. This questionnaire will assist the team to make decisions about how best to address each individual’s needs.
  • Returned questionnaires are then triaged and employees may be offered: a management referral meeting, placed on waiting list for the long Covid group programme, or placed on waiting list for one to one input with therapists. Staff member and manager are advised of outcome of the triage. For those who indicate a potential return to work in 6-8 weeks a management referral is offered in the first instance.
  • Once the employee has had their initial assessment further referrals to other member of the team for rehabilitation can proceed (if applicable). Initial assessment appointments are likely to be carried out by Telephone or remotely through Attend Anywhere at this time.
  • At the end of engagement with the Long Covid Team the management referral form will be updated and shared with the employee, manager and HR advisor regarding the outcome of the assessment the employee’s fitness to work, any reasonable adjustments to be considered and a timescale for review (if applicable).

Should any referrals under 12 weeks be submitted in error, the manager will be advised the staff
member does not meet the Long Covid Team criteria and advised that there is further information
for managers and staff on the Long Covid Team website. This covers self- management information
to support the employee with their recovery and some return to work considerations.

Long Covid Team Services
Long Covid Group

This is an 8 week programme. The group meets once a week for 90 minutes via teams. Each week is
a different topic. Topics include: introduction to long Covid and recovery, fatigue management
sessions (2), thinking skills, breathlessness, dysautomonia, nutrition, adjustment and managing
emotional response, return to work planning.

Occupational Health Nurse
  • Triage and provide information / signpost for symptoms not included in the Occupational Health (OH) Long Covid rehabilitation
  • Will be the first point of contact, may highlight potential Red Flag conditions and liaise with others in OH team
  • Manage own caseload of staff members who have no particular rehabilitation need
Occupational Therapist
  • Assess and identify changes in activities of daily living.
  • Assess and treat fatigue and its impact on daily activity.
  • Assess and treat cognitive changes
  • Offer guided self-help for emotional change
Physiotherapist
  • Assess and treat respiratory conditions
  • Assess and treat musculoskeletal symptoms
  • Assess and treat fatigue symptoms
Clinical Psychologist
  • Assess and support staff to adjust to living with and managing Long Covid.
  • Assess and support staff to overcome any barriers to engaging in the Long Covid group programme.
  • Assess and support staff to address any additional severe and enduring mental health difficulties
Information for Managers

Long Covid involves a continuation of a broad range of debilitating physical, cognitive, and
psychological symptoms that persists beyond 12 weeks. Initial “Mild” symptoms are not reflective of
long term outcomes for many. For many people, it will be a combination of physical and
psychological symptoms; and an exacerbation of pre-existing symptoms may further complicate
their presentation.

Possible features of Long Covid in the workplace
  • Difficulty in standing for long periods, or in sustaining normal work due to fatigue
  • Reduced ability with physical tasks, e.g. lifting or walking longer distances
  • Increased breathlessness with activity which can lead to poor tolerance with wearing face masks.
  • Trouble concentrating with tasks, takes longer to complete tasks and employee may worry about making mistakes.
  • Need for more frequent trips to toilet, more frequent rest breaks for recovery of energy.
  • Attempt by staff to “push on” and “overcome” despite increasing symptoms can result in further absence periods i.e. Sick leave, following by return, followed by relapse and further leave.
Example of recommendations for a staff member returning to work following an extended Covid
absence
  • The individual plan should be tailored to each staff member based on the severity of symptoms and their role / tasks at work.
  • Phased return to work with shorter days and non-consecutive days initially. Due to the nature of fatigue the staff member may require an extended phased return more than the standard 4 weeks – may require up to 8 or 12 weeks. Advising starting with 1 short shift (may be as short as 3-4 hours) then gradually building up the amount of shifts per week before considering increasing the shift length for a more gentle phased return as this complements the fatigue management advice. It may be that the staff member is not always able to increase their hours in a linear way – may be that on some weeks they have a flare in their symptoms and any planned increases are paused or take a step back to a previous level which they were coping with. The staff member should be able to determine this based on their symptoms by that stage and liaise with their manager when further support required.
  • Consider some temporary adjustment to workload, opportunity to work alongside a colleague for the first few weeks for support if needed / supernumerary. Explore options for additional support/assistance with the more physical aspects of the role e.g. working with lower risk individuals.
  • Consideration of temporary alternative work if they are unable to resume to the more physical aspects of the role e.g. Learn pro / non clinical work (this may be helpful or it may be that based on what impacts on their symptoms, it is unhelpful or not required).Some people may need to limit the amount of time doing physical or PC tasks depending on symptoms
  • Keep shift patterns routine e.g. same start time each day and avoiding mix of early / late /night shifts until they have managed to build up their hours and duties.
  • There may also be role specific adjustments such as; being kept on own ward / smaller geographical area, not being responsible for emergency page, reducing clinical caseload initial supervision for clinical decision making (e.g. drug rounds), avoiding interruptions through day and avoiding on-call / nights etc.
Resources

Guidance for Managers and employers on facilitating return to work of employees with Long Covid.

Guidance for healthcare professionals on return to work for patients with Long Covid

Online Support & Resources

Long Covid involves a continuation of a broad range of debilitating physical,
cognitive, and psychological symptoms that persists beyond 12 weeks. The National
Wellbeing Hub has developed some resources to assist those coping with the
prolonged aftereffects of Covid. This is aimed at supporting people working in
health and social care with living with the uncertainty that this condition can bring
and their anxieties about returning to work.

These include two evidence-informed articles, one aimed at managers providing
advice on how to support staff returning to work with Long Covid, and one aimed at
people experiencing Long Covid
These are supplemented by a Top Tip sheet with
brief guidance for managing recovery from Long Covid.


In addition to the written materials, they’ve produced a series of three short videos.
For these, they’ve spoken to two professionals who have both experienced Long
Covid. In one, we hear about Janine’s path to recovery, while the other
charts Grace’s return to work and how she is managing the ongoing challenges
associated with this.

They’ve also spoken to Dr John Harden, Deputy National
Clinical Directo
r at the Scottish Government, who talks through what Long Covid is,
what to do if you’re experiencing Long Covid, and how to manage some of the more
common symptoms.


The following links also provide useful information and self-management advice.

Peer Support Groups

Long Covid Support
Self Help UK – Covid 19 Survivors Group