‘Learn lessons on rehab from Covid,’ CSP tells government hearing

CSP assistant director Ruth ten Hove gave evidence to the all party parliamentary group on coronavirus, which was set up to ensure that lessons are learned from the UK’s handling of the coronavirus outbreak.

All parties giving evidence to the hearing about Covid and employment, which included the BMA and RCOT, agreed that access to high-quality rehab support must be put in place for people with Long Covid to be well enough to work without it triggering extreme fatigue.

The same applied to others with long-term conditions, ten Hove argued: 'The validation and recognition of the fatigue symptom through long Covid has really highlighted the disabling impact of fatigue on people with long-term conditions.'

At the hearing on Tuesday (29 June), ten Hove argued that improving community rehabilitation must be a critical part of the UK’s response to coronavirus.

'What Covid has done is shine a spotlight on what are the many benefits of rehabilitation for those with Covid but also the many gaps which exist in the system as well,' she told the cross-party group of MPs, chaired by Caroline Lucas.

We would be looking to the government to really… use the learning from Covid to think about how we can expand the provision in the community, looking at the use of the support worker workforce, the use of digital technologies and the use of the advanced practice agenda to build capacity and capability within the community.

She highlighted how Covid had placed additional pressures on community services that had been overlooked in the media focus on acute care.

'We are looking at an increase in the rehab needs outside of hospitals,' ten Hove said. 'There is a lot of visibility around the acute management of people with Covid and Long Covid but actually once they leave hospital the visibility is much, much less.'

She highlighted that Long Covid would become one of a range of long-term conditions with a significant rehabilitation need, adding to a backlog of cases linked to deconditioning during lockdown.

She stressed the government needed to look 'across the whole system not just secondary care but the infrastructure and support that needs to exist within the community in order for services to be delivered to the standard that enables people to live their lives as they would wish.'

Dealing with an unknown condition has taught healthcare workers to take a personalised approach to each patient, tailoring treatments to individual physical and mental health needs.  'Covid has taught us that we can look differently at rehab,' she said emphasising the need to look at the person, not at a range of symptoms. 'That is key in the reform of rehab services going forward - that they build around the needs of the individual person not necessarily based on single conditions because people present with a whole range of different needs.'  

The understanding of Covid is still developing, so the healthcare response must remain agile, drawing on expertise from across disciplines, she argued. 'What’s really key in the effective delivery of Covid assessment clinics is that they are multi-disciplinary clinics so if people have requirements for particular rehab, they can also be given self-management advice.'

Throughout the hearing, the efforts healthcare staff made to adapt to the demands of the pandemic were praised. The toll from the pandemic on their mental health and wellbeing was also recognised, though ten Hove highlighted that staff working in communities had patchy access to support compared with those working in hospitals.

In written evidence to the hearing, the CSP invited the government to discuss the Community Rehabilitation Alliance’s call for a national review of rehabilitation that would shine a light on this neglected area of healthcare.