18 December 2020
The BPS has welcomed ‘Covid-19 rapid guideline: managing the long-term effects of Covid-19’, published today by the National Institute for Health and Care Excellence (NICE), but says greater focus must be placed on the multidisciplinary rehabilitation crucial to supporting patients through their recovery.
BPS vice-president Professor David Murphy, said:
“We warmly welcome this important new guidance from NICE, and the opportunity given to the British Psychological Society to provide extensive expert feedback to support its development.
It was already clear in April, when the BPS published its guidance on meeting the needs of people recovering from Covid-19, that a significant proportion of patients would experience persistent symptoms and disability.
As this guidance makes clear, it is not just those who were hospitalised are affected by this - we know that most people with ‘long Covid’ were not hospitalised and often struggled to access health services, which has been a cause of considerable distress.
We welcome NICE’s clear recommendation that a holistic, person-centred approach should be adopted in assessing people with persisting effects of Covid-19, and the recognition that these can be both physical and psychological, and impact on multiple areas of people’s lives, activities and relationships.
However, we are extremely disappointed and concerned at the lack of detailed recommendations regarding multidisciplinary rehabilitation, which we view as crucial in supporting patients through their recovery. The guidance is almost completely silent on what this should consist of, and how it should be organised.
The NICE approach to guidance is based on evaluating outcome evidence related to a specific condition, which of course is very limited in such a new disease.
However, in our own guidance we drew upon the wealth of knowledge that exists about effective rehabilitation in other relevant areas, such as pulmonary, cardiac, and neurological rehabilitation and also research other viruses such as SARS and MERS.
We strongly recommended that NICE adopt a broader focus in its response to this novel condition, particularly in relation to rehabilitation where many common principles have been identified that are valid across conditions.
There is no doubt the guidelines will lead to better recognition and understanding of the persistent effects of Covid-19 in health professionals, which we hope will lead to more patients feeling listened to and believed, as this sadly not always been the case to date.
However, in the absence of clear recommendations for multidisciplinary rehabilitation, integrating physical and psychological aspects, I personally fear that patients may end up bouncing around the health system like the balls in a pinball machine, ultimately not receiving the support they need and ending up, through no fault of their own, generating demand on multiple other services that are themselves struggling to manage the backlog in care for patients with other conditions.”