Better Care

Long Covid service success

Ground-breaking partnership in vanguard of long Covid research and care

Long Covid – or post-Covid syndrome - was first identified in May 2020 during the first wave of the coronavirus pandemic and several months before the first vaccines became available in December 2020.

The latest ONS figures (Feb 2023) indicate about two million people in the UK have long Covid. Research suggests up to 20 per cent of people who contract the virus will go on to have longer term symptoms – but much uncertainty remains about causes and long-term effects.

Established in January 2021, the Birmingham and Solihull long Covid service brought together community, acute and mental health clinicians in a ground-breaking partnership to use established treatments and develop new models of care to provide relief, rehabilitation and support for people who experienced 'long' symptoms after their initial Covid infection.

Long Covid service
RECOVERY: Long Covid service patient Graham White with physio Beci Drury at Sutton Cottage Hospital

The service brings together healthcare professionals from across the local system to support developing a rehabilitation plan specific for each patient - the diverse range of expertise in the team means specialist advice is available when it is needed, supporting timely access to the right care for patients.

Through phone, video and outpatient clinics, BCHC supports patients referred by their GP, while University Hospitals Birmingham (UHB) supports patients who were hospitalised by Covid-19 infection at an outpatient clinic at the Birmingham Chest Clinic. Mental health services are also available to patients.


Over 2,400 people who experienced long Covid symptoms have been helped by the partnership service since its launch.

School IT technician Graham Whitehad Covid-19 twice – first in October 2021 and again in March 2022. His GP referred him to the long Covid service in August 2022 and he underwent an initial online assessment via video link the following month.

“The first time I knew something wasn’t right was when I noticed a ham salad sandwich tasted like petrol,” said the 43-year-old. “I was no longer testing positive for Covid but I was still coughing, very chesty, and as for the brain fog!

“I was continually breathless - I normally walk to and from work, about seven miles a day. But I just couldn’t do it anymore. I felt absolutely exhausted, waking up tired and struggling to carry out the most basic physical activities.

“Initially, I had weekly video consultations with a Physio, which were very insightful and calming - it can be a real struggle at home on your own, wondering if what you’re experiencing is long Covid or something else. It’s good to know you’re not going bonkers!

“The first stage was a course of breathing exercises to help with relaxation and focus but also to help maximise the efficiency of my respiratory function.

“That was followed by face-to-face sessions to address musculoskeletal issues and continue supporting my concentration and relaxation techniques. I also had some acupuncture, which really helped reduce stress and anxiety.

“I had fibromyalgia already from an accident, so I had some awareness of what brain fog is like. But this was much worse - more like a sudden loss of key parts of my cognitive ability. A bit like when you first woke up and it normally takes a moment to work out where you are as you regain consciousness.

“But this would typically last for at least 15 seconds at random times– I had to learn to recognise it, remember my breathing techniques to stay calm, and wait for the ‘fog’ to clear a bit so I could focus.”

Graham’s rehabilitation journey has been life-changing in more ways than one – because it has inspired a whole change of career direction after he was accepted for nurse associate training at Queen Elizabeth Hospital.

He said: “I’ve been very fortunate to have a really understanding and supportive employer as I’ve gone through this journey. But the switch to healthcare is something I’ve been thinking about for some time. Being a beneficiary of such care and expertise has given me the extra motivation I needed to go for it!”

Graham’s physiotherapist Beci Drury said: “I’m really passionate about the psychological aspect of this holistic approach to treating this condition.

“Much more research is needed, but people experiencing ‘long’ symptoms of viral illnesses seems to be much more common, so there’s a case for building on the lessons learned from clinics like ours and extending the reach of therapy and support for these patients.

“The community-based part of the service has been very important because some people become quite scared about having these symptoms. Some people wouldn’t want even to go out of the house. So, it’s important we are set up to take the care to them.

“Everyone involved in delivering the long Covid service is very proud of what we’ve achieved, and we would really like it to continue and keep learning from the work because we’ve all become quite specialised in our fields.”

“The impact of Covid-19 highlighted health inequalities and the service has worked with local community charities across Birmingham and Solihull to raise awareness of the symptoms and support available with hard-to-reach communities.”

Research has shown that long Covid clinics in England are helping people live with and recover from their symptoms and have an important role to play in establishing both the causes of long Covid and the best rehabilitation techniques to support patients. Vaccination has reduced the number of people who have developed long Covid but several patients infected early in the pandemic still have long Covid symptoms - and funding for the Birmingham and Solihull service is presently due to end in March 2024.

UHB’s outpatient clinic is led by consultant Dr Nandan Gautam, who said: “Our service had to be put together very quickly in the first phase of the pandemic and it quickly became clear that the varying needs of our patient cohort demanded a partnership between the acute and community healthcare providers in order to provide the care and support required.

“During a time of great pressure and uncertainty, the whole team has worked incredibly hard, drawing on a wide range of experience and expertise to make a huge difference to the quality of life of hundreds of people. I believe that we’ve made a very compelling case for more of this sort of integrated collaborative working for a range of healthcare needs in the future.”