Title: LOng COvid Multidisciplinary consortium: Optimising Treatments and servIces acrOss the NHS (LOCOMOTION)
Funder: Department of Health and Social Care

Abstract: Background: Long COVID (LC) or Post-COVID syndrome affects up to one million people in the UK and is a syndrome of persistent and fluctuating symptoms, with underlying organ dysfunction and multimorbidity. England has 83 dedicated multidisciplinary LC clinics (with no funding yet in Scotland, Wales or Northern Ireland), but these are unable to meet the growing demand and many patients are currently not getting timely care. There is an urgent need to develop a UK-wide efficient integrated LC service. Aim: We will optimise LC management across three settings of care &ndash; LC specialist clinics (Workstream WS1); Homes/self-management (WS2) and Primary care (WS3). Methods: WS1: The management options for multisystem medical problems will be standardised to derive best practice guidance using a Quality Improvement collaborative involving embedded clinician researchers from 10 UK-wide LC clinics. Experience-based co-design with patients and healthcare professionals will inform training and resources for both. Ethnic and socioeconomic inequalities of care and vocational challenges of patients will be addressed using qualitative and mixed-methods approaches. WS2: A digital platform incorporating wearable technology will capture symptom fluctuations and individual condition triggers to enable biofeedback for self-management. Core outcomes measures including the first published LC patient-reported outcome measure (C19 YRS Yorkshire Rehabilitation Scale, developed by the co-CI) will be made available on the digital platform for monitoring and directing interventions remotely. WS3: Existing primary care and LC clinic integrated data will aid in developing and evaluating new integrated cost-effective service models that will enable the best practice guidance developed in WS1 to be delivered at point of contact in primary care. We have links with previously funded NIHR LC projects to enable co-learning and maximising impact. PPI/E: Individuals with lived experience of LC have contributed to proposal design and will remain actively involved in all aspects of study through ongoing co-creation.

Lay abstract: Long Covid (LC) affects over one million people in the UK, it has various symptoms and impacts daily life. Although there are 83 LC clinics in England, most people have not had access to them, and have to wait long to be seen. We realise the urgency for LC patients to access prompt and appropriate care in clinics and doctors surgeries. Our research aims to produce a gold standard for care by analysing what is happening to patients now, creating new systems of care and evaluating them to establish best practice. Our proposal includes patients working as equal partners and has been developed with LC patients. Their key priorities are correct clinical assessment; advice and treatment; and help with returning to work and other roles. Our research is based on the experience of a wide range of NHS professionals already treating people in ten LC clinics across the UK, led by academics (universities) with links to other LC funded studies. The research will be in three places: LC clinics, at home (including self-monitoring on a mobile device using a set of questions on symptoms built into an app) and doctors surgeries. We will track where patients are being referred or not referred, and learn from the experience of clinics by interviewing patients and recording outcomes. Throughout, specialists in Healthcare Inequality will reach people who are not accessing clinics. We will put in place new processes in clinics and doctors surgeries, monitored throughout to make sure they are the correct standard, accessible for patients and staff, and cost-effective. Comparing findings across our partnership of ten LC Clinics we will learn more about treatment, providing real-time education to other healthcare staff and patients, and establishing a gold standard that can be shared within England and the rest of the UK.

Research activity codes: 8.4 RESEARCH DESIGN AND METHODOLOGIES (HEALTH SERVICES);7.1 INDIVIDUAL CARE NEEDS;8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: INFECTION