COVID-19 rapid guideline: managing the long-term effects of COVID-19

After the holistic assessment, discuss with the person (and their family or carers, if appropriate) the options available and what each involves. These should include:

• advice on self-management, with the option of supported self‑management (see section 5.1 on self-management and supported self-management) and

• 1 or more of the following, depending on clinical need and local pathways:

  • support from integrated and coordinated primary care, community, rehabilitation and mental health services

  • referral to an integrated multidisciplinary assessment service

  • referral to specialist care for specific complications. [2020, amended 2021]

Use shared decision making to agree what support and rehabilitation the person needs, including how and when it should be provided. [2021]

When discussing with the person the appropriate level of support and management:

• take account of the overall impact their symptoms are having on their life and usual activities, even if each individual symptom alone may not warrant referral

• look at the overall trajectory of their symptoms, taking into account that symptoms often fluctuate and recur so they might need different levels of support at different times. [2021]
  
  For advice on working with people to make decisions about their treatment and care, see NICE's guidelines on shared decision making and decision making and mental capacity and Healthcare Improvement Scotland's 'What Matters To You' website.