© North Bristol NHS Trust. This edition published August 2023. Review due August 2026. NBT003488

© North Bristol NHS Trust. This edition published August 2023. Review due August 2026. NBT003489

Resources for people who may be struggling with work because of Long Covid

These resources may help you and your employers if you are struggling with work because of Long Covid. We have chosen ones that contain a wide range of information for various challenges you may have. You might choose to share some of these with your employer.

Covid 19 return to work guide for managers

The "Covid 19 return to work guide for managers" by the Society for Occupational Medicine contains detailed advice on a phased return to work, which can be a very important for people with long Covid symptoms and may be a new concept for employers. It contains a comprehensive overview of work-related issues faced by employers and employees. 
https://www.som.org.uk/COVID-19_return_to_work_guide_for_managers.pdf

C19 return to work guide for recovering workers

The “C19 return to work guide for recovering workers” (2021) by the Society for Occupational Medicine provides a comprehensive overview of managerial and employee duties and expectations.
https://www.som.org.uk/COVID-19_return_to_work_guide_for_recovering_workers.pdf 

Webinars "Returning to work with on-going COVID-19 symptoms: Guidance for employees and managers

The webinars "Returning to work with on-going COVID-19 symptoms: Guidance for employees and managers" (2021) by University Hospitals of Derby and Burton NHS Foundation Trust provide information for managers and employees and covers practical steps.
https://www.youtube.com/playlist?list=PLfPD5ilcfEbit6R2OgezYD9YeNvnniSyb 

"Long Covid FAQs" on the Chartered Institute of Personnel and Development website

The page "Long Covid FAQs" on the Chartered Institute of Personnel and Development website is directed at employers, and contains some useful facts and statistics, and some information on legal rights.
https://www.cipd.co.uk/knowledge/coronavirus/faqs/long-covid 

Faculty of Occupational Medicine Guidance for managers & employers

The "Guidance for managers & employers on facilitating return to work of employees with post-COVID syndrome" (2021) by the Faculty of Occupational Medicine provides employers with general advice on returning to work, and some useful examples of reasonable adjustments.
https://www.fom.ac.uk/wp-content/uploads/FOM-Guidance-post-COVID_employers-managers.pdf 

Access to Work

Access to Work can provide practical and financial support if you have a disability or long-term condition. This can be useful whether you have a job, are looking for work, are on supported internship or traineeship or want to become or are self-employed. 
https://www.gov.uk/government/publications/access-to-work-factsheet

This video was delivered as a webinar and provides an overview of Long Covid and the impact on people’s working lives and presents key strategies and principles that can support people to return to work and to stay in work. 

Contributors:  

Dr Tim Robinson provides an overview of the symptoms and management of Long Covid. Dr Robinson works in the Community Long COVID Single Point of Access assessment clinic which covers Bristol, North Somerset and South Gloucestershire (known as BNSSG). 

 Fiona Mckechnie shares approaches and adjustments that have been used to support people with fatigue syndromes in the workplace. Fiona is an Occupational Therapist in the Bristol M.E. Service, North Bristol NHS Trust. 

If you have Long Covid and would like to have support, please contact your GP to request a referral to your nearest Long Covid clinic. 

TIA is a medical emergency - anyone suffering a suspected TIA should see a doctor immediately.

You may be referred to the TIA clinic because you had symptoms suggesting you’ve had a transient ischaemic attack (TIA), or a minor stroke. A TIA is sometimes called a mini stroke.

Why is an urgent appointment with a stroke specialist so important?

About one in ten people who have a TIA develop a stroke within the next week, but we can greatly reduce this with the right treatment.

The right medication can reduce your chance of a stroke, as can changes to your diet and exercise. Rarely an operation may be useful. We will discuss all this when you see us in clinic.

What happens now?

The clinician who initially diagnosed you may give you medication to take. You need to take this each day until you are seen in our clinic. They will also make a referral to the TIA Service.

TIA clinics run daily, including weekends. Every day, the stroke specialist on duty will review all new referrals. If we decide that we need to see you urgently over the weekend or at a bank holiday, the co-ordinator of the TIA Service will phone you on the day tell you what time to come to the unit.

Otherwise, the TIA co-ordinator will be in touch on the next working day to arrange an appointment for you to come in. In some cases, the appointment will be a telephone consultation only. The appointment will usually be on the same day. If you have not heard from us within two working days, please ring the TIA co-ordinator on 0117 342 4800.

Where are the TIA clinics?

Across the Bristol, North Somerset and South Gloucestershire (BNSSG) region, TIA clinics are operated centrally by University Hospitals Bristol and Weston (UHBW) NHS Trust.

There are clinics at Bristol Royal Infirmary and Weston General Hospital and weekend clinics at Southmead Hospital. If you are told to attend a TIA clinic, the TIA co-ordinator will tell you which clinic to attend.

Bristol Royal Infirmary

On week days days, the TIA clinic co-ordinator will tell you where you need to go. This will generally be the TIA Outpatient clinic A403 (Zone A, Level 4). Sometimes they will ask you to go straight to the radiology department to have a brain scan (Location A217, Zone A, Level 2) or to the vascular sciences department for a carotid doppler scan (Location A225, Zone A, Level 2).

Weston General Hospital

On week days, the TIA clinic co-ordinator will tell you where you need to go. This will generally be the TIA Outpatient Clinic within The Main Outpatients area of Weston General Hospital. The Main Outpatients is located at the front of the hospital.

Southmead Hospital

At weekends, clinics will be delivered at Southmead Hospital by the stroke/neurology service (Location Gate 12).

What can I expect to happen at my appointment?

A stroke specialist clinician will ask you to tell them about the symptoms, your past medical history, and what medicines you are currently taking. This will be followed by a physical examination. The clinician will discuss your diagnosis with you. You may be given new medications or a prescription. If you currently pay for your prescriptions, please ensure that you have a means of payment with you

What may we need to do? (Each case is different – you may not need all these investigations)

• • A blood pressure check
  • A heart recording (ECG)
  • A scan of the arteries in your neck
  • A brain scan
  • A blood test
  • A consultation with a stroke specialist - this may be a consultant, registrar or an advanced nurse practitioner for stroke

You can expect to be at the clinic for at least 3-4 hours and the appointment may take most of the day

What do I need to bring?

Please bring a list of all the prescribed tablets you take – this is very important. If there are other tablets you buy over the counter, please tell us about these. Please also bring any medications you will require throughout the day. If possible, it will be helpful for the person who witnessed you having your symptoms to come to the appointment as well.

There are cafes and shops all locations where you can purchase refreshments. Alternatively, you may want to bring your own provisions.

What about driving?

It is not safe or legal for you to drive until you have been seen in clinic. We will discuss any possible further driving restrictions related to your diagnosis with you in the clinic.

What if I have further symptoms before the specialist appointment?

If you think you are having a stroke, don’t wait – call 999!

What do I need to do?

Please bear these points in mind: 

• • DO NOT DRIVE until you are assessed at the clinic
  • it would be helpful if anyone who witnessed your symptoms could accompany you to the appointment
  • bring any medications that you are taking, or your repeat prescription order form
  • eat and drink as normal
  • your appointment may take several hours.
  • If you have any recurrence of symptoms before your clinic appointment and they resolve within 5 minutes please call NHS 111, if they do not resolve within 5 minutes call 999.

With ongoing support from Southmead Hospital Charity, the DISCOVER study aims to collect blood samples and other routinely collected microbiological samples as well as medical information from patients with suspected coronavirus.

These blood samples will be analysed for both routine and new tests. Patients will be followed up with after one month to see how coronavirus affected them, and to see how useful the blood tests were at predicting their condition.

Biological samples will also be stored (anonymously) for future research on how COVID-19 makes people ill. In the future, this information could help doctors decide which tests are useful in managing coronavirus.

Dr David Arnold, a Respiratory Doctor at NBT, shares more about the importance of the DISCOVER study:

Video Transcript

Study Results:

Patient outcomes after hospitalisation with COVID-19 and implications for follow-up; results from a prospective UK cohort

Are vaccines safe in patients with Long COVID? A prospective observational study?

Thank you to all of our research teams who are making such a different to people’s lives, and also to Southmead Hospital Charity which is raising much-needed funds for COVID-19 research.

Point of care testing (POCT), also known as extra-laboratory testing or Near Patient Testing (NPT), refers to any analytical test performed for or by a patient outside the conventional laboratory setting.

The Point of Care Testing Team provides support for many POCT applications to North Bristol NHS Trust.

The service encompasses:

• Advice on the selection and procurement of POCT equipment.
• Maintenance and servicing of blood gas analysers across the Trust.
• Replacement and servicing of blood glucose/ketone meters.
• Supply of consumables for blood glucose meters including quality control solutions, batteries and user manuals.
• Supply of Pregnancy testing kits (via Pharmacy).
• Training in blood gas analysis, blood glucose analysis, capillary blood collection, urinalysis, haemoglobin testing and pregnancy testing.
• Training materials for urinalysis and pregnancy testing.
• External Quality Assurance schemes for blood glucose and some other POCT tests.
• Support for Haematology analysers situated in Out Patients departments and Operating Theatres.
• Covid-19 testing using Abbott ID Now devices.

Please also see the results of our latest POCT User Survey.

Updated 26/10/2021

Currently, there is extremely limited information regarding the risks posed by SARS-CoV-2 virus responsible for COVID-19 to patients with cancer.

This study aims to understand the presentation, management and outcomes of cancer patients with COVID19. The influence of cancer type and treatment will be explored as well as comparing cancer patients with non-cancer patients.

This study will provide valuable information that would educate as well as help inform practice for future possible outbreaks. The information may also inform the development of guidelines with regard to the care and management of cancer patients with viruses such as COVID19 and similar infectious diseases.

Cancer is immunosuppressive, the nature of the immunosuppression seems to be influenced by the microbiota, in addition pulmonary infections are also influenced by the host microbiota, therefore it is important to understand this impact in cancer patients. Analysis of samples from cancer patients with COVID19 offer the opportunity to learn more of these interactions.

The purpose of CCP-CANCER UK study is to obtain additional data from patients with cancer who were/are recruited into the Principal CCP-UK study which is the key national protocol for characterising COVID19 in the UK population. This study is designed to supplement, not replace, the Principal CCP-UK protocol.

This study will be open to research sites who are currently participating in the Principal CCP-UK study.

The CCP-Cancer UK study will run for two years. An additional specific cancer data set will be collected from participant's existing medical records. This cancer specific information when combined with the rich data set related to the COVID-19 episode (derived from CCP-UK) will enable a full understanding of COVID-19 in patients with cancer as well as enable a comparison with non-cancer patients.

The Urology Research Team at NBT is a multidisciplinary team of healthcare professionals, academics and members of the public working across both functional urology and oncology.

Our research is supported by the Department of Health and the Bristol Urological Institute. We conduct research across a variety of settings, including laboratory based work and clinical work.

We work on a range of commercial and non-commercial, qualitative and quantitative research and collaborate with colleagues locally, nationally and internationally in order to improve outcomes for patients suffering from various urological conditions, including but not limited to:

• Cancers such as prostate, bladder, kidney, penile and testicular
• Male and female incontinence
• Kidney disease including stone problems
• Uretic disease
• Benign prostate disease

We have close links with the University of Bristol and University of the West of England (UWE). We also work with patient groups such as Prospect.

Meet the team:

Becky Cousins - Lead Research Nurse

Marta Cobos-Arrivabene - Research Nurse

Victoria Garner - Research Nurse

Kathryn Jones - Research Administrator

Malnutrition is a serious condition that happens when your diet does not contain the right amount of nutrients. Signs of malnutrition include weight loss, increased tiredness and poor wound healing.

If you or someone you know is at risk of malnutrition it is important to recognise and treat early.

Calculate the risk of malnutrition for you or someone you know.

There are many causes of malnutrition including loss of appetite, difficulty swallowing and changes to taste and smell. If left untreated, malnutrition can cause loss of muscle strength, increased risk of infection and low mood.

If you are in the community and are worried that you or someone you know is at risk of malnutrition, take a look at the following resources. If weight loss continues or you have already lost a lot of weight without meaning to, please speak with your GP and they may refer you to a community dietitian.

For ways to increase energy and protein intake at home, click on the below links:

• High Protein Foods
• The importance of protein
• Increasing Energy and Protein intake
• Malnutrition: Food Fact Sheet

For ways to increase variety in your diet, click on the below links:

• Fruit and vegetables – how to get five-a-day
• Information on Iron
• Information on Vitamin D
• Information on Fibre
• Do I need supplements?
• Eat Well, Spend Less

If you or someone you know is in hospital take a look at the following resources.

For ways to increase energy and protein intake in hospital:

• The importance of eating well in hospital

Additional information

For information on nutrition and COVID 19: Malnutrition Pathway COVID-19 Leaflets

For information on malnutrition and specific conditions: www.malnutritionpathway.co.uk/specific-resources 

For information on diet and specific conditions:

 www.bda.uk.com/food-health/food-facts.html

www.bda.uk.com/resource/pressure-ulcers-pressure-sores-diet.html