Academia - C19-YRS.me

Leeds Long Covid Rehab Service win the BMJ Clinical Leadership Team of the Year Award 2021

C19-YRS.me — Wed, 29 Sep 2021 19:00:03 +0000

On Wednesday, 29 September the winners of the 13th Annual BMJ Awards were announced at a virtual ceremony. In such a challenging year, we recognised the extraordinary and innovative work of healthcare teams across the UK, and presented them with their trophies.

The Leeds Long Covid Rehab Service, provided by Leeds Community Healthcare Trust & Leeds Teaching Hospitals, has been awarded the 2021 BMJ Clinical Leadership Team of the Year Award.

This award recognises a team that exemplifies the qualities of clinical leadership, requiring ideas and enthusiasm and often by doing things differently.

https://thebmjawards.bmj.com/bmj-awards-showcase-2021/

Congratulations to the team!

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ELAROS and the Leeds Covid Rehab Team win Medipex’s NHS Innovation Awards 2021

C19-YRS.me — Wed, 22 Sep 2021 13:00:58 +0000

On 22nd September, Medipex held their 14th NHS Innovation Awards, which recognises a wealth of inventive devices, technologies and systems designed to improve the health and wellbeing of NHS patients every year. The event is an opportunity to acknowledge and promote the achievements of Winners and Finalists who include NHS staff members, academic teams and companies across the Yorkshire & Humber who have developed innovative ideas to improve patient care across the NHS.

Jennifer Davison and Rachel Tarrant, on behalf of The Leeds Long Covid Community Rehabilitation Service based at Leeds Community Healthcare NHS Trust, in partnership with Leeds Teaching Hospitals, Leeds GP Confederation, Leeds CCG, and University of Leeds were nominated as finalists for their “Design and implementation of the Leeds Long covid Community Rehabilitation service”

Dr Manoj Sivan from Leeds Teaching Hospitals NHS Trust in conjunction with Paul O’Brien from Elaros and colleagues from University of Leeds, Leeds Community Healthcare Trust, and Leeds Teaching Hospitals Trust were also nominated as finalists for “The world’s first validated digital assessment, triage, management, and monitoring system for Long COVID”

The C19-YRS consortium is proud to announce that both finalists were announced as joint winners for the Management of Long Term Conditions in Medipex’s 2021 Awards and Showcase 2021.

http://www.medipex.co.uk/events/nhs-innovation-awards-2021/

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BBC North West feature C19-YRS in Salford

C19-YRS.me — Fri, 03 Sep 2021 18:30:53 +0000

Northern Care Alliance NHS Group report the succeses of the digital C19-YRS platform

The Northern Care Alliance NHS group (NCA) has published an article detailing some of their experiences of using the Covid-19 Yorkshire Rehabilitation Scale (C19-YRS).

All of the quotes in this article are taken from the original NCA press release which can be found here.

You can also watch the full BBC North West News Item from the 3rd September 2021 from the 3rd September here.

The NCA has worked with Salford city council to support members of their community suffering from long-COVID. Their team relied on manual screening using the paper version of the C19-YRS prior to the release of the digital version. However the rising numbers of patients in need of support with long-COVID precipitated a need for a more efficient solution.

The release of the digital C19-YRS has meant that “patients will be able to download an app onto their mobile device and update their progress at varying stages of their recovery, allowing their clinician to make any changes to their care management plan.”

This has been the intended purpose of the C19-YRS throughout development, and the testimonials from Salford Royal and Salford’s Single Point of Access team demonstrate the success of the system.

Patient attitudes towards the digital C19-YRS have been very positive, with Taruna Patel from Salford’s Single Point of Access team stating that “Our patients are very keen to use the app as another tool. By inputting the information themselves, they will be able to see how their health is improving over time and use the information to form a discussion with their clinician, as well as to show their family.”.

A patient from Salford stated that “I found the app easy to download and very user friendly. I’m looking forward to using it more and I’m intrigued as to the next step, hoping it will help me to get the right support and care.”

The benefits the digital C19-YRS had for the NCA extend don’t just impact patients, and the staff have also felt an easing in the burden of Long-COVID management. “Previously we were making calls and asking people around 30 questions over the phone with the varying responses. It was quite tiring for patients and time consuming, particularly those with severe long-COVID symptoms.”.

Further advantages with the digital system have also been appreciated by the team at Salford, such as improved communication with the Long-COVID Clinic Team, which has allowed them to decide on the “length and type of appointments…to match the needs of the patient.”.

The NCA report also touches on some of the research that is being undertaken using the C19-YRS platform by researchers from the University of Leeds. This is the NIHR funded LOCOMOTION study, led by Professor Nawar Bakerly. The NCA has stated that the digital C19-YRS will allow them to “contribute to national and local research” and Sarah Cannon of Salford PCT believes that the digital C19-YRS “will also help with reporting data required for long Covid at a national level.”

The digital C19-YRS is developed by ELAROS in a partnership with the University of Leeds, Leeds Teaching Hospitals and Leeds Community Healthcare NHS Trusts, with support from our software developers, Pipe and Piper.

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University of Leeds awarded £3.4 million NIHR-funded long Covid research project with support from ELAROS

C19-YRS.me — Tue, 20 Jul 2021 11:00:48 +0000

An extensive range of 15 projects from across the UK have been awarded a total of £19.6 million to examine causes of long COVID, trial drugs to tackle it, and investigate symptoms such as breathlessness and ‘brain fog’ that have become synonymous with the condition. Studies will also evaluate health services and explore ways patients can monitor the condition to optimise their recovery and return to work.

A major £3.4 million research project has been awarded to a research consortium led by The University of Leeds which includes Imperial College London, King’s College London and The University of Oxford, with ELAROS named as a commercial partner.

The LOCOMOTION (LOng COVID Multidisciplinary consortium: Optimising Treatments and servIces acrOss the NHS) study aims to create a “gold standard” approach for the treatment of long Covid and will identify best practice in providing services, ensuring people are supported quickly and receive the right treatments from the right healthcare professionals – in their own home, through their GP or at specialist long COVID clinics.

A major focus of the project is centred on the development and optimisation of ELAROS’ C19-YRS platform which will launch at 10x clinical sites across England, Northern Ireland, Scotland, and Wales almost overnight. The incentive is to gather large amounts of patient data quickly to help the consortium devise ways of supporting the nearly 2 million long Covid patients in the UK, and to further validate the C19-YRS scale to develop a standardised approach.

The official press release from The University of Leeds can be found here: https://www.leeds.ac.uk/news-health/news/article/4871/creating-a-gold-standard-of-care-for-long-covid

Further details on the other round winners can be found in the following article: https://www.nihr.ac.uk/news/196-million-awarded-to-new-research-studies-to-help-diagnose-and-treat-long-covid/28205

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Digital C19-YRS Officially Launched

C19-YRS.me — Fri, 28 May 2021 13:31:02 +0000

Digital platform to support patients coping with long covid goes live

People with long covid could be monitored with the aid of a ground-breaking mobile phone app and clinical website.

The system has been developed to help NHS rehabilitation teams manage the large number of people suffering from the debilitating effects of the illness. Patients will also be able to use the app to track their recovery.

The app will initially be available to patients in 27 NHS Trusts, including the Salford Royal, Pennine Acute Hospitals, Liverpool University Hospitals, Airedale and Leeds Community Healthcare NHS Trusts, with ELAROS in advance discussion with several others. The public will not have direct access to the app – instead, patients will be invited to download it by their doctor or a member of their rehabilitation team.

Developed by ELAROS in a partnership with the University of Leeds, Leeds Teaching Hospitals and Leeds Community Healthcare NHS Trusts, with support from our software developers, Pipe and Piper, the app will enable patients to self-report their symptoms and the impact their symptoms are having on daily living.

The first hospitals to use the system will go live with it next week (June 1).

One million-plus have long covid

Long covid refers to persistent symptoms that last for four weeks or longer after contracting covid-19, and include breathlessness, fatigue, brain fog, psychological distress, pain, and a general decline in quality of life.

Figures from the Office of National Statistics have revealed that during four weeks in February and March, more than one million people in the UK were experiencing long covid – including 697,000 people who had experienced symptoms for at least 12 weeks. Of those, about 674,000 said the condition was adversely affecting their day-to-day activities.

Approximately 70,000 had been ill for a year.

“We need efficient systems to manage the growing caseload and to standardise care across the NHS.”

DR MANOJ SIVAN, UNIVERSITY OF LEEDS

The information that a patient puts onto the app will be stored on a secure and confidential database which can be accessed by the NHS team involved in their care, to monitor their progress and to evaluate treatment options.

Dr Manoj Sivan, Associate Professor in the School of Medicine at the University of Leeds and Consultant in Rehabilitation Medicine at Leeds Teaching Hospital and Community Healthcare NHS Trusts, is the lead academic in the project.

He said: “Long covid is a new condition, and it is causing long-term health problems for many patients. Given the scale of the problem, it is likely to strain healthcare services and burden the economy. We need efficient systems to manage the growing caseload and to standardise care across the NHS.

“The app and associated web portal will allow healthcare staff to rapidly assess and triage patients. Patients and families can also see their progression and their response to treatments.”

Assessment of long covid symptoms

The app takes the patient through a series of questions to record their health status before contracting covid, and what it is now. The information is displayed in radar plots: one showing the severity of symptoms and the second how the symptoms are impacting on a patient’s ability to perform daily activities – their level of functional disability.

Patients will be asked to regularly update the app and over time, the radar plots will show what progress they are making towards recovering their health.

A series of radar plots showing how a patient’s symptoms have changed over time. The higher the score, the more severe the symptoms. As the patient improves, the radar plot will shrink back to the pre covid measurement (shown in blue).

Jenny Davison, Physiotherapist and Long Covid Rehabilitation Service Coordinator with Leeds Community Healthcare Trust, said: “A patient will be able to update the app at different stages in their recovery – and it will show them and their clinician how they are improving and what areas might need more targeted input.

“It provides an excellent visual demonstration of the data in graph format for patient to see at a glance the improvements they have made.”

Professor Paul O’Brien, Chief Executive of ELAROS, said: “The digital nature of the system will allow us to rapidly improve the clinical tool in partnership with healthcare professionals as we learn more about the condition. Our aim is to help healthcare teams provide the most effective support for patients recovering from long covid.

“This is a not-for-profit initiative for all NHS organisations as part of ELAROS’ contribution to the national effort to tackle Covid.”

App uses the latest scientific research

The app uses a version of the COVID-19 Yorkshire Rehabilitation Scale (C19-YRS), a questionnaire developed by Dr Sivan and his team during the first wave of the pandemic to aid the diagnosis and assessment of long covid symptoms.

C19-YRS is now widely used across the NHS and has been recommended for routine use by NHS England in their national guidance for post-covid syndrome assessment clinics. Guidelines from the National Institute of Health and Care Excellence also support its use for comprehensive assessment of patients.

If a patient agrees, their responses recorded on the app can be shared with accredited research institutions, but personal details will be removed.

Further information

For more information on the system, visit: www.c19-yrs.com

For healthcare organisations who wish to adopt the digital platform, please contact: c19-yrs@elaros.com

For more press details and requests to interview Dr Manoj Sivan and/or a member of the ELAROS team, please contact David Lewis in the press office at the University of Leeds: pressoffice@leeds.ac.uk

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NHS England: National guidance for post-COVID syndrome assessment clinics (Version 2, April 2021)

C19-YRS.me — Fri, 28 May 2021 13:27:04 +0000

NHS England and NHS Improvement recently published their updated National guidance for post-COVID syndrome assessment clinics in April 2021.

The guidance builds upon its initial version, published in November 2020, which announced its £20 million investment into setting up 40 Long COVID clinics to assess and manage these individuals and recommended the use of the C19-YRS as an outcome measure to be used at first assessment, 6 weeks and 6 months to monitor progress.

This latest version directly references ELAROS’ digital C19-YRS on page 32, recommending continued use of the tool for the initial assessment and triaging of long Covid patients.

Its Purpose:

“The purpose of this document is to inform the commissioning of post-COVID syndrome assessment clinics. This guidance will assist local healthcare systems in establishing and maintaining post-COVID assessment services for patients experiencing long-term health effects following COVID-19 infection.

Clinics should offer physical, cognitive, psychological and psychiatric assessments with the aim of providing consistent services for people with post-COVID syndrome (‘Long COVID’). These services should support those who need them, irrespective of whether they were hospitalised and regardless of whether clinically diagnosed or by a SARS-CoV-2 test.”

Published on the 26th April, 2021: https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/11/C1248-national-guidance-post-covid-syndrome-assessment-clinics-v2.pdf

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NICE guideline on long covid (Sivan et al. BMJ 2020)

C19-YRS.me — Wed, 23 Dec 2020 12:48:30 +0000

Research must be done urgently to fill the many gaps in this new “living guideline”

(Manoj Sivan and Sharon Taylor, 2020) The covid-19 pandemic has killed over 1.6 million people worldwide,1 caused the worst healthcare crisis of this century, and put a huge dent in our economies. The magnitude of the population still struggling with symptoms four weeks after their acute illness—commonly called “long covid”—is becoming obvious and demands urgent prioritisation to prevent a further blow to health systems and the healthcare workforce.

Long covid is thought to occur in approximately 10% of people infected,2 3 so there are likely more than 5 million people affected globally. The National Institute for Health and Care Excellence (NICE), the Scottish Intercollegiate Guidelines Network, and the Royal College of General Practitioners have developed a rapid guideline for managing the long term effects or antibody test. Any other approach risks missing the many thousands of people who did not have access to testing in the early phases of the pandemic. The recommendations emphasise comprehensive assessment by a multidisciplinary team and support the use of virtual methods of assessment, including screening questionnaires such as C19-YRS (Yorkshire)

The guidance mentions screening blood tests (such as full blood count; clotting profile; renal, liver, and thyroid functions; and C reactive protein) and tests of both cardiac and lung function to capture reversible abnormalities, but it lacks detail on the management of serious life threatening complications of covid-19 to assist long covid services being set up in the NHS5 and elsewhere. A lack of systematic research means that the current guideline is necessarily preliminary, but it will be updated regularly as new evidence emerges—becoming a “living guideline.” This approach is essential as the current guideline lacks important detail, including a comprehensive list of organ complications seen in patients with long covid, the investigations required, and specific interventions for these complications.

Invited editorial re NICE guideline on long covid – Manoj Sivan (Leeds) & Sharon Taylor (London) Published: 23 December 2020 BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4938

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NICE: COVID-19 rapid guideline: managing the long-term effects of COVID-19 (Dec 2020)

C19-YRS.me — Fri, 18 Dec 2020 12:39:17 +0000

This guideline covers identifying, assessing and managing the long-term effects of COVID-19, often described as ‘long COVID’. It makes recommendations about care in all healthcare settings for adults, children and young people who have new or ongoing symptoms 4 weeks or more after the start of acute COVID-19. It also includes advice on organising services for long COVID.

This guideline has been developed jointly by NICE, the Scottish Intercollegiate Guidelines Network (SIGN) and the Royal College of General Practitioners (RCGP).

To develop the recommendations, we have used the following clinical definitions for the initial illness and long COVID at different times:

Acute COVID-19: signs and symptoms of COVID-19 for up to 4 weeks.
Ongoing symptomatic COVID-19: signs and symptoms of COVID-19 from 4 to 12 weeks.
Post-COVID-19 syndrome: signs and symptoms that develop during or after an infection consistent with COVID-19, continue for more than 12 weeks and are not explained by an alternative diagnosis.

In addition to the clinical case definitions, ‘long COVID’ is commonly used to describe signs and symptoms that continue or develop after acute COVID‑19. It includes both ongoing symptomatic COVID‑19 and post‑COVID‑19 syndrome (defined above).

Published on the 18th December 2020: https://www.nice.org.uk/guidance/ng188/resources/covid19-rapid-guideline-managing-the-longterm-effects-of-covid19-pdf-66142028400325 Information: https://www.nice.org.uk/guidance/ng188

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NHS England: National guidance for post-COVID syndrome assessment clinics (November 2020)

C19-YRS.me — Fri, 06 Nov 2020 12:40:16 +0000

NHS England recently invested £20 M in setting up 40 Long COVID clinics to assess and manage these individuals. They have recommended the use of C19-YRS as an outcome measure to be used at first assessment, 6 weeks and 6 months to monitor progress.

The purpose of this document is to provide commissioning guidance on the development of a specification to assist local healthcare systems to establish post-COVID assessment clinics for patients experiencing long-term health effects following COVID-19 infection. Clinics will offer physical, cognitive and psychological assessments with the aim of providing consistent post-COVID syndrome services for all who need them, whether they were hospitalised or not and regardless of whether clinically diagnosed or by a SARS-CoV- 2 test.

It will be critical to gather and analyse data, participate in shared learning and use this information to inform future practice and reduce unwarranted variation in the management and subsequent outcomes of patients with post-COVID syndrome symptoms. The data will be used to inform the management of patients, as well as informing service providers and commissioners in resource planning to maximise resource and service resilience.

NHS England and NHS Improvement London has reviewed the instruments available to monitor patient recovery trajectories and the impact of symptoms on an individual’s functional status. Based on this review the use of two validated tools for routine collection are recommended:

The COVID-19 Yorkshire Rehab Screening Tool (C19-YRS) is a comprehensive multi-system telephone tool which has been developed by multi-disciplinary rehabilitation teams from Leeds, Airedale and Hull NHS Trusts to assess and capture symptoms and guide rehabilitation interventions. The tool can be found in appendix C.
The post COVID-19 Functional Status Tool is an ordinal, 6-point tool used to measure a variety of functional outcomes during recovery from COVID-19. The scale which has steps ranging from no symptoms to death can be used to measure the impact of symptoms on functional performance and the effect of interventions on the recovery trajectory. The post COVID-19 Functional Status Tool is intended to be used at a number of different time points during a patient’s recovery in order to measure change in status and support an understanding of the patient’s recovery trajectory. It may be completed either by clinical professionals or by the patient themselves with the use of the flowchart. If the patient has cognitive or other limitations which prevents them from providing responses, the tool is suitable for a family member or carer to respond on their behalf. The tool can be found in appendix D

Published on the 6th November, 2020. https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/11/C0840-national-guidance-for-post-covid-syndrome-assesment-clinics-111220.pdf

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Development of an integrated rehabilitation pathway for individuals recovering from COVID-19 in the community (Sivan et al JRM 2020)

C19-YRS.me — Mon, 24 Aug 2020 12:24:56 +0000

Development of an integrated rehabilitation pathway for individuals recovering from COVID-19 in the community

Objective: COVID-19 is a multisystem illness that has considerable long-term physical, psychological, cognitive, social and vocational sequelae in survivors. Given the scale of this burden and lockdown measures in most countries, there is a need for an integrated rehabilitation pathway using a tele-medicine approach to screen and manage these sequelae in a systematic and efficient way.

Methods: A multidisciplinary team of professionals in the UK developed a comprehensive pragmatic telephone screening tool, the COVID-19 Yorkshire Rehabilitation Screen (C19-YRS), and an integrated rehabilitation pathway, which spans the acute hospital trust, community trust and primary care service within the National Health Service (NHS) service model.

Results: The C19-YRS telephone screening tool, developed previously, was used to screen symptoms and grade their severity. Referral criteria thresholds were applied to the output of C19-YRS to inform the decision-making process in the rehabilitation pathway. A dedicated multidisciplinary COVID-19 rehabilitation team is the core troubleshooting forum for managing complex cases with needs spanning multiple domains of the health condition.

Conclusion: The authors recommend that health services dealing with the COVID-19 pandemic adopt a comprehensive telephone screening system and an integrated rehabilitation pathway to manage the large number of survivors in a timely and effective manner and to enable the provision of targeted interventions.

Sivan et al. August 2020. JRM Development of an integrated rehabilitation pathway for individuals recovering from COVID-19 in the community. DOI: 10.2340/16501977-2727

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