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‘Community nurses and primary care not ready for rise in long Covid’



Community and primary care nurses need extra resources to cope with rising long Covid cases, which could overtake rates of dementia, leaders in the sector have warned.  

Leading nurses have told Nursing in Practice many people with long Covid will need long-term and complex nursing care, but policy discussions have so far not taken enough into account the capacity of community and practice nursing.

Dr Elaine Maxwell, nurse academic and author of the National Institute for Health Research’s ongoing long Covid review, said: ‘[People with long Covid] need things skilled nurses are good at – such as supporting them through changing their health status, guiding their ongoing monitoring and being the patient advocate.’ 

But she said ‘not enough conversations’ were happening about how nurses could respond to this, including whether extra staff or training was needed.

There ‘hasn’t been much of a response from nursing’ to prepare for the rising long Covid cases coming their way, Dr Maxwell said. Likewise, Government and decision-makers had not done enough to discuss policies around the nursing response to long Covid, and nurses have not been included in any talks, she added.

She warned: ‘We may end up with more people with long Covid than dementia’. Official data last month showed more than one million people in England are living with long Covid. 

Dr Maxwell questioned whether community nurses would be able to cope. The sector suffers from chronic staffing problems, with the latest data showing staff numbers falling from 41,156 a decade ago in December 2010 to 36,736 at the same time last year.

While practice nurse numbers have stayed relatively constant in the last five years, from 15,601 in March 2016 to 16,801 in March this year, primary care is busier than ever as it grapples with the Covid-19 vaccination programme and catching up with a backlog of care.

Although the Government has set up 83 long Covid clinics across England, a recent survey from the campaigning group Long Covid Support found 74% of patients struggled to secure a referral to these clinics. Dr Maxwell also pointed out that many patients who manage to get an appointment at the long Covid clinic may to primary care teams and the community if they are not referred on.

Gail Allsopp, a GP consultant working in Derbyshire and clinical policy lead at the Royal College of General Practitioners, at a Westminster Health Forum conference on long Covid last month, said primary care needs more resources to deal with long Covid presentations. 

She said: ‘These are complex and multi-system presentations. In primary care, we need multiple contacts and repeat interactions. This takes time. This is therefore taking time away from other things happening in primary care.’ 

Ms Allsopp added that primary care needs better access to diagnostics, which are mainly secondary care based, as a ‘matter of urgency’. She also called for ‘adequate funding’ for rehabilitation and community treatment to increase services and tackle huge waiting lists. 

QNI chief executive Dr Crystal Oldman said: ‘There’s still a huge amount of work going on that’s completely unseen around end-of-life care, long-term conditions and long Covid.  

‘The more we can raise the voice of nurses, then perhaps we’ll get more recognition around the resources that need to be put into understaffed community and practice nursing teams – and address what’s needed to support the growing numbers with long-term problems such as long Covid.’ 

The Department of Health and Social Care and NHS England did not respond to requests for comment from Nursing in Practice.  

Although, Health Education England chief nurse Mark Radford told Nursing in Practice in an interview nursing has a ‘fundamental role’ to play in leading the fight against long Covid. More from that interview will be published on Monday.  

Previous research has shown fatigue is the most common symptom of long Covid and it may be as many as four different syndromes