Pioneering post COVID service helps southwest Londoner get life back on track

Published: 22nd February 2023

More than 500 people suffering with Long Covid in southwest London have received help from a pioneering post-COVID service, led by Central London Community Healthcare NHS Trust.

One patient using the service had been living with Long Covid for months. After visiting her GP and having tests to rule out other possible causes of her symptoms, 56-year-old Justine Walsh was referred to the Wandsworth and Merton Post Covid Assessment Clinic last September.

The innovative service, which is therapy-led and medically supported in the community rather than in a hospital-setting, offers support with fatigue management, breathlessness, self-management advice on sleep, physical activity and diet, and psychological support to cope with the effects of the illness. It offers patients a holistic service closer to home with input from physiotherapists, occupational therapists and rehabilitation assistants.

Speaking about her experience, Justine said: “I caught Covid just after Christmas 2021, but it wasn’t until May 2022 that my symptoms like joint pain, migraines and fatigue became too much, and I had to stop working.”

Prior to Long Covid, the fit and active mother of two enjoyed exercising regularly and spending time with her two school-aged children.

“Before Covid, I had a very active lifestyle. I worked full-time as a project manager and would cycle to work every day in central London. I had a busy social life and was always doing something. But when I got Long Covid, that all changed.”

Since the post covid service launched in April 2021, it has supported 515 patients and has so far received excellent feedback. Ninety-four per cent of service users who provided feedback in 2022 rated the service as good or very good, and 100 per cent said that staff treated them with respect and dignity and took the time to find out about them as an individual.

Justine, who lives in Wandsworth, commented:

“The service supported me to manage fatigue and energy levels. There are things I used to take for granted, like going for a walk, that I was suddenly struggling with. The service helped me to accept my condition and build up my daily activities gradually, getting back into healthy routines.

“I kept a diary of my daily activities, used an app to help manage my sleep issues and would check in weekly with my clinician. It was good to have someone to talk to who was non-judgemental and understood what I was going through. I now feel like I have the tools and resources to manage my condition, should I get any flare ups in the future. I’ve even started a phased return to work this month, which I’m really happy about. The post covid service has helped me get my life back.”

The service offers virtual telephone and video appointments as well as face-to-face meetings to make it as convenient as possible for people to access the service from the comfort of their home. Many patients report that this enables them to better juggle their symptoms, childcare responsibilities, and work.

Speaking about her appointments, Justine said:

“All my sessions were done virtually which was great as it can be draining having to get up, out the house and to a clinic for an appointment. This way I was able to stay at home and do the appointments from the comfort of my sofa. I got used to working that way during the pandemic, so I was already familiar with the video technology.”

Long Covid can affect individuals in a number of ways, including physically, socially and psychologically. That’s why the post covid service works in close partnership with primary care, secondary care and the community and voluntary sector to provide direct referrals to social prescribing programmes like the English National Opera Breathe programme, Voices of Hope and Merton Connected as well as local exercise and spiritual centres.

The service also has a direct referral to mental health support via local NHS Talking Therapies services.

Vladimira Kalev, Clinical Lead Occupational Therapist at Wandsworth and Merton Post Covid Assessment Service said:

“As an advocate of community services, CLCH developed a post covid pathway in collaboration with St George’s NHS Trust that provides holistic care and treatment, is wrapped around the individual patient and focuses on what is important to them. This model was then replicated by NHS England across the country. The average age of our patients is 44 years old, with most already juggling severe symptoms, childcare responsibilities, and work. So far, we’ve had a lot of positive feedback from our patients, many of whom are pleased they can complete the programme virtually, meaning they get human connection without the physical aspect of travelling to a clinic. Not only does this improve accessibility for patients, but it allows us to put more resources and time into face-to-face appointments for patients who need them.” 

Karen Daly, Clinical Lead for Specialist Post Covid Assessment Services in South West London and Consultant at St George’s NHS Trust said:

“Through collaborative working between St George’s and CLCH, a therapy-led, medically supported model of post COVID care was developed. Delivering the service in the community ensures that every aspect of a patient’s wellbeing, including the physical, psychological and social, are taken into consideration and treatment is as holistic as possible. Through close working between a range of specialists at St George’s and the post COVID service, patients’ care is managed in a timely and integrated way to optimise their recovery. The impact of this has been to increase the skills and confidence of the community teams to manage Long Covid patients.”

Anirban Gupta, GP in Merton and Long Covid Clinical Lead for NHS England – London and NHS South West London said:

“As a GP, I have seen first-hand how the service has improved the quality of life of my patients living with Long Covid, with many sharing that the interventions and exercises they’ve learned through the programme have led to real results. I encourage anyone who feels they may have symptoms of Long Covid, such as fatigue, breathlessness, headaches or dizziness, to contact their GP and get the help they need.”

Harpreet Shergill, Trust NHS Talking Therapies – Long Term Conditions Specialist Pathway Lead at South West London and St George’s NHS Mental Health NHS Trust, said:

“Physical health conditions can affect mental health, and it is thought around one in four people with Long Covid develop a mental health issue. At Merton Uplift and Talk Wandsworth, we work closely with the post covid service to provide confidential and effective mental health support to patients who are experiencing common mental health problems like stress, anxiety and depression.

“By working in an integrated and co-produced way, we’re able to offer treatment with an understanding of the issues an individual is facing and get them the support they need in a timely way. This collaborative way of working is the gold standard and provides not only a feedback loop for professionals and individuals, but it also links the individual to all aspects of their healthcare.”

Ben Halschka, Joint Acting CEO and Head of Social Prescribing at Merton Connected: 

“Social prescribing works hand in glove with the post covid service to provide a non-medical referral option that links patients to local groups and activities, helping them to make positive lifestyle changes and learn new skills. Social prescribing works alongside other treatments and interventions to improve overall health and wellbeing. All Merton Social Prescribing Link Workers have a background in either psychology, counselling, education, health or social care and we are able to provide holistic and personally tailored solutions to patients.”


Common symptoms of Long Covid include fatigue, breathlessness, headaches, dizziness, and deterioration in mental health, and many people experience multiple symptoms.

If you think you are experiencing symptoms of Long Covid – also known as post COVID syndrome – speak to your GP. Following tests, your GP will be able to give you more information about your local service.

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