Long Covid clinic referral (UK)

What Long Covid is, per NICE

The joint NICE NG188 guideline (NICE / SIGN / RCGP, "COVID-19 rapid guideline: managing the long-term effects of COVID-19") defines two relevant clinical situations:

Ongoing symptomatic Covid-19 — signs and symptoms 4–12 weeks after the start of acute Covid-19.
Post-Covid-19 syndrome ("Long Covid") — signs and symptoms developed during or after acute Covid-19 that continue for more than 12 weeks and are not explained by another diagnosis.

The most common features are fatigue, post-exertional malaise, breathlessness, brain fog, palpitations, chest pain, sleep disturbance and orthostatic intolerance. NG188 emphasises that this is a multi-system condition and that symptoms can fluctuate and relapse.

When NICE expects a referral

NG188 recommends that primary care:

Rules out acute or life-threatening complications (such as pulmonary embolism or myocarditis) using clinical assessment and appropriate investigations.
Refers people with ongoing symptomatic Covid-19 or Post-Covid-19 syndrome for further assessment and investigation where symptoms are interfering with daily life and cannot be managed in primary care alone.
Considers referral to a multidisciplinary post-Covid assessment service.

In practice, a referral is clinically reasonable if you have symptoms persisting beyond 12 weeks that affect work, sleep, exercise tolerance or daily functioning — and another diagnosis hasn't been confirmed.

Build a 2-week symptom diary first

The single most useful thing you can take to the appointment is a structured symptom diary covering at least two weeks. For each day record: the symptoms experienced, their severity (0–10), suspected triggers (exertion, food, posture), and the impact on what you could and couldn't do. This makes the conversation about evidence, not impression.

The exact wording to ask your GP for

Dear [Dr ___], I have had symptoms persisting for [X] weeks since my acute Covid-19 illness in [month/year]. The dominant symptoms are [list — e.g. post-exertional fatigue, breathlessness on exertion, palpitations on standing, cognitive impairment], severity [0–10], affecting [work / sleep / daily activities]. Under NICE guideline NG188 (COVID-19 rapid guideline: managing the long-term effects of COVID-19), I am writing to formally request: 1. Investigations to exclude other causes of these symptoms, including [as appropriate: ECG, FBC, ferritin, TFTs, vitamin D, B12, fasting glucose, chest X-ray, lying/standing BP]. 2. Referral to my local NHS post-Covid assessment service (Long Covid clinic) for multidisciplinary assessment. 3. A written management plan in line with NG188 recommendations on personalised care. Please add this request to my medical record. If you do not consider referral clinically appropriate, please put your reasoning in writing, citing the guideline or evidence you are relying on. I would like a written response within 28 days. Yours sincerely, [Your name] NHS number: [if known] Date of birth: [DD/MM/YYYY] Enclosure: 2-week symptom diary.

If your GP refuses

Get the refusal in writing. Ask which guideline it relies on. A blanket "we don't refer for that" is not a clinical reason.
Escalate to the practice manager. A refusal that doesn't reference NG188 is hard for a practice to defend on review.
Contact your Integrated Care Board. ICBs commission Long Covid services and have an interest in being told when patients are being gatekept out of them.
Consider a formal complaint. Failing to refer despite NICE recommending it, with no clinical reason recorded, can be a breach of the GMC's Good Medical Practice (2024).

If you'd rather not draft this yourself, our £49 formal letter generates the NICE-cited request above, tailored to your symptoms, and frames it as a request your GP must add to your record and respond to within 28 days.

What happens at the clinic

Long Covid clinics vary, but typically include a respiratory or general medicine consultant, a physiotherapist (with pacing / post-exertional malaise training), an occupational therapist, and access to clinical psychology. Initial assessment usually covers a structured symptom inventory, lying-and-standing BP, basic exercise tolerance and a personalised rehabilitation plan. Referrals onward to cardiology, neurology or rheumatology happen when indicated.

Frequently asked questions

›Can my GP refer me to a Long Covid clinic?

Yes. NHS England Long Covid services are accessed via GP referral. Under NICE guideline NG188, a person with symptoms persisting beyond 12 weeks after acute Covid-19 that aren't explained by another diagnosis should be considered for referral to a post-Covid assessment service.

›What does NICE NG188 say about Long Covid referral?

NG188 (the joint NICE / SIGN / RCGP guideline on managing long-term effects of Covid-19) recommends that primary care refers people with ongoing symptomatic Covid-19 (4–12 weeks) and Post-Covid-19 syndrome (≥12 weeks) for multidisciplinary assessment, including ruling out serious complications and providing rehabilitation.

›Are NHS Long Covid clinics still open in 2026?

Yes — but unevenly. NHS England commissions Long Covid assessment services in every ICB area, but several services have been merged into general post-acute or rehabilitation pathways. Ask your ICB which provider currently runs the service.

›Can I self-refer to a Long Covid clinic?

Generally no — Long Covid services in England are accessed through a GP referral. A few areas accept self-referral after a positive Covid test history; check your ICB website.

›What if my GP refuses to refer me?

Get the refusal in writing and ask which guideline it relies on. NG188 sets a clear expectation of referral, and a written, NICE-cited request from you is much harder to deflect than a verbal request in a 10-minute appointment.

›What evidence should I bring to the appointment?

A symptom diary (date, symptom, severity 0–10, trigger if any), proof of acute Covid infection if you have it, a list of medications, and any abnormal investigations (HR, BP, fatigue scores, exercise tolerance).