Integrated Care priorities for complex multi-system long-term conditions and for Long COVID

The importance of integrated care for complex multiple long-term conditions was acknowledged before the COVID pandemic, but remained a challenge. The pandemic and consequent development of long COVID required rapid adaptation of health services to address the population’s needs. In the UK, long COVID clinics were set up to address symptoms occurring simultaneously in several organ systems. This required complex interventions including integrated care and provided opportunities to improve the integrated care provision for complex multiple long-term conditions. This Delphi consensus study was conducted in the UK and found similar integrated care priorities for long COVID and complex multiple long-term conditions, provided by480 patients and health care providers, with an 80% consensus rate. The resultant recommendations were based on more than 1100 responses from survey participants and were supported by patients, health care professionals, and by patient charities. Participants identified the need to allocate resources to support integrated care, access to care and treatments that work, diagnostic procedures that support the personalization of treatment in an integrated care environment, and structural consultation between primary and specialist care settings including physical and mental health care. Based on the findings we describe a model for delivering integrated care as a complex intervention delivered by a multidisciplinary team for people with complex multisystem conditions. These recommendations can inform improvement of integrated care for complex multiple long-term conditions and long COVID at international level.