Accessing care for Long Covid from the perspectives of patients and healthcare practitioners: A qualitative study

Turk, Fidan; Sweetman, Jennifer; Chew‐Graham, Carolyn A.; Gabbay, Mark; Shepherd, Jessie; van der Feltz‐Cornelis, Christina

Abstract

Background
Long Covid is an emerging long-term condition, with those affected raising concerns about lack of healthcare support.

Objective
We conducted a qualitative study to identify facilitators and barriers to healthcare access for people with Long Covid, aiming to enhance our understanding of the specific nature of these barriers and how patient experiences may vary.

Setting and Participants
In the context of the Symptoms, Trajectory, Inequalities and Management: Understanding Long-COVID to Address and Transform Existing Integrated Care Pathways (STIMULATE-ICP) Delphi study, a nationally distributed online survey was conducted. Eight patients and eight healthcare practitioners (HCP) were interviewed via telephone or video call. Framework analysis, sensitised by the candidacy theory, was used to identify barriers and facilitators over four levels of access to care.

Results
Three themes were identified: (i) patients' efforts to navigate emerging pathways for Long Covid, (ii) the patient–HCP interaction and (iii) service resources and structural constraints. Barriers to specialist care included long waiting times, communication gaps across services and a lack of continuity in care. Facilitators included collaborative, patient-centred approaches, patients' active role in their healthcare and blended approaches for appointments. The perspectives of both patients and HCPs largely aligned.

Discussion
The candidacy framework was valuable in understanding the experiences of people with Long Covid seeking access to healthcare. Individuals perceived themselves as eligible for care, but they often encountered obstacles in obtaining the expected level of care or, in some cases, did not receive it at all. Our findings are discussed in the context of the candidacy model through multiple processes of identification, negotiation, permeability and appearances at health services. These themes seem to be especially important for the emerging new pathway model and are relevant to both primary and secondary care.

Conclusions
This study highlights that despite these interviews being conducted two years after the start of the COVID-19 pandemic, people with Long Covid still struggle to access healthcare, emphasising the ongoing need to provide equitable timely healthcare access for people with Long Covid.

Patient or Public Contribution
People with Long Covid advised on all stages of this research.

Citation

Turk, F., Sweetman, J., Chew‐Graham, C. A., Gabbay, M., Shepherd, J., & van der Feltz‐Cornelis, C. (2024). Accessing care for Long Covid from the perspectives of patients and healthcare practitioners: A qualitative study. Health Expectations, 27(2), Article e14008. https://doi.org/10.1111/hex.14008

• Journal Article Type: Article
• Acceptance Date: Feb 21, 2024
• Online Publication Date: Mar 14, 2024
• Publication Date: 2024-04
• Deposit Date: Mar 18, 2024
• Publicly Available Date: Mar 18, 2024
• Journal: Health Expectations
• Print ISSN: 1369-6513
• Electronic ISSN: 1369-7625
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 27
• Issue: 2
• Article Number: e14008
• DOI: https://doi.org/10.1111/hex.14008
• Keywords: Long Covid, multiple symptoms, lived experiences, qualitative study, long‐term conditions, waiting times, access to care
• Public URL: https://keele-repository.worktribe.com/output/775924
• Publisher URL: https://onlinelibrary.wiley.com/doi/10.1111/hex.14008