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Long COVID clinic - a real MDT, working from NICE guidance.

A consultant-led multidisciplinary programme for persistent post-COVID symptoms - fatigue, PEM, breathlessness, POTS, brain fog and unrefreshing sleep. Graded pacing and a real return-to-work plan.

A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a private long COVID pathway costs in the UK.

In short

Consultant assessment: £250–£500. MDT programme: £1,500–£4,000.

ServiceIndicative range
Consultant long COVID consultation £250–£500
Follow-up consultation £200–£350
Multidisciplinary programme (6–8 weeks) £1,500–£4,000
Extended MDT programme (12 weeks) £3,500–£6,500
Autonomic (tilt-table) testing £450–£800
CPET (cardiopulmonary exercise test) £500–£850
Full lung function testing £300–£550

The problem

Long COVID care is uneven - patchy NHS clinics, magical-thinking programmes.

  • Rule out treatable mimics first

    Anaemia, thyroid disease, sleep apnoea and myocarditis can look like long COVID. A proper first assessment separates them.

  • Respect post-exertional malaise

    Where PEM is present, graded exercise programmes trigger relapse. Pacing and titrated activity are standard.

  • Return to work is a plan, not a date

    Phased return, workplace adjustments, employer letters and Access to Work - the practical scaffolding.

When it helps

When a long COVID clinic is the right step.

  • Persistent fatigue and post-exertional malaise (PEM)

    Pacing, energy-envelope work and psychology for adjustment - not graded exercise that triggers crashes.

  • Breathlessness and disordered breathing

    Dysfunctional breathing is common after COVID. Respiratory physio, breathing retraining.

  • Palpitations and POTS

    Postural tachycardia and orthostatic intolerance - tilt-table, salt/fluid strategies, targeted medication.

  • Brain fog and cognitive symptoms

    Structured cognitive rehab from OT, workplace pacing and reasonable adjustments.

  • Sleep disturbance and unrefreshing sleep

    Sleep architecture screening, CBT-I where appropriate.

  • Anxiety, low mood and health-related distress

    Psychology for a real physical illness - adjustment, uncertainty, loss of function.

  • Return to work with adjustments

    Phased return plans, employer letters, occupational-health input.

  • Red flag: new chest pain, syncope, focal deficit

    Any new central chest pain, syncope, focal neurology or sudden severe breathlessness is urgent - A&E or same-day cardiology.

Programme options

From a single consultation to a 12-week multidisciplinary block.

  • Consultant assessment only

    A single 45–60 minute consultation, clinical letter, and a plan you can take back to your GP.

  • Short investigation panel

    Consultant plus a focused set of tests - bloods, autonomic assessment, CPET or lung function.

  • 6–8 week multidisciplinary programme

    Rehab physio, OT, psychology and dietitian where relevant, coordinated weekly.

  • 12 week extended programme

    For more complex patients with autonomic dysfunction, PEM or return-to-work challenges.

  • Autonomic (POTS) pathway

    Tilt-table or 10-minute stand testing, HRV work, salt and fluid strategies.

  • Respiratory rehab pathway

    For breathlessness, dysfunctional breathing, deconditioning - respiratory physio, breathing retraining.

  • Cognitive rehab and return-to-work

    OT-led cognitive strategies, employer letters, phased return plans.

  • Virtual follow-up between blocks

    Video check-ins with the physio or consultant between blocks.

Safety and recovery

What to expect through a long COVID pathway.

  • Pacing, not pushing

    For anyone with PEM, exercise progression must be titrated to symptoms. NICE ME/CFS guidance warns against graded exercise programmes.

  • Rule out treatable mimics

    New anaemia, thyroid disease, sleep apnoea, autoimmune disease and myocarditis can look like long COVID.

  • Cardiovascular symptoms warrant work-up

    New chest pain, syncope or exercise-triggered arrhythmia needs cardiology input.

  • Autonomic dysfunction is real and treatable

    POTS and orthostatic intolerance are common. Compression, fluid and salt strategies, sometimes ivabradine.

  • Mental health support alongside, not instead of

    Depression and anxiety are common consequences and worsen recovery. Treated in parallel.

  • Medication caution

    Some patients are sensitive to standard doses of beta-blockers, antidepressants or SSRIs. Start low, titrate slowly.

  • Fitness to drive and safety-critical work

    Cognitive symptoms, syncope or POTS can affect driving safety. DVLA guidance and honest self-assessment matter.

  • Setbacks and plateaus are normal

    Recovery is rarely linear. Setbacks after infection or overexertion are common.

  • What warrants same-day team or A&E

    Central chest pain unrelieved, syncope, sudden severe breathlessness, focal neurology need urgent assessment.

Reading your clinic notes

Your clinic report in four parts. Read the last one first.

A UK long COVID consultant reviewing a clinic letter
  1. 01

    Symptom pattern and objective measures

    Symptom timeline since infection, PEM screening, orthostatic vitals, sit-to-stand, baseline blood work.

  2. 02

    Interventions and dosing

    The disciplines involved, weekly sessions, pacing envelope, medication changes.

  3. 03

    Progress and objective retesting

    Symptom scores, functional walk tests, autonomic retesting, and return-to-work milestones.

  4. 04

    Home plan and follow-up

    Read this first: home programme, medication, return-to-work plan, employer letter.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealix

Insurers cover long COVID inconsistently - usually assessment and some rehab, sometimes with session caps.

Frequently asked

Everything we get asked about long COVID clinics.

  • What is long COVID and how is it diagnosed?

    Long COVID is a cluster of symptoms - fatigue, PEM, breathlessness, palpitations, brain fog, sleep disturbance - that persist beyond 12 weeks after SARS-CoV-2 infection. Diagnosis is clinical, once treatable mimics have been ruled out.

  • Is long COVID care available on the NHS?

    Yes - NHS long COVID clinics exist across England, but access is uneven and waiting lists are commonly 3–12 months. Some ICBs have decommissioned services. If your local NHS clinic can see you within a sensible window, we point you there.

  • What does the multidisciplinary programme include?

    Rehab physio for graded, symptom-titrated activity; OT for pacing and cognitive load; psychology for adjustment and mood; and dietitian input where relevant. A consultant reviews weekly. Programmes usually run 6–12 weeks.

  • Is graded exercise therapy safe for long COVID?

    For patients with post-exertional malaise (PEM), no. NICE ME/CFS guidance explicitly warns against fixed, incrementally-increasing exercise programmes because they trigger relapse. Our physios work to pacing and symptom-titrated activity.

  • How much does private long COVID care cost in the UK?

    A consultant consultation is £250–£500. A 6–8 week multidisciplinary programme is £1,500–£4,000, and a 12-week programme is £3,500–£6,500. Autonomic testing is £450–£800 and CPET £500–£850.

  • How long is recovery - will I get back to normal?

    Most patients improve gradually over 6–24 months with the right pacing, treatment of specific problems and mood support. A minority reach full recovery within 12 months; a significant group have a longer trajectory.

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