Rehabilitation Medicine consultants have depth and breadth of knowledge through formal medical training and experiential knowledge to assist individuals holistically address symptoms diagnostically and prognostically to minimise illness and optimise health, wellbeing and quality of life. The service is rehabilitative and time-limited.
It is a Lothian-wide service for patients who have been given, and accepted, a diagnosis of Long Covid, ME/CFS or Post-Viral Fatigue Syndrome. The service is based at the Cunningham Unit, Astley Ainslie Hospital and works closely with a multi-professional team including specialists in speech and language, physiotherapy, occupational therapy, psychology and the Lothian Work Support Service.
Baseline investigations and referral form criteria should be met and investigations with other services completed prior to referral. Please ensure patient acknowledgement that referral to the clinic is not for further clinical investigation or the prescription of unlicensed medication/ treatments.
Please also see recognised clinical investigation pathways of relevance below:
- Post COVID breathlessness pathway including when pulmonary embolism is suspected; Respiratory-Post-Covid-Syndrome-v10.pdf
- Not all Post-Covid breathlessness is respiratory in nature:
- Consider dysautonomnia or POTS. See RefHelp page on PoTS here: Postural Tachycardia Syndrome (PoTS) – RefHelp and Home – PoTS UK
- Chronic spontaneous urticaria (and mast cell activation syndrome) Chronic spontaneous urticaria – RefHelp
- Patients with ongoing fevers >38oC or symptoms of infection of more than 3 weeks duration, documented in a temperature diary, where no other explanation for the fever is apparent, especially if the patient is immunocompromised, should be referred to Infectious Diseases
- Patients with symptoms more suggestive of a possible cancer diagnosis (such as lymphadenopathy or unexplained weight loss) should be urgently referred via the appropriate USOC Sci Gateway pathway see: Supporting documents – Summary: Scottish Referral Guidelines for Suspected Cancer 2025 – gov.scot
- GPs can refer directly for CT scan of the chest / abdomen / pelvis for those with non-specific features concerning for malignancy GP Access to CT for Suspected Cancer (No Clinically Obvious Primary) – RefHelp
- Please note – Digital support pathway for long COVID is no longer available
AH & MA 17/12/25
Who can Refer
- GP
- ME/CSF service staff members
Who to refer:
Individuals with a clear diagnosis of Long Covid/ME-CFS* (confirmed by undertaking a full history, examination and baseline investigations in line with Recommendations | Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management | Guidance | NICE and/or Overview | COVID-19 rapid guideline: managing the long-term effects of COVID-19 | Guidance | NICE) – who are seeking to explore and holistically address symptoms diagnostically and prognostically to minimise illness, optimise wellbeing and quality of life.
* Please consider referring ME/CSF patients to Chronic Fatigue Rehabilitation Service: ME-CFS – RefHelp service first.
Who not to refer:
- Patients where the diagnosis of ME-CFS is unclear or investigations are ongoing.
- Patients should not be referred to this service for confirmation of diagnosis.
- Patients seeking further investigations or the prescription of unlicenced medications.
How to refer:
To refer to this service please complete the referral form criteria and send by email to: loth.csireferrals@nhs.scot
