COVID-19 and long COVID

While we don't have a specific COVID-19 or long COVID Specialist Clinic (Outpatient service), we do accept long COVID patients to our other specialists based on their symptoms and presenting complaints.

Key points

The RMH does not have a dedicated COVID-19 or long COVID specialist clinic (outpatient) service
Patients can be referred to the most appropriate specific service for care based on their symptoms

Patients need a referral from their GP or healthcare provider. Access referral information

What we do

The Royal Melbourne Hospital (RMH) does not have a specific COVID-19 or long COVID-19 specialist clinic (outpatient service). However, we do accept long COVID patients to our other services, depending on symptoms.

Guidelines for referring long COVID patients

The RMH uses the Department of Health guidelines to manage patients with long COVID-19 and requests that GPs and other referrers review these guidelines before referring to the RMH for care. These guidelines list current services that can be considered to provide consultation for post COVID-19 symptoms.

Patients should be referred to the most appropriate specialist for consultation based on their current symptoms and presenting complaints.

Our clinics

Find out more about our Specialist Clinics (Outpatients).

Who can use our service

Long COVID patients are classified as those who have multiple, persistent symptoms that:

Have lasted for more than 2 months
Developed after, or have been exacerbated by, a COVID-19 infection (at least 3 months ago)
Cannot be explained by an alternative diagnosis (that is a diagnosis of probable or confirmed long COVID)

These symptoms must be:

Having an impact on daily activities, such as work, study, school or carer role, or
Worsening or unresponsive to medical management so requires further advice on, or a review of, the current management plan

A different service should be considered for patients who do not meet these referral criteria.

Who our service is not for

Referral to a public hospital is not appropriate for patients who:

Are not able to actively participate in an assessment process or where the patient, or their carer, does not consent to being referred to a public hospital service
Do not have a probable or confirmed diagnosis of long COVID
Want to receive services as a compensable patient should not be referred to a health service that only provides publicly funded services

We will usually not accept referrals related to occupational physician support or return to work plans.

Where appropriate and available, we may direct referrals for patients eligible for compensable services (such as through WorkSafe) to an alternative specialist clinic or service.

Which service is most appropriate

Patients with single symptoms should be referred to the most appropriate service for that symptom. For example, patients with a single symptom of fatigue should be referred to a rehabilitation service.

The following other statewide referral criteria include reference to post-COVID-19 symptoms:

See 'Referrals' in the health professionals tab below for information to include in a Specialist Clinic referral request.

For patients

For health professionals

Referrals

We accept GP and specialist referrals:

Use The RMH GP Referral Form or a template from your own system
Complete and fax your referral to Specialist Clinics (Outpatients) on (03) 9342 4234

We do not accept email referrals.

What to include in your referral

As outlined by the Department of Health, referral requests should include:

Patient demographic information
Referrer demographic information
Reason for referral
Presenting problem
Service(s) requested
Required referral information specified by statewide or local referral criteria
Current patient management
Impact of the problem on the patient
Name of the consultant and provider number (for Medicare clinics)
Investigation reports related to the referral

Urgent and after-hours support

Referrals are triaged based on priority. In an emergency, patients can go to the Emergency & Trauma Service at any time.

For advice, urgent referrals and out of hours support, call The RMH Switchboard on (03) 9342 7000 to page our registrar on call.

View Dept of Health guidelines

Special referral instructions

Required information for long COVID patients

In addition to the standard referral information listed above, include the following for long COVID patients:

Reason for referral, as well as the expectation or outcome anticipated by the patient (or their carer) and the referring clinician
Onset, nature and duration of symptoms linked to COVID-19 infection with details on pre-morbid function
Month and year of COVID-19 infection(s)
Full blood examination, liver function tests, urea and electrolytes
Comprehensive past medical history, particularly any history of infectious mononucleosis (glandular fever) or chronic fatigue syndrome
Current and complete medication history (including non-prescription medicines, herbs and supplements)
Investigations, imaging and medical or allied health assessments relevant to any of the following symptoms of concern (only provide if the patient has any of these symptoms of concern):
- Chest pain – provide details of any previous cardiology assessments or opinions
- Shortness of breath or respiratory symptoms – provide any relevant x-ray, imaging or investigation results, D-dimer test results and any previous respiratory assessments or opinions
- Cognitive issues – provide thyroid stimulating hormone levels, vitamin B12 and folate test results, pre-infection psychological status and cognitive function and current level of cognitive function
- Fatigue – provide iron studies or serum ferritin, thyroid stimulating hormone levels, vitamin B12 and folate test results
- Functional impairment – provide pre-infection level mobility or activities of daily living, or both, and current level of function or degree of impairment
Whether the patient is eligible for compensable services (for example, through WorkSafe)

Provide if available

If available, also include:

Results from most recent COVID-19 Yorkshire rehabilitation screening tool, or similar symptom burden questionnaire (available on HealthPathways)
Pre-exercise screening (for example, 6-minute walk test, incremental shuttle walk test)
Any other underlying pathology that has been assessed and is being managed
If the person identifies as an Aboriginal and/or Torres Strait Islander
If the person is part of a vulnerable population such as:
- People from culturally and linguistically diverse backgrounds
- Older Australians
- Carers of people with chronic conditions
- People experiencing socio-economic disadvantage
- People living in remote, or rural and regional locations
- People with a disability
- People with mental illness
- People who are, or have been, incarcerated
- People who are terminally ill
- People with experiences of family violence
- People in out-of-home care, foster care or state care

HealthPathways Melbourne provides guidance on best practice assessment and management of common medical conditions, including when and where to refer patients.

Parkville Connect is a secure web-based portal providing GPs, specialists and other health professionals with information in the Parkville electronic medical record (EMR).