Purpose and primary audience

This toolkit, which is delivered as a mobile app and as a website, provides recommendations for decision-making based on SIGN Guideline 161 - Managing the long-term effects of COVID-19 and additional targeted information for clinicians to support the implementation of this guideline from the Scottish Government Implementation Support Note

The app and website present current evidence and recommendations on assessment, investigations and referral, planning care, management and follow up for people experiencing long-term effects of COVID-19, as well as case definitions for different stages of individuals’ experiences of symptoms. It contains information and links to resources which support a consistent national approach to clinical assessment, shared decision making and individualised care planning conversations, including self management and further referral where needed.

This software is an informational and educational resource. It is not a medical device as defined by the Medical Devices Directive.

Why was this app developed

This app and website have been developed to provide health and care practitioners with quick and easy access at point of care to evidence-based recommendations and learning resources for the identification, investigation, assessment and management of people experiencing long-term effects of COVID-19.

This new and emerging condition, which has been described using a variety of terms including ‘long COVID’, can have a significant effect on people’s quality of life. It also presents many challenges when trying to determine the best-practice standards of care based on the current evidence. Until the publication of the guideline on which this easy access toolkit is based there was no clinical definition or clear treatment pathway, and there remains a minimal, though evolving, evidence base.

Organisations involved in this app/website

This UK-wide guideline has been developed collaboratively by SIGN, NICE, and the Royal College of General Practitioners (RCGP).  

SIGN is a collaborative network of clinicians, other healthcare professionals and patient organisations and is part of Healthcare Improvement Scotland.

NICE provides national guidance and advice to improve health and social care.

The Royal College of General Practitioners is the professional body for general practitioners in the United Kingdom.

The guideline on which this toolkit is based was developed by a multidisciplinary panel of healthcare professionals and patient representatives using a standard methodology based on a systematic review of the evidence.

Further details can be found in Developing NICE guidelines: the manual (Appendix L: Interim process and methods for guidelines developed in response to health and social care emergencies), available at nice.org.uk

The Scottish Government Implementation Support Note was developed with input from key stakeholders including those from the Clinical Leads Advisory Group for Scotland, COVID-19 Clinical Guidance Cell, Specialty Advisors to the Chief Medical Officer, senior medical advisors to the Scottish Government, people with lived experience and the third sector and SIGN.

Digital Health and Care Institute (DHI): The Digital Health and Care Institute is a health and care innovation centre based in the University of Strathclyde. It is  funded jointly by Scottish Government Digital Health and Care and the Scottish Funding Council. DHI plays a pivotal role in inspiring, enabling and combining industry and academic expertise with service, business and technical innovation to create person-centred digital health and care innovations. DHI focuses on shifting the balance of care from a traditional treatment model, through the development of digital health and care innovations that focus on prevention, early detection, post event care and independent assisted living.  

DHI leads and manages the national Decision Support Programme on behalf of Scottish Government, as a core objective within Scotland’s Digital Health and Care Strategy. The app and website have been built using the Right Decision Service tools which DHI has developed as a key deliverable for the national programme. 

NHS Greater Glasgow and Clyde Library Network:  The  NHSGGC Library Network provides library and information services to all staff working within NHSGGC and its partner organisations. 

As part of the National Decision Support Programme, NHSGGC Knowledge Services provide knowledge management expertise to support use of Right Decision Service tools. 

Tactuum Ltd: is a software company based in Glasgow, with an office in the US. Tactuum’s mission is to improve healthcare services through the delivery of digital services supporting healthcare providers and patients.  Tactuum provides the technology and digital expertise to deliver Right Decision Service tools for the National Decision Support Programme. 


We (Healthcare Improvement Scotland) hope that the information in this app/website will be useful to you, but we accept no responsibility and offer no warranties for the content or your use of it, as far as the law allows us to exclude such liability. 

Clinical knowledge is constantly changing. As new information become available, changes in treatment, procedures, equipment and the use of drugs become necessary. The developers and contributors have taken care to ensure that the information given is correct and current. However, users of this resource are strongly advised to confirm that the information complies with the latest legislation and standards of practice. 

All use of this resource is subject to Scots law and the jurisdiction of the Scottish courts and is subject to this disclaimer. Any views given on the site are not necessarily those of Healthcare Improvement Scotland or anyone connected with us. 

Healthcare Improvement Scotland is not responsible for the content of external websites which link to or are linked to by this application. This is because: 

  • Healthcare Improvement Scotland does not produce or maintain them 
  • Healthcare Improvement Scotland cannot change them, and 
  • they can be changed without Healthcare Improvement Scotland knowledge or permission.

Some external links may be to websites that also offer commercial services. If a link to a particular website is included on our site, it does not mean that Healthcare Improvement Scotland officially endorses that website, its owners, products or services. 


Copyright information for the two sources of content within this app/website is shown below. 

Scottish Intercollegiate Guidelines Network (SIGN); National Institute of Health and Care Excellence (NICE): The Royal College of General Practitioners, 2020. Managing the long-term effects of COVID-19. SIGN 161. Edinburgh: SIGN; 2020. 

Copyright of this guideline is retained by SIGN. Users may download or print copies for their own use and may photocopy guidelines for the purpose of implementation.  

The review is licensed under the Creative Commons Attribution-Noncommercial-NoDerivatives 4.0 International Licence. This allows for the copy and redistribution of SIGN guidelines as long as SIGN is fully acknowledged and given credit. The material must not be remixed, transformed or built upon in any way. View a copy of this licence here.   

Please cite the review as: Scottish Intercollegiate Guidelines Network (SIGN). Managing the long-term effects of COVID-19. Edinburgh: SIGN; 2020. [cited dd mmm yyyy]. Available from URL: https://www.sign.ac.uk/our-guidelines/managing-the-long-term-effects-of-covid-19/  

Users wishing to use reproduce or republish SIGN material for commercial purposes must seek prior approval for reproduction in any medium by completing the form here. Applicants for such permission should be aware that:  

  • SIGN resources do not endorse specific products.  
  • Reproduction of SIGN material must be verbatim.  
  • Within marketing material there must be a clear separation between any SIGN material and product specific information or marketing.  
  • SIGN does not endorse in any way derivative or excerpted materials based on these guidelines, and it cannot be held liable for the content or use of any such adapted products.  
  • The use of the SIGN name or logo for the purposes of advertising or implied endorsement of any derived product or service is strictly forbidden. 


SIGN, NICE and the RCGP have committed to developing the guideline using a ‘living’ approach, which means that targeted areas of the guideline will be continuously reviewed and updated in response to emerging evidence.  Technical maintenance and updating of the app is carried out by Tactuum Ltd and funded through the national decision support programme led by the Digital Health and Care Institute.   


The app is compliant with:

  • Android and Apple accessibility standards for native mobile apps
  • The website is compliant with WC3A 2.0 Standards.

Browser and operating system compatibility

  • The app is supported by Android 4.4 or later and iOS 8.0 or later devices.
  • The website is optimised for use on both desktop and mobile devices in the following browsers - IE9+, Chrome, Edge and Safari.


Please use this form to provide feedback about this app / web: SIGN Managing the long-term effects of COVID feedback form.