text: Post COVID 19 assessment in a specialist clinical service a 12 month single centre prospective study in 1325 individuals Post COVID 19 complications require simultaneous characterisation and management to plan policy and health system responses We describe the 12 month experience of the first UK dedicated post COVID 19 clinical service to include hospitalised and non hospitalised patients In a single centre observational analysis we report the demographics symptoms comorbidities investigations treatments functional recovery specialist referral and rehabilitation of 1325 individuals assessed at the University College London Hospitals post COVID 19 service between April 2020 and April 2021 comparing by referral route posthospitalised PH non hospitalised NH and post emergency department PED Symptoms associated with poor recovery or inability to return to work full time were assessed using multivariable logistic regression 1325 individuals were assessed PH 547 41 3 PED 212 16 NH 566 42 7 Compared with the PH and PED groups the NH group were younger median 44 6 35 6 52 8 years vs 58 3 47 0 67 7 years and 48 5 39 4 55 7 years more likely to be female 68 2 43 0 and 59 9 less likely to be of ethnic minority 30 9 52 7 and 41 0 or seen later after symptom onset median IQR 194 118 298 days 69 51 111 days and 76 55 128 days all p 0 0001 All groups had similar rates of onward specialist referral NH 18 7 PH 16 1 and PED 18 9 p 0 452 and were more likely to require support for breathlessness 23 7 5 5 and 15 1 p 0 001 and fatigue 17 8 4 8 and 8 0 p 0 001 Hospitalised patients had higher rates of pulmonary emboli persistent lung interstitial abnormalities and other organ impairment 716 54 0 individuals reported 75 optimal health median 70 IQR 55 85 Less than half of employed individuals could return to work full time at first assessment Post COVID 19 symptoms were significant in PH and NH patients with significant ongoing healthcare needs and utilisation Trials of interventions and patient centred pathways for diagnostic and treatment approaches are urgently required 