Information for GPs


The South Tees CFS/ME service is based in the Centre for Clinical Infection at The James Cook University Hospital, Middlesbrough.  The service is commissioned for patients over 18, registered with a GP in the Teesside and, Redcar and Cleveland areas.

Patients in North Yorkshire should be referred to the Yorkshire Fatigue Clinic.

Referral process

Referrals are to be made via the NHS e-referral system (formerly Choose and Book).

Please be aware that the service is commissioned for people with CFS/ME and we are unable to offer input to those with chronic fatigue associated with other health conditions, e.g. neurological disorders, obesity, active mental health difficulties etc. 

Referral criteria

Inclusion criteria Exclusion criteria
Patients MUST currently be reporting FATIGUE which:

  • is the principal symptom
  • of definite onset and NOT lifelong
  • is severe, disabling and significantly impedes everyday life (e.g. education, work, socialising)
  • affects BOTH physical and cognitive functioning (e.g. memory, concentration, problem solving)
  • has been present for in excess of 4 months, and present for at least 50% of this time

Patients MUST be 18 years of age or older

Patients MUST be willing / able to attend outpatient appointments and engage in a therapeutic rehabilitation programme



Patients should NOT be referred if their fatigue can be explained by any other medical condition known to cause chronic fatigue eg:

  • active medical conditions such as; sleep apnoea, untreated hypothyroidism, anaemia, diabetes
  • recognised side effects of medication
  • a previously diagnosed medical condition whose resolution has not been documented beyond reasonable doubt, e.g. malignancy, unresolved Hepatitis B or C, viral infections
  • alcohol or substance misuse
  • severe obesity (BMI 40 or over)
  • active pre-existing mental health conditions, e.g. depression, anxiety, PTSD




Patient information required

  • presenting symptoms and how they impact everyday life
  • past medical / psychiatric history
  • current medication and drug allergies
  • pre-referral test results
  • any interpretation required and which language
  • any other special requirements e.g. sensory impairment, learning difficulty etc.

Pre-referral investigations required

  • FBC, U&E, LFTs, TSH, CK, ESR or PV, CRP, random blood glucose and coeliac screen
  • RhF / ANF (if arthralgia present)

All the above must be present or the referral will be declined!

Referral screening

Referrals are screened by Consultant and CFS/ME Clinical Lead, Dr John Williams.  Should any information be incomplete or the patient does not meet service criteria, the referral will be declined and the patient’s appointment cancelled.

Best practice guidelines

NICE guidelines

In 2015 NICE produced pathways deriving from the 2007 Clinical Guidance (CG53) for CFS/ME.  The pathways detail best practice for; assessment and diagnosis, management, and specialist care.  They can be downloaded below.

BACME guidelines

In 2015, the British Association for CFS/ME (BACME) released a guide detailing best practice for symptom management and therapy provision.  This is a particularly useful guide for GPs and other health professionals in primary care.

Advice and guidance

If you would like to discuss a referral or you have a query relating to a patient with CFS/ME, please do not hesitate to contact the service on: 01642 854462 or 835677.