Information for GPs

Referrals

The South Tees CFS and 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.

Referral process

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

Referral criteria

Inclusion 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 (for example education, work, socialising) affects BOTH physical and cognitive functioning (for example memory, concentration, problem solving) has been present for in excess of four months, and present for at least 50% of this time.

Patients MUST be 18 years of age or older. Patients MUST be willing and able to attend outpatient appointments and engage in a therapeutic rehabilitation programme.  

Exclusion criteria

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, for example 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)

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

NICE pathways detail best practice for; assessment and diagnosis, management, and specialist care.  They can be downloaded viat he NICE website.

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.