National Health Service
The National Health Service (NHS) is the UK's universal health care provider, and is free at the point of need (exception for minor charges like some prescriptions, glasses, or dental care). The NHS was created in 1948, with the aim of providing good health care to all, regardless of wealth. The NHS provides healthcare to over 64 million, and the NHS website is the UK's biggest health website. 
The NHS is publicly funded; mainly through UK taxes and National Insurance (social security) deductions from employers' and individuals' personal income.
NHS diagnostic criteria for CFS/ME[edit | edit source]
The Fukuda criteria for Chronic Fatigue Syndrome are used to diagnosis CFS/ME in the UK.
Extreme physical and mental tiredness (fatigue)
- that doesn't go away with rest or sleep
- a different type of tiredness from you experienced before
- fatigue may feel overwhelming
Other symptoms may include:
- sleep problems, such as insomnia
- muscle or joint pain
- a sore throat or sore glands that aren't swollen
- problems thinking, remembering or concentrating
- flu-like symptoms
- feeling dizzy or sick
- fast or irregular heartbeats (heart palpitations)
Symptoms last at least 4 months in adults (3 months in children).
Exercising usually makes the symptoms of worse.
Sometimes the effect is delayed and you'll feel very tired a few hours after you've exercised, or even the next day.
Source: NHS (2018)
This has been criticized as being too broad. 
NHS treatment of ME/CFS[edit | edit source]
The NHS regards Chronic Fatigue Syndrome and Myalgic Encephalomyelitis as the same illness, and refers to both as Chronic Fatigue Syndrome. Specialist services are commissioned in some areas; in other areas GPs provide treatment instead. 
NICE Guidelines[edit | edit source]
British patients receive free care from the NHS, but treatments generally to follow the NICE guidelines from 2007. A recent review of these heavily criticized NICE guidelines resulted in the decision to update them. Currently, the NICE guidelines recommend that Graded exercise therapy (GET) and Cognitive behavioral therapy (CBT) should be offered, based on evidence the PACE trial. The guidelines also cover pacing, lifestyle changes and medication options. There are no medications licensed for CFS/ME, but medications are available for some symptoms.
See an example "Chronic Fatigue Service" described here.
Learn more[edit | edit source]
NHS Choices[edit | edit source]
NHS Choices is a consumer facing web site published by the National Health Service. It provides summarised information for both lay people and clinicians about health conditions, recent research as well as information such as how to find a local General Practitioner (GP).
References[edit | edit source]
- "About the NHS". nhs.uk. Retrieved Oct 4, 2018.
- NHS. "About us". NHS. Retrieved Oct 4, 2018.
- NICE (Aug 2007). "Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy): | Guidance and guidelines | Surveillance Decision | NICE". NICE. Retrieved Oct 4, 2018.
- NHS (May 16, 2017). "Chronic Fatigue Syndrome - Symptoms". NHS. Retrieved Oct 4, 2018.
- No Dissing! NHS Choices Behind the Headlines needs to repair relationship with its readers by James C. Coyne - Quick Thoughts - Nov. 29, 2015
myalgic encephalomyelitis (ME) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.
chronic fatigue syndrome (CFS) - A controversial term, invented by the U.S. Centers for Disease Control, that generally refers to a collection of symptoms as “fatigue”. There have been multiple attempts to come up with a set of diagnostic criteria to define this term, but few of those diagnostic criteria are currently in use. Previous attempts to define this term include the Fukuda criteria and the Oxford criteria. Some view the term as a useful diagnostic category for people with long-term fatigue of unexplained origin. Others view the term as a derogatory term borne out of animus towards patients. Some view the term as a synonym of myalgic encephalomyelitis, while others view myalgic encephalomyelitis as a distinct disease.
graded exercise therapy (GET) - A gradual increase in exercise or activity, according to a pre-defined plan. Focuses on overcoming the patient's alleged unhelpful illness beliefs that exertion can exacerbate symptoms, rather than on reversing physical deconditioning. Considered controversial, and possibly harmful, in the treatment or management of ME. One of the treatment arms of the controversial PACE trial.
pacing - The practice of staying within one's "energy envelope" by interspersing periods of activity with periods of rest. ME/CFS patients use pacing to avoid or reduce post-exertional malaise (PEM). Some patients use a heart rate monitor to help with pacing.