Sentinel’s ME/CFS service is the primary chronic fatigue service for the West Devon area. It aims to provide assessment and treatment sessions, for patients diagnosed with ME/CFS.

Chronic Fatigue syndrome

Myalgic Encephalomyalitis (ME) / Chronic Fatigue Syndrome (CFS) is a fluctuating condition that is characterised by persistent or relapsing fatigue. It affects everyone differently with varying severity and long-term outlook, although there are lifestyle changes that people can make, to help manage their condition. The World Health Organisation (WHO) classifies ME/CFS as a neurological condition; whose symptoms can be as disabling as other serious diagnosis such as rheumatoid arthritis and cardiac conditions. The National Institute of Clinical Excellence (NICE) estimates that over 250,000 people in England and Wales have ME/CFS.

Currently the causes of ME/CFS are uncertain. Onset can be acute and possible causes
include persistent viral infections, immune disturbance, genetic vulnerability and prolonged and persistent stress. International research into the condition and its causes is on-going.

suspecting a diagnosis of ME/CFS

It is important to know that there is currently no diagnostic test for ME/CFS. It is recognised on clinical grounds alone, when all other causes for the debilitating fatigue and other symptoms have been excluded. In order to do this it is recommended that people undergo thorough medical assessment by their GP first, including blood tests, prior to being assessed for ME/CFS.

what are the symptoms of ME/CFS?

Following the release of the updated NICE guidelines, the criteria for suspecting and considering a referral to a specialist ME/CFS service is now more stringent. Patients should only be referred if they are experiencing  all 4 symptoms outlined below for 3 months or more.
If a person’s ability to engage in occupational, educational, social or personal activities is significantly reduced from pre-illness level as a result of their symptoms, then a referral to this specialist ME/CFS team should be considered.

NICE guidelines

The National Institute of Care Excellence offer guidelines and recommendations for a range of different health conditions. The recommendations are always evidence-based, and set out the care and services suitable for most people with a specific condition. Sentinel Healthcare Southwest CIC is commissioned to provide treatment based on NICE guidelines. These have been updated for ME/CFS in October 2021, and as a result the assessment and treatment approach within this service has been reviewed to ensure it’s adherence to the latest NICE recommendations.

Symptoms

    1. Debilitating fatigue that is worsened by activity, is not caused by excessive cognitive, physical, emotional or social exertion, and is not significantly relieved by rest.
    2. Post-exertional malaise after activity in which the worsening of symptoms:
      • is often delayed in onset by hours or days
      • is disproportionate to the activity
      • has a prolonged recovery time that may last hours, days, weeks or longer.
    3. Unrefreshing sleep or sleep disturbance (or both), which may include:
      • feeling exhausted
      • feeling flu-like and stiff on waking
      • broken or shallow sleep
      • altered sleep pattern or hypersomnia.
    4. Cognitive difficulties (sometimes described as ‘brain fog’), which may include:
      • problems finding words or numbers
      • difficulty in speaking
      • slowed responsiveness
      • short-term memory problems, and difficulty concentrating or multitasking.

    A person’s fatigue should not be life-long in origin or caused by excessive working hours

Service Outline

We are a small, part-time team comprised of 6 medical hours per month, and the hours equivalent of one therapist, covering West Devon.

Due to limited resources we are unable to offer long-term contact with patients, or to conduct home assessments or visits. If patients have severe ME/CFS resulting in being bedbound or housebound, it is appropriate for their GP to refer them to Adult Social Care/Intermediate Care Teams with their agreement, as a care package and equipment may be required. We would then liaise with these services to offer a combined treatment approach.

Office Hours

Mon-Weds 9:30am- 4:30pm

Telephone: 01752 435205

Referral Process

There is a standardised referral form available from the Devon formulary Website. We require detail regarding precipitating factors, duration and the impact on the patient’s functional ability. This must be completed by the GP and not the patient themselves.

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