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Services 2

Chronic fatigue

The Team provides a multi-disciplinary service for adult patients with a diagnosis of Chronic Fatigue Syndrome (CFS).

Dandelion

 

We provide assessment, treatment, education and information for adults over 18 years old. Once appropriate investigations have been completed by the GP, patients will be assessed jointly by the Consultant Physician and a member of the therapy team. Other co-existing problems can also be managed by the team, as long as they do not exclude the diagnosis of Chronic Fatigue Syndrome or do not require other specialist services. We can also provide expert advice, education and support to health professionals, other organisations, families and carers as appropriate.

The service is based within the Department of Psychological Medicine at:

Clarendon House
Victoria House
Park Street
Hull
HU2 8TD

Tel: 01482 617735
Fax: 01482 322211

The general contact hours for the service are 9am to 5pm, Monday-Friday.

Assessment clinics are held at Castle Hill Hospital and the therapy aspect of the service is based at the Department of Psychological Medicine. Referral for Physiotherapy can be made by members of the CFS team as appropriate.

The team aims to enable patients to manage their symptoms independently and improve their own quality of life through the use of evidence-based interventions. It aims to work collaboratively with patients, patients’ families and their carers to establish an agreed approach to treatment and to work jointly with other services, as necessary, to meet the needs of patients holistically.

Because of the controversial nature of Chronic Fatigue Syndrome, we aim to promote a clear understanding of the facts for which there is evidence and address some of the negative attitudes around this topic; through the provision of information, supervision and training.

We believe that CFS is a condition whose causes are still largely unknown. Nevertheless the effects are well documented and these include physical, emotional and social consequences. Given that the causes are unknown, there is no single recognised ‘cure’. What we can offer is treatment to reduce the effects in the three areas mentioned above.

This service does not take the view that CFS is ‘all in the mind’, not do we believe that patients are mentally ill. However evidence suggests that, as with many long term physical conditions, there may be psychological or social issues which can predispose trigger or perpetuate CFS. Therefore our treatment approach reflects this and includes physical, social and psychological elements.

Treatment and interventions

Our team, though small, includes professionals with a variety of skills and is able to provide a number of treatment approaches.  These include pacing and graded activity, occupational therapy, psychological therapy, psychiatry and physiotherapy.

Appropriate supervision and training are maintained to ensure the above treatments are effectively delivered. Issues of sleep, stress, mood, relationships and medication are covered, if necessary, to facilitate the effective management of CFS. Short and longer term interventions are provided as appropriate, although all episodes of care are time limited to around 20 sessions due to demands upon the services and the team’s philosophy of promoting independence.

We make use of well-researched outcome measures to assess and monitor fatigue and psychological health. All patients are asked to complete these monitoring forms at the first assessment and again periodically throughout their treatment. Anonymised information from these measures is used to report on the effectiveness of the team’s work. If we undertake formal research by, going beyond normal outcome monitoring, patients will be expressly asked to give their consent for this and their care will not be affected if they decline to take part in any research project.

Referral criteria

Referrals are accepted from GPs only. Hospital consultants should normally ask the patient’s GP to make the referral. Referrals should be made in writing to the team using the CFS referral form which is available on the intranet and the referral should include results of necessary investigations, as detailed on the referral form; to screen for differential diagnoses. This should be completed before a diagnosis of CFS, or a referral to the service, is made. 

Key elements of the criteria for referral include:
• Fatigue must not have been lifelong
• Must have been present for at least 4 months
• Not explained by any other medical diagnosis
• Must result in substantial functional impairment
 
The team accepts referrals for adults above the age of 18 with no fixed upper age limit.  There is currently no service available locally for children.
If a diagnosis of CFS is secondary to another diagnosis, for example mental health problems or pain, the team may be able to work jointly with other services to address the chronic fatigue aspect of the problem, if appropriate.

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