Chronic Fatigue Syndrome

What is Chronic Fatigue Syndrome?

Chronic fatigue syndrome (CFS) is a long-term illness with a wide range of  symptoms. The most common symptom is extreme tiredness.

CFS is also known as ME, which stands for myalgic encephalomyelitis. There's some debate over the correct term to use for the condition, but this document will refer to it as CFS/ME.

CFS/ME can affect anyone, including children. It's more common in women, and tends to develop between the patients mid-20s and mid-40s. It can follow from a viral infection, quite often the trigger is unclear. In addition, patients with CFS/ME may have other symptoms, including:

  • Sleep problems
  • Muscle or joint pain
  • Headaches
  • 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)
  • Most people find over-exercising makes their symptoms worse.


The severity of symptoms can vary from day to day, or even within a day.

The symptoms of CFS/ME are similar to the symptoms of some other illnesses, so it's important that the patient sees their GP to get a correct diagnosis.

Most patients with CFS get better over time, although some people don't make a full recovery. It's also likely there will be periods when your symptoms get better or worse.

Children and young people with CFS/ME are more likely to recover fully.

Patient eligibility criteria

Based upon the evidence identified there is some evidence to show Cognitive Behavioural Therapy (CBT) has a positive impact on patients with CFS/ME through reducing symptoms of fatigue.

There was also moderate quality evidence that Graded Exercise Therapy (GET) was more effective at reducing fatigue compared to ‘passive’ treatment or no treatment and had a positive effect on people’s daily physical functioning, sleep and self-ratings of overall health.

CBT in the form of a pacing programme or an individualised care package (which combines CBT and GET as required to support the individual patient); will be funded through the commissioned provider in the following circumstances:

1. The patient has a confirmed diagnosis of mild or moderate CFS/ME


2. The patient has undergone a holistic assessment with a CFS/ME treatment specialist team and either a group programme, or individualised programme, has been deemed by the specialist clinical team the most appropriate intervention for the patient in their individual circumstances.

In patient care or therapy in a residential setting are not routinely commissioned for the treatment of CFS/ME due to the lack of clinical evidence to support this intervention.

This means (for patients who DO NOT meet the above criteria) the CCG will ONLY fund the treatment if an Individual Funding Request (IFR) application proves exceptional clinical need and that is supported by the CCG.

Advice and further guidance

  • For more information, search for ‘Chronic Fatigue Syndrome (CFS/ME)’ at
  • Choosing Wisely UKis part of a global initiative aimed at improving conversations between patients and their doctors and nurses.

Or visit the following website:

Treatment policy for patients covered by NHS Birmingham and Solihull CCG

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