Delivering as a CCG

Chronic Fatigue Syndrome service

Current provision

The current service at Nottingham University Hospitals (NUH) assesses and helps those patients diagnosed with mild to moderate Chronic Fatigue Syndrome (CFS). The service supports patients to develop appropriate strategies for managing their symptoms and improving their quality of life.

Patients begin with a therapist or consultant assessment. Patients can be discharged at this point with advice, or they can receive one or more of the following interventions:

  • 6-8 individual sessions with an occupational therapist
  • 9 week group programme led by appropriate therapists
  • 10 -12 individual Cognitive Behavioural Therapy (CBT) or Psychology sessions

Case for change

The National Institute for Clinical Excellence (NICE) has published guidelines for CFS management which recommend the following:

  • Patients and therapists working together
  • Cognitive Behavioural Therapy
  • Grade Exercise Therapy

NICE highlights that these are the interventions for which there is the clearest evidence of benefit.  In addition the guidelines advise that CFS services should provide support if symptoms worsen during treatment and should develop a plan to manage relapses.

In support of NICE guidelines, value for money and in line with the priorities and principles of the Sustainability and Transformation Plan, it is proposed that a community based service is commissioned.

Proposal for community based service to meet the needs of patients with CFS

The proposal is that a community based service will provide the following:

  • Be delivered by a multi-disciplinary team which will include appropriate CFS specialists that can triage all referrals and manage patient’s physical, psychological and social needs
  • Act as a single point of access for patients with chronic pain or CFS providing a simpler patient journey
  • Provide a holistic assessment and management approach for patients with chronic pain or CFS as early as possible in the pathway
  • Support patients living with chronic pain or CFS and their nominated carers to:
    • manage their own condition and make decisions about self-care and treatment
    • allow them to live as independently as possible continue care and support (where appropriate) learnt through the service post discharge
  • Provide appropriate access points for patients and carers following discharge to support in the management of flare ups and avoid re-entry into the service where possible

This service will provide evidence based interventions only, as identified by NICE.  The Group Therapy that is currently provided will not continue.  There will be some cost savings by following NICE guidance.

Tell us what you think

The engagement period for this service review has now ended.  For an update on the decisions on services, click here.


If you would like a paper copy of the You-said-we-did Summary,  please call 0800 028 3693 (option 2)

For further comments, please send your comments to the Patient Experience Team on or write to:


Patient Experience Team

South Nottinghamshire CCGs

Civic Centre

Arnot Hill Park




If you would like a paper copy of the You-said-we-did summary please call 0800 028 3693 (option 2)


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