{"id":33306,"date":"2021-11-02T12:28:02","date_gmt":"2021-11-02T12:28:02","guid":{"rendered":"https:\/\/wames.org.uk\/cms-english\/?p=33306"},"modified":"2021-11-07T12:11:55","modified_gmt":"2021-11-07T12:11:55","slug":"nice-me-cfs-guideline-me-community-expresses-hope-caution","status":"publish","type":"post","link":"https:\/\/wames.org.uk\/cms-english\/nice-me-cfs-guideline-me-community-expresses-hope-caution\/","title":{"rendered":"NICE ME\/CFS guideline &#8211; ME community expresses hope &#038; caution"},"content":{"rendered":"<h2><strong>NICE ME\/CFS guideline<\/strong><\/h2>\n<h2 style=\"padding-left: 40px;\"><strong>Cautious welcome from WAMES &amp; the ME community<\/strong><\/h2>\n<h3><\/h3>\n<p>WAMES welcomes the publication of the <a href=\"https:\/\/www.nice.org.uk\/guidance\/ng206\" target=\"_blank\" rel=\"noopener\">2021 NICE guideline for ME\/CFS<\/a> and the decision by NICE to \u2018follow the science\u2019 regarding the inappropriateness of GET and CBT as treatments for ME\/CFS. Any inflexible treatment based on theories of deconditioning and faulty beliefs, (which encourage people to pushing beyond ones limits) are now recognised to be harmful, and instead <a href=\"https:\/\/me-pedia.org\/wiki\/Pacing\" target=\"_blank\" rel=\"noopener\">Pacing<\/a> or energy management, (learning to function better within one&#8217;s energy envelope), is the recommended management approach.<\/p>\n<p><img data-recalc-dims=\"1\" decoding=\"async\" class=\"alignright size-medium wp-image-33336 lazyload\" data-src=\"https:\/\/i0.wp.com\/wames.org.uk\/cms-english\/wp-content\/uploads\/2021\/11\/climbing-helping.jpg?resize=300%2C300&#038;ssl=1\" alt=\"\" width=\"300\" height=\"300\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 300px; --smush-placeholder-aspect-ratio: 300\/300;\" \/>Add to that the inclusion of <a href=\"https:\/\/me-pedia.org\/wiki\/Post-exertional_malaise\" target=\"_blank\" rel=\"noopener\">Post-Exertional Malaise<\/a> as an essential diagnostic criteria and <strong><span style=\"color: #339966;\">we hopefully have a solid base to build a healthcare approach on<\/span><\/strong>, while recognising that there is much scope for improvement and research.<\/p>\n<p>We believe that the delay in publishing was a serious error on NICE\u2019s part. It caused immense distress to patients and their families and possible harm, especially to those who are newly diagnosed. It delayed the start of much needed change and failed to achieve the support from health professionals who had objected to the stricter definition of ME and the removal of the therapies they practised.<\/p>\n<p>We are not optimistic that the road to healthcare improvement will be speedy and smooth. Some of the language in the guideline is unclear and open to interpretation, and there is still a significant amount of opposition to implementing the changes, with signs that some services could attempt to rebrand, rather than change their practices. Within Wales there is also little understanding of ME and PEM so it will be harder to share and spread \u2018good practice\u2019. We are however committed to working with Welsh Government, commissioners, NHS Wales and Social Care Wales to <strong><span style=\"color: #339966;\">use the Guideline to start to tackle the healthcare crisis that is ME\/CFS in Wales.<\/span><\/strong><\/p>\n<p>&nbsp;<\/p>\n<h3><strong>WAMES&#8217; medical advisor says:<\/strong><\/h3>\n<p><em>&#8220;As a paediatrician who has had to defend many innocent families of children and young persons with ME from safeguarding proceedings, I hope that the guidelines will finally put a stop to this injustice, and that no longer will young people with ME\u00a0 be labelled as having \u201cMedically Unexplained Symptoms\u201d or being\u00a0 \u201cPerplexing Presentations\u201d as an excuse to refer to social services. Children and young people with ME deserve a firm positive diagnosis from their paediatricians. This will protect them from undue pressures, and\u00a0 lead to appropriate support and help.\u201d<\/em><\/p>\n<div id=\"attachment_1275\" style=\"width: 160px\" class=\"wp-caption alignleft\"><img data-recalc-dims=\"1\" decoding=\"async\" aria-describedby=\"caption-attachment-1275\" class=\"wp-image-1275 size-thumbnail lazyload\" data-src=\"https:\/\/i0.wp.com\/wames.org.uk\/cms-english\/wp-content\/uploads\/2012\/04\/P1020748a2-150x150.jpg?resize=150%2C150&#038;ssl=1\" alt=\"\" width=\"150\" height=\"150\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 150px; --smush-placeholder-aspect-ratio: 150\/150;\" \/><p id=\"caption-attachment-1275\" class=\"wp-caption-text\">Dr Nigel Speight, WAMES medical adviser<\/p><\/div>\n<p style=\"text-align: right;\">Dr Nigel Speight,<br \/>\nAdvisor, WAMES<br \/>\nHonorary Fellow, Doctors with M.E.<br \/>\nPaediatric Physician,<br \/>\nCo- Author, International Consensus Criteria,<br \/>\nCo-Author, Pediatric Primer in Frontiers in Pediatrics,<br \/>\nAdvisor, 25% ME Group,<br \/>\nResearcher<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h3><strong>More statements:<\/strong><\/h3>\n<p>Below are links to organisations and individuals in the ME community who have reacted with delight and hope for the future, through to cautious longing and anger at the unscientific and bureaucratic delay.<\/p>\n<p><strong>Action for ME<\/strong>: <a href=\"https:\/\/www.actionforme.org.uk\/news\/nice-publish-guideline\/\" target=\"_blank\" rel=\"noopener\">NICE publish the guideline<\/a><\/p>\n<p style=\"padding-left: 40px;\">\u201cThe new NICE guideline is welcomed because it acknowledges the truth of people\u2019s experiences, and creates <strong><span style=\"color: #339966;\">a foundation for hope<\/span><\/strong> that future children and adults with ME will not repeat the anguish of the past.\u201d\u00a0(Sonya Chowdhury, CEO, Action for ME)<\/p>\n<p><strong>Doctors with ME<\/strong>: <a href=\"https:\/\/doctorswith.me\/nice-2021-a-triumph-of-science-over-discrimination\" target=\"_blank\" rel=\"noopener\">NICE 2021: A Triumph of Science over Discrimination<\/a><\/p>\n<p style=\"padding-left: 40px;\">Doctors with M.E. considers the launch of this guideline to be <strong><span style=\"color: #339966;\">a\u00a0watershed moment<\/span><\/strong> in the history of ME\/CFS medical care in the UK, with implications that extend to those Long Covid (PASC) patients who also meet ME\/CFS diagnostic criteria. [Includes quotes from Prof Brian Hughes, Caroline Kingdon, Tom Kindlon, Dr Karl Morten, Dr Charles Shepherd, Dr Nigel Speight, Dr David Strain, Dr William Weir, Dr Asad Khan, Dr Ben Marsh, Dr Shaun Peter Qureshi, Dr KN Hng, Dr Nina Muirhead, Dr Keith Geraghty, Dr Richard Ramyar]<\/p>\n<p><strong>Forward ME<\/strong>: <a href=\"https:\/\/forward-me.co.uk\/news-updates\/\" target=\"_blank\" rel=\"noopener\">New NICE guidelines on ME: forward-ME statement &amp; media support<\/a><\/p>\n<p style=\"padding-left: 40px;\">Doctors, and people with ME welcome the new NICE guideline on ME\/CFS, which brings major improvements to the diagnosis, management and support for people with ME &#8211; <strong><span style=\"color: #339966;\">driving\u00a0major improvements in care<\/span><\/strong><\/p>\n<p><strong>Invest in ME:\u00a0<\/strong><a href=\"https:\/\/investinme.org\/ng206-guidelines-publication-oct2021.shtml\" target=\"_blank\" rel=\"noopener\">NICE guidelines &#8211; taking us forward to 2007<\/a><\/p>\n<p style=\"padding-left: 40px;\">Following the \u2018veritable omnishambles \u2018 of the pause in NICE guideline publication Invest in ME (IiME) find the 2021 guideline \u201cis only able to <strong><span style=\"color: #339966;\">attempt to undo the damage<\/span><\/strong> done by inaction, ignorance, apathy and negligence during the past 14 years\u2026 it stands as a testament to 14 years of nothing much changing for people with ME, 14 years of failure from governments and establishment healthcare and research organisations in treating this disease.\u201d<\/p>\n<p><strong>#MEAction:\u00a0<\/strong><a href=\"https:\/\/www.meaction.net\/2021\/10\/29\/final-nice-me-cfs-guideline-published-find-out-the-big-news\/\" target=\"_blank\" rel=\"noopener\">Final NICE ME\/CFS guideline published &#8211; find out the big news!<\/a><\/p>\n<p style=\"padding-left: 40px;\">Overall, #MEAction UK is pleased that the final guideline is<strong><span style=\"color: #339966;\"> a significant improvement<\/span> <\/strong>on the 2007 CFS\/ME guideline&#8230;Concerns remain around how the section on incorporating physical activity will be implemented in practice. While some physiotherapists have a clear understanding of ME and can provide helpful support, others will require significant training and education to ensure harmful practices do indeed stop.<\/p>\n<p><strong>ME Association:<\/strong> <a href=\"https:\/\/meassociation.org.uk\/2021\/10\/the-new-nice-guideline-on-me-cfs-is-published\/\" target=\"_blank\" rel=\"noopener\">The new NICE guideline on ME\/CFS is published!<\/a><\/p>\n<p style=\"padding-left: 40px;\">After a very through review of all the evidence \u2013 from clinical trials, experts and patients \u2013 we now have a new guideline that has reversed these recommendations and should be widely welcomed by people with ME&#8230; The next challenge involves educating and training all health professionals on how to diagnose and manage ME and setting up a full network of hospital-based referral services where GPs can refer for further help.<\/p>\n<p><strong>MECFS Skeptic<\/strong> (Michiel Tack): <a href=\"https:\/\/mecfsskeptic.com\/a-historic-change-for-the-me-cfs-community\/\" target=\"_blank\" rel=\"noopener\">A historic change for the ME\/CFS community<\/a><\/p>\n<p style=\"padding-left: 40px;\">The development of the guideline has been a long process mired with controversy, criticism, and unexpected delays. Its final publication, however, represents a historic change for the ME\/CFS community&#8230; 29 October may turn out to be <strong><span style=\"color: #339966;\">a historical turning point<\/span><\/strong>. Hopefully, this will open the way to more fruitful scientific research on the illness and eventually, a cure.<\/p>\n<p><strong>ME Research UK<\/strong>: <a href=\"https:\/\/www.meresearch.org.uk\/response-to-updated-nice-guideline\/\" target=\"_blank\" rel=\"noopener\">Our response to the updated NICE guideline<\/a><\/p>\n<p style=\"padding-left: 40px;\">Today\u2019s publication by NICE of its updated&#8230; guideline marks <strong><span style=\"color: #339966;\">a significant step<\/span><\/strong> in both the acceptance of ME as a physical illness and the recognition of appropriate treatment needs of those affected by the condition.\u00a0We broadly welcome this significant update and improvement to the previous 14-year-old document, but<strong><span style=\"color: #339966;\"> it marks only the beginning of the transformation needed<\/span><\/strong> for ME to be more fully understood and, ultimately, for a cure to be found.<\/p>\n<p><strong>MESiG<\/strong>: Today, NICE have finally published the guidelines for ME\/CFS. This is <strong><span style=\"color: #339966;\">a big step in the right direction<\/span><\/strong>. Graded exercise Therapy is not to be offered as an effective treatment! #GETisGONE\u00a0 \u00a0<a href=\"https:\/\/www.facebook.com\/MESiGWales\/?ref=nf&amp;hc_ref=ARSJgghDzfOoKM1Y9OeIggOl9fXfMGj-fMFe_4laD2cFcVqwHf643heQYklKZSVbixU&amp;__xts__%5B0%5D=68.ARDEL-OXwyWAWza12-bs6EbOrsWOScbZFsnAhv-I0DcR5vSIABWFU_BBtqzkFGgkG1IA8fX0sbpPVH2oIKIw6f_k84uLEk3KOX_hxk20paBa-fxRwioWd9emdtSfrdMvd0tHuMgr5AnzsV6Fa0aIUTWDq6WZyrvPYbOMTVYljW1w_4OS9lyExZpc1Ay7q2qxwCdvRBbtTNfez2viE771KPLbjSOqZuWZ09N2uSN9ZYvml-JFfQywi0pt_C1T25sE4NnMaOiItGdTeQ2XelVbE9_l802tsnJIQ1xM3vt0wnamuaKN_utv6Q&amp;__tn__=%3C-R\" target=\"_blank\" rel=\"noopener\">Facebook 29 Oct 2021<\/a><\/p>\n<p><strong>ME Trust<\/strong>: <a href=\"https:\/\/metrust.org.uk\/new-nice-guideline-for-me-cfs\/\" target=\"_blank\" rel=\"noopener\">New NICE guideline for ME\/CFS<\/a><\/p>\n<p style=\"padding-left: 40px;\">The ME Trust welcomes the publication of the new NICE Guideline.\u00a0We are very pleased&#8230; and hope that it will improve the care and support available to people with this debilitating and chronic illness.<\/p>\n<p><strong>Solve MECFS:\u00a0<\/strong><a href=\"https:\/\/solvecfs.org\/archive\/\" target=\"_blank\" rel=\"noopener\">NICE publishes new guidance on diagnosing, treating ME\/CFS<\/a><\/p>\n<p style=\"padding-left: 40px;\">Most significantly, the new guidance removes recommendations for Graded Exercise Therapy (GET) due to poor quality evidence, and downgrades recommendations of Cognitive Behavioral Therapy (CBT). This is a <span style=\"color: #339966;\"><strong>historic victory<\/strong> <\/span>for millions with ME\/CFS.<\/p>\n<p><strong>Science 4 ME:\u00a0<\/strong><a href=\"https:\/\/www.s4me.info\/threads\/uk-nice-2021-me-cfs-guideline-published-29th-october-post-publication-discussion.22996\/\" target=\"_blank\" rel=\"noopener\">New NICE guideline creates hope for change at last<\/a><\/p>\n<p style=\"padding-left: 40px;\">Science for ME, an online forum for people with ME\/CFS, clinicians, and researchers, has welcomed the\u00a0much-anticipated\u00a0publication, calling it a <strong><span style=\"color: #339966;\">paradigm shift in the care of people<\/span><\/strong> with this debilitating condition &#8211; <span style=\"color: #339966;\"><strong><span style=\"color: #339966;\">hope for change<\/span>.<\/strong><\/span><\/p>\n<p>Tymes Trust<\/p>\n<p><strong>Virology (Prof Tuller)<\/strong>: Trial By Error: NICE liberates new ME\/CFS guideline after two-month hijacking nightmare<\/p>\n<p style=\"padding-left: 40px;\">It is hard to dispute the validity of many concerns raised by critics, including the tally of the damage caused by long-standing policies. Like any clinical guideline, this one is open to abuse by health care professionals who choose to ignore or misinterpret or mis-apply its recommendations. Nonetheless, as\u00a0another patient noted on Facebook, the publication is a way to \u201cbank some of the progress\u201d that has been made in correcting the scientific narrative\u2014and can serve as <strong><span style=\"color: #339966;\">an impetus for seeking related changes<\/span><\/strong> in medical practice and research.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>NICE ME\/CFS guideline Cautious welcome from WAMES &amp; the ME community WAMES welcomes the publication of the 2021 NICE guideline for ME\/CFS and the decision by NICE to \u2018follow the science\u2019 regarding the inappropriateness of GET and CBT as treatments &hellip; <a href=\"https:\/\/wames.org.uk\/cms-english\/nice-me-cfs-guideline-me-community-expresses-hope-caution\/\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[7101],"class_list":["post-33306","post","type-post","status-publish","format-standard","hentry","category-news","tag-nice-me-cfs-guideline"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p5qkYK-8Fc","_links":{"self":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/33306","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/comments?post=33306"}],"version-history":[{"count":10,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/33306\/revisions"}],"predecessor-version":[{"id":33394,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/33306\/revisions\/33394"}],"wp:attachment":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/media?parent=33306"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/categories?post=33306"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/tags?post=33306"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}