Recurring concern

Inadequate professional competence in ME/CFS care

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First reported 8 Oct 2024•Latest report 7 Jul 2025

Definition

What this concern includes

Includes failures in professional training, education, knowledge, competence assurance or clinical understanding specifically concerning ME/CFS and its treatment, including severe ME, where the deficiency can impair recognition, support or care.

Not included

  • Excludes generic medical training or competence deficiencies where ME/CFS is not the material clinical condition.
  • Excludes failures in ME/CFS service availability, commissioning, research or implementation of clinical guidance where professional competence is not the deficient control.
  • Excludes failures in treatment, diagnosis or access to care after professionals have demonstrated adequate ME/CFS competence, unless the competence process itself is also deficient.
  • Excludes patient or public awareness concerns that do not concern the competence of healthcare professionals providing ME/CFS care.
Reports
2

Distinct published reports

Individual concerns
2

A report can raise multiple concerns

Date range
2024–2025

First to latest report issue date

Stated actions
9

Described in published responses

Reports over time

Reports over time

Reports about this concern issued each year.

* 2026 is projected from reports observed to 7 Sep 2026.

Most frequent recipients

Most frequent recipients

Reports about this concern sent to each recipient.

Department of Health and Social Care2
Medical Research Council1
Medical Schools Council1
National Institute for Health and Care Excellence1
National Institute for Health and Care Research1
NHS England1

Concerns and responses across reports

Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.

  1. Avon

    AI-generated summary

    Sarah Jayne Lewis · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Sarah Jayne Lewis, who had severe ME/CFS and was largely bedbound, was found deceased at home on 9 August 2024 after taking an overdose with the intention of ending her life. The inquest concluded suicide, with acute toxicity recorded as the cause of death. Concerns included inconsistent national provision of ME services, limited research and treatment options, insufficient professional understanding and training, and unclear implementation of updated NICE guidance.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Lack of professional understanding and training about ME

    Wider context from the report

    “(3) Other professionals do not understand ME, what it is or the symptoms it causes. This can be a barrier to those with ME receiving support, or accessing care/treatment they need. A hospital passport is now being utilised at North Bristol, which assists sufferers. However, it is not clear that this is being used in all areas, and there remains a lack of understanding about ME. Education and training about this has not been prioritised. ”

    Source location

    Sarah Jayne Lewis · Prevention of Future Deaths report
    Page 3 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Develop and publish ME/CFS guidance recommending assessment and skills for specialist services.

    Verbatim wording from the response

    “Our guideline on myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management [NG206] makes recommendations on the assessment and skills required for such a specialist service and NICE staff supported the development of the delivery plan.”

    Source location

    Response from National Institution for Health and Care Excellence
    Page 2 · response
    Published 15 July 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Support development and publish e-learning materials consistent with ME/CFS guidance on the NICE website.

    Verbatim wording from the response

    “Education and training is the remit of the professional colleges and the NHS. NICE has supported the development of e-learning materials consistent with NICE guidance on ME/CFS which we make available on our website as they are published.”

    Source location

    Response from National Institution for Health and Care Excellence
    Page 2 · response
    Published 15 July 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Commission and publish a Clinical Knowledge Summary on ME/CFS for primary-care professionals.

    Verbatim wording from the response

    “NICE has also commissioned a Clinical Knowledge Summary (CKS) topic on ME/CFS, developed by Clarity Informatics Ltd, which was published in May 2025. CKS topics are a source of advice and information primarily for health professionals working in primary care, but they do not constitute formal NICE guidance.”

    Source location

    Response from National Institution for Health and Care Excellence
    Page 2 · response
    Published 15 July 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Work with NHS England to develop e-learning for healthcare and other professionals on ME/CFS.

    Verbatim wording from the response

    “In relation to the issue of some people still perceiving ME/CFS as not being real and healthcare and other professionals misunderstanding ME/CFS, the Department has been working closely with NHS England to develop an e-learning course on ME/CFS for healthcare and other professionals, with the aim of supporting staff to be able to provide better care and improve patient outcomes. NHS England’s e-learning package comprises three sessions.”

    Source location

    Response from Department of Health and Social Care
    Page 2 · response
    Published 15 July 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Continue promoting ME/CFS e-learning through professional, sector and representative networks and targeted communications.

    Verbatim wording from the response

    “DHSC will continue to reach out to its networks, including the Royal College of Nursing, to promote the e-learning, and will issue targeted communications regarding the e-learning via wider sector networks, such as the Health and Wellbeing Boards, adult social care provider networks, and representative bodies and charities.”

    Source location

    Response from Department of Health and Social Care
    Page 3 · response
    Published 15 July 2025

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Education and training about ME/CFS are the responsibility of professional colleges and the NHS.

    Verbatim wording from the response

    “Education and training is the remit of the professional colleges and the NHS. NICE has supported the development of e-learning materials consistent with NICE guidance on ME/CFS which we make available on our website as they are published.”

    Source location

    Response from National Institution for Health and Care Excellence
    Page 2 · response
    Published 15 July 2025

    Open published response
  2. Devon, Plymouth and Torbay

    AI-generated summary

    Maeve Boothby O’Neill · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Maeve Boothby O’Neill, who had severe ME and was bedbound, died at home on 3 October 2021 after three hospital admissions during 2021. The report identified concerns about the lack of specialist care provision for severe ME, limited research funding and medical training, and insufficient guidance on managing severe ME in the home or community, including nutritional support.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Extremely limited doctor training on ME/CFS treatment, especially severe ME

    Wider context from the report

    “(3) During the course of the inquest it became clear that there was extremely limited training for Doctors on ME/ CFS and how to treat it – especially in relation to severe ME. ”

    Source location

    Maeve Boothby O’Neill · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Share the NHS England e-learning package on ME with medical schools.

    Verbatim wording from the response

    “Additionally, the Department for Health and Social Care shared their response to this section 28 request with me and I can confirm that I have shared NHS England e-learning package on ME with medical schools.”

    Source location

    Response from MSC
    Page 2 · response
    Published 8 October 2024

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Develop an e-learning course on ME/CFS for healthcare professionals with NHS England.

    Verbatim wording from the response

    “In relation to the issue of training for doctors on ME/CFS and how to treat it, especially in relation to severe ME/CFS, the Department is working with NHS England to develop an e-learning course on ME/CFS for healthcare professionals, with the aim of supporting staff to”

    Source location

    Response from DHSC and NIHR
    Page 2 · response
    Published 8 October 2024

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Publish an introductory e-learning module covering ME/CFS causes, diagnosis and management.

    Verbatim wording from the response

    “Your Report also raises the concern that there is limited training for doctors on ME/CFS and how to treat it, particularly for cases of severe ME. There is currently a limited evidence base for the treatment of severe ME/CFS, which does create challenge to developing educational resource. However, in May this year, in development with DHSC, NHS England published the first of three new e-learning modules. An ‘Introduction to ME/CFS’ provides an overview of the potential causes, diagnostic criteria and management strategies. A further two modules, aimed at the NHS clinical workforces, are now in development, the first of which will cover management in primary care, followed by the third module which will provide guidance on the management of severe ME/CFS in secondary care settings.”

    Source location

    Response from NHSE
    Page 2 · response
    Published 8 October 2024

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Develop two further ME/CFS e-learning modules covering primary-care management and severe ME/CFS management in secondary care.

    Verbatim wording from the response

    “Your Report also raises the concern that there is limited training for doctors on ME/CFS and how to treat it, particularly for cases of severe ME. There is currently a limited evidence base for the treatment of severe ME/CFS, which does create challenge to developing educational resource. However, in May this year, in development with DHSC, NHS England published the first of three new e-learning modules. An ‘Introduction to ME/CFS’ provides an overview of the potential causes, diagnostic criteria and management strategies. A further two modules, aimed at the NHS clinical workforces, are now in development, the first of which will cover management in primary care, followed by the third module which will provide guidance on the management of severe ME/CFS in secondary care settings.”

    Source location

    Response from NHSE
    Page 2 · response
    Published 8 October 2024

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    The Medical Schools Council cannot compel medical schools to change curricula or require particular content to be delivered.

    Verbatim wording from the response

    “MSC is the membership body for medical schools in the UK and as such it has no power to compel medical schools to change curricula or require that content be delivered in a certain way. The General Medical Council (GMC) is the regulator of undergraduate medical education and is responsible for quality assuring medical schools. However, I have looked into how ME/CFS is taught and assessed across medical schools, and I have some information that I hope you will find reassuring.”

    Source location

    Response from MSC
    Page 1 · response
    Published 8 October 2024

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    The GMC regulates and quality assures undergraduate medical education, including the relevant curriculum standards.

    Verbatim wording from the response

    “MSC is the membership body for medical schools in the UK and as such it has no power to compel medical schools to change curricula or require that content be delivered in a certain way. The General Medical Council (GMC) is the regulator of undergraduate medical education and is responsible for quality assuring medical schools. However, I have looked into how ME/CFS is taught and assessed across medical schools, and I have some information that I hope you will find reassuring.”

    Source location

    Response from MSC
    Page 1 · response
    Published 8 October 2024

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Postgraduate medical education and training are outside the Medical Schools Council’s responsibility.

    Verbatim wording from the response

    “I would like to finish by stressing that medical school is the first step of a long process of education and training that doctors in the UK undertake. It is important that lessons learnt in undergraduate medical education are built on when a doctor enters postgraduate medical education and training. MSC is not responsible for these stages of training which are regulated by the GMC. The curricula for specialty and GP training are developed by medical Royal Colleges who are also responsible for the assessment of specialist knowledge. In order that Royal Colleges and GMC are aware of this case I am copying in Professor ████████, Director of Education and Standards at GMC and ████████, Director of Education and Quality at the Academy of Medical Royal Colleges.”

    Source location

    Response from MSC
    Page 2 · response
    Published 8 October 2024

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    The GMC regulates postgraduate training, while medical Royal Colleges develop specialty and general practice curricula and assess specialist knowledge.

    Verbatim wording from the response

    “I would like to finish by stressing that medical school is the first step of a long process of education and training that doctors in the UK undertake. It is important that lessons learnt in undergraduate medical education are built on when a doctor enters postgraduate medical education and training. MSC is not responsible for these stages of training which are regulated by the GMC. The curricula for specialty and GP training are developed by medical Royal Colleges who are also responsible for the assessment of specialist knowledge. In order that Royal Colleges and GMC are aware of this case I am copying in Professor ████████, Director of Education and Standards at GMC and ████████, Director of Education and Quality at the Academy of Medical Royal Colleges.”

    Source location

    Response from MSC
    Page 2 · response
    Published 8 October 2024

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    NHS England, NICE and the Medical Schools Council will address concerns falling within their respective areas of competence.

    Verbatim wording from the response

    “In preparing this response, DHSC officials have liaised with NHS England, NICE and the Medical Schools Council to ensure a comprehensive approach to fully addressing your”

    Source location

    Response from DHSC and NIHR
    Page 1 · response
    Published 8 October 2024

    Open published response
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Data last updated 7 September 2026