April 2018 Minutes of the CMRC meeting and latest news

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Cinders66

Senior Member (Voting Rights)
IMG_3508.jpg IMG_3508.jpg https://www.actionforme.org.uk/uploads/images/2018/05/Draft_Chair_approved_mins_24.4.18.pdf

I don't know if this has already been published, it's the April CMRC minutes. I looked it up to see what was most recent. It seems Sonya chowdhurys time and salary is largely devoted to her role and work with the CMRC which might be why she's absent elsewhere. There is a few names listed I am not sure of. It says at the end they've decided they no longer require services of the SMC, so no more SMC representative/attendance.


There's also this board paper that the CMRC have been using with MRC etc.
https://www.actionforme.org.uk/uploads/images/2018/06/cmrc-rising-to-the-challenge-240418.pdf

Interestingly the beginning of it is the same as the parliamentary briefing prepared by groups. It did sound to me AFME ish and I'm surprised to be honest that AFME were given the task of defining ME given their long history of not endorsing any criteria and insisting CFS = ME etc.

"What is CFS/M.E.? CFS/M.E. is a long-term (chronic), fluctuating, neurological condition that causes symptoms affecting many body systems, more commonly the nervous and immune systems, which affects all age groups (including children and adolescents) and all ethnic and socioeconomic strata. People with M.E. experience severe, persistent fatigue associated with post- exertional malaise, the body’s inability to recover after expending even small amounts of energy, leading to a flare-up in symptoms. Few make good progress and may recover, while most others remain ill for a number of years and may never recover. People with CFS/M.E. score lower overall on health-related quality of life tests than most other chronic conditions. An estimated 250,000 people are affected by CFS/M.E. in the UK.

NICE Guidelines: NICE acknowledges that the physical symptoms can be disabling. NICE identifies three levels of severity: Mild: Are mobile, can care for themselves and can do light domestic tasks with difficulty; Moderate: Have reduced mobility have usually stopped work, school and are restricted in all activities of daily living and Severe: Unable to do any activity themselves, are often unable to leave the house, depend on a wheelchair for mobility and experience severe cognitive difficulties. "

There's three pages of stuff very worth reading.

I've just quoted down to their section on NICE's three levels, as that completely erases my level , level 4 bedridden. The rest is arguing their case for the future they envision of a dementia platform and a modified version of MEGA forming a CFS centre, tying in with NIH stuff.


There's also this presentation

https://www.actionforme.org.uk/uplo...stems-medicine-board-presentation-240418.pptx

Lots to read.
The most interesting part is a letter from the chief medical officer to Stephen Holgate expressing interest in a research collaborative and wanting to meet, along with Jeremy hunt.

This is I assume what iime were alluding to in a post discussed here:
https://www.s4me.info/threads/13th-...nference-1st-june-2018.532/page-10#post-79813

I regularly check social media and haven't seen this put out there, driving forward a Mega study still seems priority. They also want to work with patients on priorities but that's not a meeting in two weeks, but a process it seems, to build on their 2007 work on prorities , I mean FGS are we living in slow motion or something?

I don't know whether to be pleased at what's happening, skeptical or annoyed at the P-g about over years until this apparent "right time " for action.
 
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Cinders66 said:
https://www.actionforme.org.uk/uploads/images/2018/05/Draft_Chair_approved_mins_24.4.18.pdf

I don't know if this has already been published, it's the April CMRC minutes. I looked it up to see what was most recent. It seems Sonya chowdhurys time and salary is largely devoted to her role and work with the CMRC which might be why she's absent elsewhere. There is a few names listed I am not sure of. It says at the end they've decided they no longer require services of the SMC, so no more SMC representative/attendance.
Click to expand...
still got BACME attending tho :cautious:
 
Some positive signs, but I'd prefer an open acknowledgement that they'd got things wrong previously.

Cinders66 said:
There's also this presentation

https://www.actionforme.org.uk/uplo...stems-medicine-board-presentation-240418.pptx
Click to expand...

slide 6: "Despite some changes to the Medical Charities over the 5 years, with some merging, others leaving and new ones joining, the CMRC remains strong."

Hmmm... not that strong? The last 5 years of the CMRC haven't been hugely impressive, have they?

From the minutes, I wondered if this is deliberate comedy understatement?:

"CL/JW
shared that the PAG are concerned that there are no effective
treatments and no universally agreed diagnostic tool."

- From a patient perspective, there are concerns that we've gotten nowhere with improving patients lives over the last forty years, and if anything,. we've just made things worse. It is good that a lot of researchers have secured comfortable careers from CFS, but is there any way we could improve outcomes for patients a bit?

"It was formally noted that given the change in terms of reference of the
CMRC, it will now manage its own communications and retain
independence. Therefore, SH wrote to the Science Media Centre thanking
them for their contribution and acknowledging the end
of role for them on the Board."

Why would SH thank the SMC for promoting bigotry and quackery?

Did we ever have it explained what the SMC were doing with the CMRC? Were they invited? Who by? Were the SMC meant to be handling CMRC communications?!

edit: Good to have the prejudice and stigma around CFS recognised:

"As Prof Sir John Bell has pointed out in a recent conversation on CFS/M.E., prejudice and stigma that wrongly remains associated with this condition and which still affects health and social care, will only be dispelled by discovery of its causal biomolecular mechanisms."

https://www.actionforme.org.uk/uploads/images/2018/06/cmrc-rising-to-the-challenge-240418.pdf
 
Esther12 said:
Some positive signs, but I'd prefer an open acknowledgement that they'd got things wrong previously.



slide 6: "Despite some changes to the Medical Charities over the 5 years, with some merging, others leaving and new ones joining, the CMRC remains strong."

Hmmm... not that strong? The last 5 years of the CMRC haven't been hugely impressive, have they?

From the minutes, I wondered if this is deliberate comedy understatement?:

"CL/JW
shared that the PAG are concerned that there are no effective
treatments and no universally agreed diagnostic tool."

- From a patient perspective, there are concerns that we've gotten nowhere with improving patients lives over the last forty years, and if anything,. we've just made things worse. It is good that a lot of researchers have secured comfortable careers from CFS, but is there any way we could improve outcomes for patients a bit?

"It was formally noted that given the change in terms of reference of the
CMRC, it will now manage its own communications and retain
independence. Therefore, SH wrote to the Science Media Centre thanking
them for their contribution and acknowledging the end
of role for them on the Board."

Why would SH thank the SMC for promoting bigotry and quackery?

Did we ever have it explained what the SMC were doing with the CMRC? Were they invited? Who by? Were the SMC meant to be handling CMRC communications?!

edit: Good to have the prejudice and stigma around CFS recognised:

"As Prof Sir John Bell has pointed out in a recent conversation on CFS/M.E., prejudice and stigma that wrongly remains associated with this condition and which still affects health and social care, will only be dispelled by discovery of its causal biomolecular mechanisms."

https://www.actionforme.org.uk/uploads/images/2018/06/cmrc-rising-to-the-challenge-240418.pdf
Click to expand...

Me too. They can't just act as if the past twenty years haven't bern totally wasted and expect the patients who've lived and suffered through that time to just get behind them with no apology or recognition even
If you read the additional supplements a) you'd think the CMRC and right since AFME started working with the MRC back in 2003? had been a success? Not the total failure not only to get funds, develop a research strategy but even to move beyond Oxford criteria use, recognise PEM as central to ME and that UK CFS umbrella they've funded bears not enough relation to the PEM systemic diseas patients are experiencing. .

They're full of self promotion of all the (too many ) CFS ME charities who joined it

No recognition it's been completely without adequate funding input - unlike the dementia uk platform

Still mainly totally focused on MEGA as the way forward as if nothing else can be done - I'm not sure what patient feeling is on the scientific justification of that

The letter from the CMO is astonishing in its failure to recognise the utter waste of time since the CMO report of 2002. Hey that's 16 years ago folks and you've refused to attend every IIME conference but now is suddenly our time? Actually I think the time was before the deaths of Sophia Mirza, Lois Owen, Lynn gilderdale, Emily collingridge, Yvonne Smith, merryn croft. All English women dead from neglect.

And indeed why thank SMC for their highly negative involvement and yes why were they asked to be involved given their terrible reputation regarding CFS, which SURELY the charities could have pointed out.

There was also mentioned that patients views were seen to be a barrier in the field. Ugh.
 
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I'm trying to imagine why the CMRC would want to have anything to do with BACME. BACME conference seemed to be entirely based on BPS approaches to treatment. As I understand it, BACME is the organisation run by and for the therapists who perpetuate BPS GET/CBT therapies.

It might be good if the BACME therapists attended the CMRC biomedical conference and learned just how out of step they are, and how out of their depth they are in trying to treat ME/CFS when they don't understand anything about it, and to face the possibility they may be doing harm.

But I can't see they can contribute anything useful to the CMRC.
 
As collaboration is the buzz word, I can see why being able to quote another major body as part of your movement is useful. Of the U.K. Research charities, two of four are now involved. It would look good on paper However it would be by patients very unwelcome with their behavioural leaning. I guess it's these isdues that would be weighed up.
 
This looks very encouraging to me.

The most important thing is that it is a pitch for more funds to the Medical Research Council's Population and Systems Medicine board. I will charitably assume that accounts for the rather glossy history of the CMRC.

The document highlights the key symptom of post-exertional malaise, and points out that research funding is exceptionally low compared with other neurological or multisystem disorders. Group points out the problem of scepticism from healthcare providers as well as patients’ problems of hostility fro them and treatment strategies that exacerbate their symptoms. Above all, it states the need to uncover cellular and molecular mechanisms of the disease.

The document goes on to say that "innovative biomedical research is urgently needed to identify risk and therapeutic targets".

It is also highlights endorsement of the need for serious biomedical research from people that will impress the MRC: NIH director Francis Collins and, from the UK, professor Sir John Bell. The latter is Prof of medicine at Oxford, has focused on immunology and genetics research and above all is or has been a serious player in the administration of UK research.
 
Sir John Irving Bell GBE FRS FMedSci FREng[1] (born 1 July 1952)[2] is a Canadian immunologist and geneticist.[3] From 2006 to 2011, he was President of the Academy of Medical Sciences, and since 2002 has held the Regius Chair of Medicine at the University of Oxford, UK.[4] He has been Chairman of OSCHR since 2006.
Click to expand...
https://en.wikipedia.org/wiki/John_Bell_(physician)

OSCHR = Office for Strategic Coordination of Health Research
The Government currently funds health related research through two main routes, the Medical Research Council (MRC) and the National Institute for Health Research (NIHR).

The 'Review of funding in UK health research' led by Sir David Cooksey in 2006 resulted in the creation of the independent Office for Strategic Coordination of Health Research (OSCHR). Cooksey had identified considerable strength in the UK science base, but revealed cultural, institutional and financial barriers to the effective translation of health research into clinical practice. The review envisioned a cultural change among the public funders of health research to address the barriers to research collaboration and to support the application and translation of basic research into patient care and economic benefit.

Since 2007, the OSCHR Board has demonstrated a powerful capacity to work across government through collaboration, addressing many of the issues required to ensure a comprehensive health research environment and leading to improved health outcomes and economic growth. The OSCHR process has helped to focus on the development of better NHS electronic data capabilities for research; create a research programme for public health and greatly enhance translation science. OSCHR is one of a number of fora where the public funders of health research work together with other stakeholders.
Click to expand...
https://mrc.ukri.org/about/what-we-do/spending-accountability/oschr/
 
It is unforgivable to me that funds weren't pitched for after the Gibson report, or after the 2012 one off ring-fenced allocation. We didn't have to just accept slow mo and no funds, that time can't be bought back. I can't look at the current out of the context of the 25 years I've been Ill waiting for research. If we haves to now pretend to MRC that everything at CMRC has been dandy and glossy and only now Is the Time for action and MRC haven't been neglectful then It's a betrayal.

I also think that this collaborating with the establishment approach typifies the MEA & AFME, who act as long as we got there in the end that's fine. That's up to them, they have chosen to be acquiescent, collaborative with MRC rather than to challenge and will now bthibk the rewards are being reaped. I do think that the new UK #MEAction movement needs to be aware of this and think they were naive in handing over for example the unrest film to those two charities to promote, because whilst I understand the idea of most reach, the idea that MEA & AFME charity heads are going to promote patient unrest or join a movement on the uk streets demanding research funds is just totally absurd. This ^^^^ is what's happening, twenty years behind schedule but when I hear that it was decided direct lobbying of Jeremy hunt was decided inappropriate unlike that in USA of NIH, is it because of ideas lead by MEA through forward ME etc that going the establishment route is best because of ^^^ , where we as patients just sit and wait and get told eventually what's been decided by tho.
 
I presume Christine Laennac and Jane Whittaker are the patient representatives. I presume also that Jane Whittaker is the one who liked 'Developing Magic: NLP Training' (albeit in 2011) (see attached).

Isn't it time patient representatives were chosen by... patients? Shouldn't they be elected via an online poll? At the moment they are not patient representatives but patients chosen by a couple of members of the CMRC.
 

Attachments

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    Jane Whittaker.jpg
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@JohnTheJack, what basis do you have for presuming Laennac and Whittaker are the patient reps? Does the CMRC not clearly identify their patient reps?

(Sorry, I haven't been reading all the CMRC material.)
 
IF CMRC really wants to claim patient engagement they should cosider holding phone ins like the nih where un selected patients can ask questions and air views. And they engage with cross section of the population, not just their fans. They could also have something similar to the CFSac in America.
I'm concerned that taking in patients views on priorities ( the views of patients they've vetted who largely sign up to anything AFME endorse) is going to either take more time /be used as another delaying tactic, depending on opinion. The ME expert group has been going since 2008 but only now insists we are a field that needs special funds and wants patient input.
 
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It's sad if all the useful patient representatives resigned, leaving only the crappy ones. This is, unfortunately, why sometimes it's not a good idea to simply abandon an organisation we don't agree with. Sometimes it genuinely is better to stay within and fight the good fight (easier said than done, though--especially if the management committee doesn't listen).

That said, the CMRC should recognise that when it haemorrhages patient representatives, it's doing something drastically wrong, and look to stem the bleeding. I feel much better now they've dropped the SMC and have Chris as Deputy Chair, but getting the right patients involved would be a next big step.

Can anyone volunteer to be a patient representative for CMRC? Can we get some good people to apply?
 
Hutan said:
@JohnTheJack, what basis do you have for presuming Laennac and Whittaker are the patient reps? Does the CMRC not clearly identify their patient reps?

(Sorry, I haven't been reading all the CMRC material.)
Click to expand...

My understanding is that membership of the PAG for MEGA was confidential. I do know some quit that group. Again as far as I understand, the remnants of the PAG formed the patient representatives to the CMRC. I don't know whether that's supposed to be confidential or not.

In any case the CMRC minutes list a number of people present:
Sonya Chowdhury (SC) Mark Jones (MJ) Christine Laennac (CL)
Charles Shepherd (CS) Gabrielle Murphy (GM) Jane Whittaker (JW)
Carmine Pariante (CP) – left at 2pm
Joined via phone:
Chris Ponting (CPP) Colin Smith (CSm) Glen Plant (GP)
Mark Edwards (ME)
Apologies:
Stephen Holgate (SH) James Brodie – (JB) Ana Antunes-Martin (AAM)
Craig Bullock (CB) Mike Dalrymple (MD) Jo Elson (JE)
Lars Erwig (LE) Claire Kidgell (CK) Paul Little (PL)

Under 5 CMRC Action Planning it says:
CL/JW shared that the PAG are concerned that there are no effective treatments and no universally agreed diagnostic tool.

I am curious about who attends these meetings so did wonder who Laennac and Whittaker are. Since they report from the PAC, then I presume they are the patient reps.

In addition, I googled them both. Almost all academics come up in a search of their name, and neither of these two returned any entries.

I did however come across that Facebook page.

I do only 'presume'.

Since the minutes name them, then it would seem the CMRC is not keeping the names confidential.

I'm not looking to cause trouble for these patients. I'm more concerned that the CMRC is selecting a handful of patients and then simply declaring them as representatives. They're not. If the CMRC really wants patient reps, then patients should choose them.
 
adambeyoncelowe said:
It's sad if all the useful patient representatives resigned, leaving only the crappy ones. This is, unfortunately, why sometimes it's not a good idea to simply abandon an organisation we don't agree with. Sometimes it genuinely is better to stay within and fight the good fight (easier said than done, though--especially if the management committee doesn't listen).

That said, the CMRC should recognise that when it haemorrhages patient representatives, it's doing something drastically wrong, and look to stem the bleeding. I feel much better now they've dropped the SMC and have Chris as Deputy Chair, but getting the right patients involved would be a next big step.

Can anyone volunteer to be a patient representative for CMRC? Can we get some good people to apply?
Click to expand...

I think there should be elections. AfME and MEA should organize these elections but should have no other role in selecting the patient reps.
 
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