Campaigning for the service model we all need - one which doesn’t make us worse

hotblack

Senior Member (Voting Rights)
Something I’ve been thinking about. And we’ve discussed in bits elsewhere. But thought a thread may be useful (edit: title changed to reflect the aims a bit better and be less clickbaity).

Slightly selfishly I think severe should be the focus of campaigns and lobbying but also think there is a practical point of differentiation here. Something which makes ME/CFS stand apart.

Loads of conditions want better services and they’re all campaigning for them. I see this closely with PD these days and imorovements are of course needed. The problems of variation across the country, not enough specialists and a scrabble for limited resources. Arguments over what treatments work or should be available. These are common in many conditions.

And we need to be realistic that prioritisation happens and those where this is a proven treatment those options with the clearest outcomes will come out on top. ME/CFS cannot win here. Politicians and NHS leaders and managers hear these requests and campaigns all the time and tbh I think switch off to a degree or at least it all merges into one blob.

What makes ME/CFS and particularly more severe forms different and unique is that the biggest problem is IMHO not the lack of services or treatments to help us but that what services exist and the wider health system actively harm us. How you define harm maybe varies but it seems pretty clear health services routinely act in way which is detrimental to our health.

That avoiding seeking care for non ME/CFS issues is entirely normal for so many is the big issue here along with clearer evidence of harms from inappropriate handling of cases of people with the.most severe forms of ME/CFS. And this is at all levels of the NHS and other health services. We all discuss it all the time. That there is no example of good care to hold up is damning in itself. Most other conditions can at least point to something to say this is what we want.

So this is why I say severe should be the focus with the priority being to on stop interactions being detrimental to our health. II guess it doesn’t because it’s a fight rather than a nice working together with people thing. And those who are more mild are more able to lobby for things.

But honestly the approach of asking for services for mild and moderate people is never going to work for severely affected people (as has been proven) and I doubt it’ll work for mild and moderate either. This is something which is clearest with the most severe but affects us all.

If we can ensure someone has some responsibility and accountability and then things will change and we can expand from there. Treatments will only come when the science allows but stopping making people worse can be done now. It seems quite a simple ask.
 
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Your previous post has got me thinking.
Forgive me if this is very naive, but could it be useful to think about creating a UK ME/CFS care society funded by donations?
A private organization that provided care at home specifically for pwME.

There seem to be similar organizations that get money from the NHS:
This would of course be the end goal here, too, but until then it might be useful to think about how to launch what is direly needed ourselves.

A big advantage would be that we could build the service as a blueprint of what is actually needed by pwME. Without any political interference by rehab or BPS.
 
The need would be for at least £10M a year. I don't see where the funds are going to come from.
Do we have an idea what the current UK ME societies earn via donations?

Let’s say we cap the cost at £1M/year, could the existence of such a service be a useful way to put pressure on the politics to finance the endeavor?
Again, having an existing system might help to direct the care as we actually need it.

Having a specialised org might also make it easier to illustrate the horrific deficiencies of the status quo via the media.
 
It’s a lovely idea @Chandelier and yes it is a model that has worked elsewhere. Marie Curie, Macmillan and various more local hospice organisations have been vital for many people with many conditions. Piggybacking on hospice care is something that I think has been discussed and may be a route for some severe patients.

I suppose I was thinking of something more transformative for the NHS and other health services. If we can get services to accept that they need to make adjustments and accommodate the needs of those who are more severely affected then doing so for mild/moderate should be easier.

And then we can all, the community of people with this condition, can start to actually build some sort of relationship with health services again. It seems we don’t have one and that is a day to day barrier for patients but also one to the sort of specialist support and involvement in trials and delivery of treatments we all hope for.

I do think we need more than just hoping the science will fix things alone. It will be key but we need more. Now but also in the future.
 
It seems quite a simple ask.
Its not, the entire system and every single medical person has been taught how to harm us and told it helps. There are so many vested interests and substantial money and careers driving against it throughout the entire systems of government and healthcare in every country. It even swims against the entire direction of medical research as it has been going on psychology solving everything for nearly 40 years and continues to do ever more research and treatment action in that direction. Its not a simple ask unfortunately, its an almost impossible ask with a system that has no checks or balances nor accountability and no desire from anyone to make one beyond us.
 
So this is why I say severe should be the focus with the priority being to on stop interactions being detrimental to our health. II guess it doesn’t because it’s a fight rather than a nice working together with people thing. And those who are more mild are more able to lobby for things.
Some arguments for focusing on the severe:

1. We can’t have a society where the worse you are the less healthcare you get.

2. It can easily be adapted to the moderate or mild through scaling it back or removing unneeded components.

3. We have to prioritise the ones that need it the most and are at a higher risk of deteriorating (or dying) from the lack of appropriate care or suicide.

4. The target group is smaller, especially if we focus on the more severe end of severe.

5. The narrative is easier for more severe because it’s so removed from normal. The patients look like patients all the time, while mild or moderate can look like healthy at times by masking so the needs are harder to dismiss.

6. We already have a blueprint from Røysumtunet (exclude the off-label treatments) and the German housing project.
 
Im in Ireland and severe also. Ireland is currently developing guidelines and I hope to write to them with some thoughts.

We have been trialling virtual wards in Ireland (for other conditions). I feel this concept could work well if monitoring isn't taxing, if staff are willing to travel to patients when necessary, if adequate treatments are provided at home.

- iv fluids and ng tubes are currently not provided at home through public system which really limits how effective the system would be

- various specialists being willing to do home visits/remote consults would be very helpful. Even 1 specialist for Ireland in each specialty with expertise/equipment in remote/home visits
 
Its not, the entire system and every single medical person has been taught how to harm us and told it helps. There are so many vested interests and substantial money and careers driving against it throughout the entire systems of government and healthcare in every country. It even swims against the entire direction of medical research as it has been going on psychology solving everything for nearly 40 years and continues to do ever more research and treatment action in that direction. Its not a simple ask unfortunately, its an almost impossible ask with a system that has no checks or balances nor accountability and no desire from anyone to make one beyond us.
Sadly, this. :mad: :grumpy:
 
How did autism do it?
At my GP reception you can ask for a sensory pack - you get earplugs and a fidget toy or something IDK but these things are available everywhere, thirty years ago a child who couldn’t sit still and behave, or an adult stimming would be tut-tutted at and treated with hostility.

I can ask for a sensory pack, but I’m not allowed to lie down on the chairs.
 
The need would be for at least £10M a year. I don't see where the funds are going to come from.
To put that into perspective:
The Department of Health and Social Care’s (DHSC) revenue budget is £202 billion in 2025-26.

£10M are 0.005% of the DHSC‘s yearly budget.

There will be a budget increase to £232 billion in 2028-29 – a real-terms average increase of 2.7%.
 
How do we get the message across to doctors unless royal colleges get involved that we need reasonable accommodation?


We asked the Royal College of physicians in Northern Ireland if @Jonathan Edwards could speak at an update day,but he has not been asked. This may be because of rules like only local speakers or something, but it's a missed opportunity.

ETA we had a local consultant put in the request
 
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