United Kingdom: South Cumbria CFS Service (Physical Health Psychology)

Andy

Andy

Retired committee member
"The Physical Health Psychology team offer a range of services across Cumbria and North Lancashire to help you to manage your physical symptoms and live a happier, healthier life.

We are a team of Healthcare Professionals made up of Psychological Practitioners, CBT Therapists, Occupational Therapists, Physiotherapists, Wellbeing Activators and Living Well Coaches."

https://php.cumbria.nhs.uk/

Selected services they supply;

Persistent Physical Symptoms Service (PPSS)

"Is PPSS right for me?

If you say “Yes” to many of the questions below, then our service may be able to help you. If you would like to be referred to our service then please discuss this with your GP. They will be able to refer you to us.

  • Have you been experiencing Persistent Physical Symptoms for more than six months ?
  • Have you been given a diagnosis of Chronic Fatigue Syndrome (ME), Persistent (Chronic) Pain, Fibromyalgia, Functional Neurological Symptoms (including non-epileptic seizures), Medically Unexplained Symptoms or Irritable Bowel Syndrome?
  • Have you had medical investigations and treatments which haven’t really helped you to manage your symptoms?
  • Do you feel your symptoms are stopping you from living life the way you would like to?
  • Are you suffering from low mood as a result of the impact the symptoms are having on your life?
  • Are you having to stop taking pain medication, or would like to stop?
.......

The Persistent Physical Symptoms Service launched in April 2016.Our team is made up of Psychological Therapists, Physiotherapists, Occupational Therapists and Living Well Coaches."

https://php.cumbria.nhs.uk/about-our-services/ppss


South Cumbria Chronic Fatigue Syndrome Service (CFS)

"Why this approach?

We use an approach that looks at you as a whole person: your physical symptoms as well as your mood and what is important to you. Our resources on the biopsychosocial model and mind-body link may help you to understand why we take this approach. The approach is supported by government guidelines, our experience, and the feedback from previous group members."

https://php.cumbria.nhs.uk/about-ou...lth-and-rehabilitation-psychology/cfs-service


Familiar Faces (FF)

"You may be offered support by the familiar faces team if you have difficulties that bring you into frequent contact with your GP and other health services.

.....

Why this approach?
  • We know that GP appointments are short and that there is not always the time to discuss everything you would like to. We can offer you longer appointments, so that you have more time to talk about all of your difficulties and needs.
  • We are aware that when you see many different doctors and other healthcare professionals, it can sometimes feel as though this is not very joined-up. We can help you to work with your whole care team to make sure that the right information is shared and that everyone understands your difficulties and needs as a whole.
  • The approach we use is based on research evidence and government guidelines.
  • We believe that shared decision making around your health and wellbeing is very important - this is based on information from the National Institute for Health and Care Excellence."

https://php.cumbria.nhs.uk/about-our-services/familiar-faces-ff
 
The Familiar Faces Cumbria Conference 2021 took place earlier in November - details here, https://www.eventbrite.co.uk/e/familiar-faces-cumbria-conference-2021-tickets-166801883925

On the agenda is a familiar name for us.

"Consultant Clinical Psychologists

09.15 – 10.00 FND and frequent attendance Professor Jon Stone"

Tweets from an attendee about this presentation.

Screenshot 2021-11-28 12.02.06.png
Code: 
https://twitter.com/ElspethDesert/status/1455828783211102216?s=20

Screenshot 2021-11-28 12.03.44.png
Code: 
https://twitter.com/ElspethDesert/status/1455831446439055362?s=20

Screenshot 2021-11-28 12.05.20.png
Code: 
https://twitter.com/ElspethDesert/status/1455828003443838981?s=20

Am I right in thinking that by using the apostrophe in "Everyone's problem", Stone unintentionally reveals more of his mindset towards patients than he probably intends?
 
I am not sure about the demonstrable pathology but that is a red herring.

I am trying to get a handle on this stuff for my book. It is shocking how it can be acceptable for old wives tales about getting people to think better thoughts are presented as evidence-based therapy.

If this sort of thing actually works let's see some data. We always used to have to have data for other treatments.
 
If you say “Yes” to many of the questions below, then our service may be able to help you. If you would like to be referred to our service then please discuss this with your GP. They will be able to refer you to us.
  • Have you been experiencing Persistent Physical Symptoms for more than six months ?
  • Have you been given a diagnosis of Chronic Fatigue Syndrome (ME), Persistent (Chronic) Pain, Fibromyalgia, Functional Neurological Symptoms (including non-epileptic seizures), Medically Unexplained Symptoms or Irritable Bowel Syndrome?
  • Have you had medical investigations and treatments which haven’t really helped you to manage your symptoms?
  • Do you feel your symptoms are stopping you from living life the way you would like to?
  • Are you suffering from low mood as a result of the impact the symptoms are having on your life?
  • Are you having to stop taking pain medication, or would like to stop?
Click to expand...
Is it a pub quiz?
 
If you say “Yes” to many of the questions below, then our service may be able to help you. If you would like to be referred to our service then please discuss this with your GP. They will be able to refer you to us.
  • Have you been experiencing Persistent Physical Symptoms for more than six months ?
  • Have you been given a diagnosis of Chronic Fatigue Syndrome (ME), Persistent (Chronic) Pain, Fibromyalgia, Functional Neurological Symptoms (including non-epileptic seizures), Medically Unexplained Symptoms or Irritable Bowel Syndrome?
  • Have you had medical investigations and treatments which haven’t really helped you to manage your symptoms?
  • Do you feel your symptoms are stopping you from living life the way you would like to?
  • Are you suffering from low mood as a result of the impact the symptoms are having on your life?
  • Are you having to stop taking pain medication, or would like to stop?
Click to expand...

Interesting that they capitalise the term Persistent Physical Symptoms. Very circular and prejudicial.

Consider what happens if the patient is asked this verbally, and doesn't realise (and is not informed) that it is a formal definition/diagnosis, and instead takes it as if being asked a more general question about a symptom pattern, and says yes. In effect the patient has been unknowingly conned into agreeing with the diagnosis.

Also questions 3-5 are so vague and generic as to be reckless, without substantial further investigation.

And I am not sure what the relevance is of the last question.
 
PPSS-Information-for-Professionals
Persistent Physical Symptoms Service (PPSS) Chronic Pain, CFS, FND, MUS Information for professionals Working across Cumbria with patients and professionals to increase understanding and confidence in management of long-term physical symptoms. The Persistent Physical Symptoms Service offers an integrated pathway for all patients with persistent physical symptoms in North, East and West Cumbria. Who is the Persistent Physical Symptoms Service (PPSS) for? The service offers evidence-based interventions to patients with persistent symptoms (of more than six months’ duration) which are not due to any underlying pathology.

This includes: Chronic Pain Chronic Fatigue Syndrome (CFS)/ Myalgic Encephalopathy (ME)) Functional Neurological Symptoms (FNS, including non-epileptic attacks) Medically Unexplained Symptoms (MUS) The Persistent Physical Symptoms Service offers: A single point of access Joint assessment with a psychological practitioner and a physiotherapist or occupational therapist Living Well groups Individual psychological therapy – including CBT Individual physiotherapy/ occupational therapy Training for health professionals on managing persistent physical symptoms Following assessment Following assessment, patients are matched to the most appropriate level (or levels) of intervention, based on their individual needs. The primary model adopted is Cognitive Behavioural Therapy (CBT), supported by additional evidence-based approaches such as Acceptance and Commitment Therapy (ACT) and Eye Movement Desensitisation and Reprocessing (EMDR) for trauma. Treatment choice is based on individual assessment and formulation. A biopsychosocial model is followed throughout the service, recognising the complex interactions between physical, psychological and environmental factors that predispose, precipitate and maintain an individual’s symptoms.
Click to expand...

Referral Criteria  18 years or older  Persistent ( > 6 months) physical symptoms related to disorders of biopsychosocial function rather than any obvious pathology  Diagnoses of CFS/ME, Chronic Pain, FNS and MUS  Symptoms cannot be managed within primary care  Relevant investigations/tests have been completed  Not awaiting further medical or surgical opinion in relation to symptoms.  An explanation of persistent symptoms has been shared with the patient by relevant medical professional (e.g. GP or Consultant)
Click to expand...
Map of Medicine Referral Form (cumbria.nhs.uk)

(dated 2018)
I don't understand how these PPS services seem to be allowed to continue to operate outside of the ME/cfs NICE guidelines?
 
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