RCGP refuses to change their classification of CFS as a mental health disorder

1  Original MEA letter dated 2 April

2  RCGP reply dated 15 May

3  MEA response dated 29 May

RCGP curriculum publication ‘Care of People with Mental Health Problems’ 

FULL TEXTS BELOW

1 Original MEA letter dated 2 April

Dear Professor Field

 

The ME Association would be grateful if you could explain why the Royal College of General Practitioners has decided to classify CFS as a mental health disorder in your publication ‘RCGP Curriculum Statement 13: Care of People with Mental Health Problems’

 

The current WHO classification for ME and PVFS is in section G93:3 of ICD10 – the neurological disease section.  CFS is indexed to this G93:3 classification.

 

The UK Department of Health has made it clear that they accept this classification, as did Ann Keen (Parliamentary Under-Secretary for Health Services at the Department of Health) when she spoke to the ME All Party Parliamentary Group at the House of Commons on 22 January 2008.

 

I would also point out that the Read Code for CFS is F286 (F is used to denote nervous system diseases) and that Read Codes for mental health disorders start with the letter E.  None of the other ‘mental health disorders in primary care’ listed in Appendix 3 of the Curriculum Statement have a code starting with F.

 

Yours sincerely

 

Dr Charles Shepherd

Hon Medical Adviser, The ME Association

 

4 Top Angel

Buckingham

MK18 1TH

(This letter was sent to Professor Steve Field, Chairman of Council at the Royal College, and passed on for reply to Dr Bill Reith, chairman of the RCGP Postgraduate Training Board.)

2 RCGP reply dated 15 May

Dear Dr Shepherd

Chronic Fatigue Syndrome in the RCGP Curriculum

I appreciate the interest that you have shown in the curriculum for speciality training for general practice. Clearly chronic fatigue synrome is a condition of sufficient importance to be included in the curriculum.

The group that developed the curriculum were aware of the difficulties of assigning this condition to a specific grouping and eventually elected to include it within the statement on ‘Care of People with Mental Health Problems’. It was a difficult decision but it was taken largely on the grounds that many specialist services are currentlyl configured and based in, or are linked to, psychology services. No assumptions should be drawn from this about the college’s views on causality.

In reaching their decision, the group also took into account the NICE guideline for CFS/ME which states:

‘Many different potential aetilogies for CFS/ME – including neurological, endocrine, immunological, genetic, psychiatric and infectious – have been investigated, the diverse nature of the symptoms can not yet be fully explained. The World Health Organization (WHO) classifies CFS/ME as a neurological illness (G93.3), and some members of the Guideline Development Group (GDG) felt that, until research further identifies its aetiology and pathogenesis, the guidelines should recognise this classification. Others felt that to do so did not reflect the nature of the illness, and risked restricting research into the causes, mechanisms and future treatments for CFS/ME.’

In the same way as medicine develops and changes as new evidence is identified, so the GP training curriculum will develop and change. In the process of any such review, it seems likely that CFS will continue to be included within the curriculum and any new evidence as to its causation and treatment will be incorporated.

The curriculum is currenrtly in the process of being reviewed in order to submit updates to the Postgraduate Medical Education and Training Board, which has to approve any changes. I will ensure that your comments are taken into account during that process.

Dr Bill Reith

Chairman, Postgraduate Training Board

Royal College of General Practitioners

14 Princes Gate

Hyde Park

London SW7 1PU

 3 MEA response dated 29 May