Assessment and care and support planning by an ME/CFS specialist team

1.5 Assessment and care and support planning by an ME/CFS specialist team

Also see the section on care for people with severe or very severe ME/CFS.

1.5.1 Carry out and record a holistic assessment to confirm the person's diagnosis of ME/CFS and inform their care and support plan. This should include:

• a medical assessment (including relevant symptoms and history, comorbidities, overall physical and mental health, anything that is known to exacerbate or alleviate symptoms, and sleep quality)
• physical functioning
• the impact of symptoms on psychological, emotional and social wellbeing
• current and past experiences of medicines (including tolerance and sensitivities), vitamins and mineral supplements
• dietary assessment (including weight history before and after their diagnosis of ME/CFS, use of restrictive and alternative diets, and access to shopping and cooking).

1.5.2 Develop and agree a personalised care and support plan with the person with ME/CFS and their family or carers (as appropriate) informed by their holistic assessment. Include the following, depending on the person's needs:

• information and support needs (see the section on information and support)
• support for activities of daily living (see the section on access to care and support and recommendation 1.6.8 on accessing social care)
• mobility and daily living aids and adaptations to increase or maintain independence (see the recommendations on aids and adaptations)
• education, training or employment support needs (see the section on supporting people with ME/CFS in work, education and training)
• self-management strategies, including energy management (see the recommendations on energy management)
• physical functioning and mobility (see the recommendations on physical functioning and mobility)
• managing ME/CFS and symptom management, including medicines management (see recommendations 1.12.1 to 1.12.26 on managing symptoms)
• guidance on managing flare-ups and relapses (see the section on managing flare-ups in symptoms and relapses)
• details of the health and social care professionals involved in the person's care, and who to contact (see recommendation 1.10.3).

1.5.3 Recognise that the person with ME/CFS is in charge of the aims of their care and support plan.

1.5.4 Give the person and their family or carers (as appropriate) a copy of their care and support plan and share a copy with their GP.