Multidisciplinary care

1.10 Multidisciplinary care

1.10.1 Provide care for people with ME/CFS using a coordinated multidisciplinary approach. Based on the person's needs, include access to health and social care professionals with expertise in the following as a minimum, with additional expertise depending on symptoms:

• medical assessment and diagnosis
• developing personalised care and support plans
• self-management strategies, including energy management
• symptom management, including prescribing and medicines management
• managing flare-ups and relapses
• activities of daily living, including dental health
• psychological, emotional and social wellbeing, including family and sexual relationships
• diet and nutrition
• mobility, avoiding falls and problems from loss of dexterity, including access to aids and rehabilitation services
• social care and support
• support to engage in work, education, social activities and hobbies.

1.10.2 Care for people whose ME/CFS is managed in primary care should be supported by advice and direct clinical consultation from an ME/CFS specialist team.

1.10.3 Give adults, children and young people with ME/CFS and their family or carers (as appropriate):

• A named contact in their primary care and/or ME/CFS specialist team to coordinate their care and support plan, help them access services and support them during periods of relapse.

1.10.4 Provide children and young people with ME/CFS and their family or carers (as appropriate):

• with details of a named professional in the ME/CFS specialist team who they can contact with any concerns about the child or young person's health, education or social life.

Moving into adults' services

1.10.5 For young adults with ME/CFS moving from children's to adults' services:

• manage transitions in line with the NICE guideline on transition from children's to adults' services for young people using health or social care services.