My take (any mistake is mine - all corrections needed and welcome):
This current FII Guideline (for social work) was produced on principle, in the wake of obsolete safeguarding guidelines, all radically revised by the current M.E Guideline NG206 1.7 (for clinics):
- in case of THE most arbitrarily safe-guarded diagnosis:
- suspected or confirmed:
- myalgic encephalopathy
There had been exposure of those inexplicable sweeps, across the UK, taking too many, and various, neuro-divergent children into “Care”, for the wrong reasons.
In some systematic confusion, mistaking the safeguarded < mental & behavioural aberrations > with the symptoms of neuro-divergence:
- in autism, adhd, the e.d thingy, fibromyalgia, lymes, and the epitome, being m.e (and now also long covid, with all children suspected, under government veto on research for differential diagnosis)
This national mistake was admitted in 2022, after being scaled up (to post-pandemic proportions).
But also, some social work cohort continued to insist that all such children need a voice, because, they are easily abused, and there is a lot of it about. So that became probable proof (in civil Courts issuing Care Orders). And so all such children “need a social worker to… give them a voice”.
That was the published SW response, to the national report on how the lens of surveillance had replaced the family supports, being withdrawn, so families were being policed, and bullied, instead.
But, however the medico-legal cases had been contrived, to pile up, it could no longer be claimed that there was a lot of F!! about. It got re-re-classified socially - and psychiatrically – as in fact, still … very rare. The British Association for Social Work (BASW) pulled its socks up.
N.I.C.E, our National Institute for Clinical Excellence, sets the current industry standard for clinics,. And, more recently, for social work too. It determines, with total authority, the cost-effective medicines which can be prescribed, and even subsidised, by our National Heath Services.
This holds locally and nationally. However it only outlines an industry standard for the subsidised M.E clinics. A clinic is a different format of medicine. N.I.C.E clinical guidelines are also cost-effective, but not mandatory. Except where overlapped with other law on Safeguards, Environment, Etc
N.I.C.E had deliberated at length to make some explicitly particular provisions, for example:
1. the unprecedented financial impact on our NHS (which only the BMJ reported to me in national news)
2. the basis of a radically revised Safeguarding Recommendation (guide line), in all cases of suspected and confirmed M.E
This recommendation was mostly based upon the anecdotal evidence of children, their parents and carers. Making it also unprecedented, but only for the sheer lack of multi-disciplned, professional evidencing
In the subtext, NG206 1.7 took great care to explain. that too few safe-guarded adults had come forward, with evidence for the asking. Likewise - most silently blazoned - the whole Safeguarding network UK did not dare come forward, with the professional evidence of record.
Not for the asking.
And so the dissenters are still, assiduously, producing more and more of their “evidences”, for their subsidised clinics. But they dare not complain about the anecdotal evidence-base, for NG206 1.7.
They do know its only anecdotal for lack of professional evidence. An inexplicable lack
So, in case of M.E, not even a Coroner could unravel these multi-disciplined, obscured Safeguarding networks. With the local Police, NHS & SS Safeguarding Teams, all duly led by their respective local Leads
Local NHS Safeguarding Lead, local SS Safeguarding Lead, and local Police Lead.
All duly convened and co-ordinated by their local practitioners, in their local procedures, with the local protocols of their local policy. World-class. Best local practice. To export to Australia.
With their world-class screening tools, being registered for the markets, as regulated medical devices.
Ditto the regulated, local, national and international markets for all the other training materials. That they produced.
Convened everywhere by GPs & SWs, then also by their Integrated Care Service ICS Co-ordinators once newly empowered to convene : the mandatory, multi-disciplined network meetings (MDTs) in their due procedures.
Every where. And all informed by the pure, and applied, sciences of Safeguarding. Lots and lots of training, on the budget, across all the fields in reach. Of a family. And there are multi-disciplined experts on their local Panels, selected and convened by the local Leads. To do the advisories
As N.I.C.E so very painstakingly explained, the primary care fields must get a guidance-advisory service from secondary level experts. In, for example, in case of suspected or confirmed M.E, being dangerously confused with the signs of F.I.I, as Maeve Boothby O’Neill lay dying.
The legend who wanted to live.
Dying for lack of the specialised medical feeds with-held, but not with-held from the other cases also categorised as “unspecified”, with intolerance for other feeds. SSSHhhhhhh.
Strangely, since December 2024,all my book-marked pages on "Nutritional supplements (non-disease specific)" can no longer be found. But it was all there, in the British National Formulary, hosted by N.I.C.E.
So, we can rely on this ongoing, total, glaring, most significant and telling absence of all the professional Safeguarder evidences. The academic, practitioner, scientific, clinical, medical and financial, medico-legal and police evidences. None of which was forthcoming for the asking and:
- hence remains silent ever since. On this subject of radically revised Safeguarding as upgraded and provided by N.I.C.E NG206 1.7 Safeguarding (in case of M.E), and by BASW (in case of F.I.I).
This dissent is now being scrutinised by the police and prosecution services, the civil and criminal Courts (on behalf of the Kidd family. And by an International Symposium for research towards the evidential differential diagnosis of children … which the UK STILL vetoes, in case of childhood.
In case of childhood cases, of suspected or confirmed Long Covid, now re-classified by Government as Factitious Illness. Presumably according to the metrics for local and central audit of subsidised M.E and Long Covid clinics.
Where else did the medical research funders get their established notion, that Long Covid, in a child is a factitious illness, hallucinated world-wide in post-pandemic derangement. World-class
So it has emerged that, the UK Long Covid clinics were still planning to escalate those sweeps of suspected and confirmed F.I.I > subcategory F.I > because, of course, a non-existent childhood illness cannot be induced, not even by a virus. Because it is non-existent
World class Lead, UK and Australia.
All based on the out-of-date F.I.I Guideline for weeping, sorry sweeping psychiatrists, which their Royal College was still unable to upgrade. To meet the new industry standard. Set by the physicians (Oct 2021) and the social workers (May 2022):
- specifically refuting their loose, unevidenced, opinionated, fringe criteria. Which remained
The catchment criteria in case of suspected or confirmed, but very very rare F.I.I (and now also F.I., much more common, with school absences to boot) ... the catchment remains a disagreement between professional bodies. And so it is still being escalated, even by locals who resolved the disagreement.
Because UK law says all disagreement, between local professionals, in a Safeguarding procedure, must be escalated, to be examined by the local Safeguarding Leads (Police, NHS, SS), even if it was already resolved by multi-disciplined teams. It must be notified. Thats how dangerous it is, forsooth
Exactly as dangerous as N.I.C.E declared, when clarifying the confusion of signs with symptoms. This was upheld by the B.A.S.W, citing N.I.C.E, and also citing the RCPsych, which still disagreed
But the new upgraded industry standard was set. The current Guideline did just what N.I.C.E said it did, on the tin, in May 2022:
it totally and conclusively resolved the disagreement, rendering it sub-standard.
The physicians have a re-formed Royal College, still with its logo on the clinical Guidance for Safeguarding in case of M.E being confused with F.I.I.
UK physicians overturned their own College, over their own liability for the physician-associates being promoted by - therefore overturned - leadership.
The social workers have a rueful British Association, citing the world-class clinical Guideline for Safeguarding, in case of M.E being confused loosely with F.I.I.
The GPs and paediatricians are more or less bound by this clincal Guideline, because it overlaps with Safeguarding Law. And it defines the risk to a child or adult with suspected M.E / F.I.I
So BASW re-directed and guided British social work, in great detail, on the due procedure for differentiating between F.I.I, and M.E … and other such targeted illnesses.
We should know what the Police and SS and NHS know, and the civil and criminal courts should also be told, likewise Parliament, the Government and the Medical Research Council, plus BACME and the other tax-exempt pension pots looking to trade on the national and international markets for:
- Medical Devices being software screening tools, all duly gathering the evidence to get registered as medical devices. Registered for post-production surveillance, and yellow card reporting. Registered with the Medical Device Registry UK. Under the Medical Device Regulations, upgraded December 2024, scuse me while I cackle, ha ha ha ha
And there is a page listing all nations' device regulators, across their international market, seeking consistency, aren’t we all?
The evidence continues to accumulate, from the A.I.M.S report, through the other mother and baby unit scandals, unto Lucy Letby. The writing on the wall. There is by now, no such way out.
Paediatricans, across the world, are also treated to a paediatric citation of NG < 206 < 1.7
Different emphasis. Thats a knack.
I am sorry to say that our paediatricans, collectively, remain unable to define a differentiating diagnostic procedure, in case of suspected or confirmed M.E / F.I.I. Not even as given.
N.I.C.E and B.A.S.W and RCPCH said:
NG206 1.7.6 Safegarding
Offer children and young people with ME/CFS a review of their care and support plan at least every 6 months, and more frequently if needed, depending on the severity and complexity of their symptoms.
Big disagreement with the incidence, there. Being exaggerated, again. Since it can’t be expanded by factitIous or induced derangement, again. Hopefully. Humph.
So. Was it paediatricians, who told the UK's medical research funders, that a post-viral illness in a child, is factitious, so we don't need the differential diagnoses researched, after all, do we? Who says?
Where children are thought to have severe or very severe ME/CFS resulting in withdrawal and school absence,
or
where manifestations of the disease are similar to those that typically arouse safeguarding concerns,
more frequent face to face review (than the six-monthly suggested in the new guideline)
should be considered to ensure the child or young person’s wellbeing.
Obviously incapable of doing the differential diagnosis, then. Albeit a defined procedure, according to the “extremely welcome” Safeguarding guidelines, provided to physicans, police and social workers, by N.I.C.E and B.A.S.W. Do we not have paediatric competence?
It is extremely welcome to see inclusions on safeguarding in the guideline, including some with specific reference to children. However, we remain concerned that:
- the provisions described for safeguarding may diminish the voice of children and young people
- and prevent the rapid identification of abuse and neglect in some instances.
The RCPCH view and advice for paediatricians:
…for paediatricians, but its soon expanded into “clinicians”. Which clinicians are we watching and advising, here? A multi-disciplined network, not yet convened, to agree
While the six-monthly review, of children or young people with ME/CFS, should be offered
- and this is stated in the guideline,
paediatricians should always discuss care options, with the patient and their family or carers.
or else.... what ??? See what I mean. Duly refer suspected “induced illness”, to the police, why don’t you say so? In order not to, as you say, delay
For a child and young person, six monthly intervals may not be enough, and the clinician may wish to see the patient more frequently.
Wishful thinking, in the notably excessive number of cases, already. The paediatrician may wish to give a rationale. That is not already refuted, by upgraded guidelines. The rationale emerging is .... it may be cancer. Another failure to do the differential diagnoses
They will also wish to consider other symptoms and issues that could be impacting the child or young person.
- whole person - Assessment of the whole person
"integrated to be holistic", bio-medically linking the neurology with the liver?
As highlighted above, there is now an inclusion on the regularity of assessments for children, in section 1.7.6 on safeguarding.
This notes that children and young people should be seen at six-monthly intervals and more frequently if needed, depending on the severity and complexity of their symptoms.
…their M.E symptoms. Not their suspected cancer, nor their supected F.I.I. For that we have the cancer guideline and the F.I.I guideline. Different review process. Not an M.E care plan at all.
Do we agree with RCPCH, it takes too looooong for a paediatrician to assess a risk in case of M.E? I never heard of "discussing care options" for someone being monitored in case of suspected cancer. Bit premature. Bio-medical investigations come first.
And routine monitoring checks, in case of confirmed MGUS. Not MUS is it, MGUS? MUS was just defined to sound the same. Gave it a vague credence. More word-play when all else fails.
But F.I.I guidelines have a lot to say about discussing the case with the family, see if they comply, or else..... Don't we publicly brief, yes brief, a globe of paediatricians, upon referring their suspicions of induced illness, to the police, duly?
On those grounds that the family did not comply upon discussion of "care options"?
My take (any mistake is mine - all corrections needed and welcome)
Fiona Gullon-Scott, Cathie Long, FII and Perplexing Presentations: What is the Evidence Base for and against Current Guidelines, and What are the Implications for Social Services?, The British Journal of Social Work, Volume 52, Issue 7, October 2022, Pages 4040–4056, https://doi.org/10.1093/bjsw/bcac037
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