Dear
I recently became aware of a training module for MECFS in The Pulse magazine, which is a publication for UK GPs. It counts towards CPD and suggests that it will help GPs provide a service to patients with mild to moderate ME under the new NHS Delivery Plan. It takes place on 24 March 2026.
https://www.pulsetoday.co.uk/news/clinical-areas/neurology/me-cfs-diagnosis-and-management-among-topics-at-free-pulse-virtual-event-for-gps/
Historically ME patients have been forced into CBT and Graded Exercise Programmes which assumed that patients were frightened of exercise and their illness was caused by inactivity and deconditioning. There is now scientific evidence that this is factually incorrect and that GET harms patients and and can cause a long term relapse.
The evidence based 2021 NICE guidelines state:
1.11.14
- any therapy based on physical activity or exercise as a cure for ME/CFS
- generalised physical activity or exercise programmes – this includes programmes developed for healthy people or people with other illnesses
- any programme that does not follow the approach in recommendation 1.11.13 or that uses fixed incremental increases in physical activity or exercise, for example, graded exercise therapy (see box 4)
- physical activity or exercise programmes that are based on deconditioning and exercise avoidance theories as perpetuating ME/CFS.
1.12.32
- aims to improve their quality of life, including functioning, and reduce the distress associated with having a chronic illness
- does not assume people have 'abnormal' illness beliefs and behaviours as an underlying cause of their ME/CFS, but recognises that thoughts, feelings, behaviours and physiology interact with each other.
Dr Alastair Miller will be conducting the training. He is a vocal proponent of the Bio Psycho Social (BPS) model of MECFS. It’s a theory that the illness is both biological and psychological. This can be true for all diseases; that they have a biological and psychological component. Unfortunately we don’t have any effective biological treatments for ME, so the focus of BPS treatment programmes is entirely on psychological approaches without treating the biological illness. These are the same treatments that the NICE guidelines found to be ineffectual at best and harmful at worst. (Imagine having cancer or a broken leg without treatment and being told that you have unhelpful illness beliefs and need to increase your activity to feel better. It’s not just unhelpful, it harms us as we cannot recover normally after exercise and it makes us sicker.)
Here is a link to an article that Dr Miller wrote last year where he contradicts the evidence based NICE guidelines.
https://www.bmj.com/content/389/bmj.r977
Please can you contact whoever is responsible for overseeing NHS training and ask them whether this CPD module for GPs is going to adhere to the new guidelines? Or is it going to contradict them and perpetuate misinformation and continue the harm to patients? If it is the latter then I expect them to take action and stop this module taking place.
Many thanks