Sweden: termination of the contract for specialist medical care for ME in Stockholm, including the Bragée ME Center, 2023

mango · Feb 23, 2023

Posts moved from News from Scandinavia

Local news from Stockholm, Sweden.

According to a news article today, the politicians of Region Stockholm (the local government responsible for healthcare among other things) have decided to terminate the contract for Exhaustion Disorder and Chronic Pain, because they think it's too expensive. They also note that some of the medical care that is currently being offered lacks evidence.

This kind of contract (Vårdval) allows private healthcare providers to offer their services to patients for the same price as public healthcare providers (the providers are compensated by the local government), and it allows patients to choose which clinic they want to attend, whether it's public or private.

We need more facts to know for sure, but it seems very likely that this will affect Bragée ME Center too. Bragée Clinics' main business is rehab for patients with exhaustion disorder and chronic pain. And the contract for ME specialist care in Stockholm is an add-on to the Exhaustion Disorder and Chronic Pain contract.

Regionstyret avskaffar vårdval för utmattade – skickas till vårdcentral
https://sverigesradio.se/artikel/ett-vardval-slopas-av-regionstyret

Auto-translate said:

The centre coalition, supported by the Left Party, in the Stockholm Region is cancelling a health care option.

It concerns specialised rehabilitation for exhaustion disorder and long-term pain, a care option that costs over SEK 300 million a year.

Patients who should really be receiving care at their health centre have ended up in this care option. But it has also been observed that there is a lack of evidence in how the care is provided.

What does this mean for patients suffering from exhaustion syndrome or long-term pain?
More people will be able to go to their care centre, as it should be. Also, we are stepping up research and development in the area of care by setting up central investigation units for parts of that care, and simply strengthening it.

Two thirds will be returned to health centres and the rest to psychiatry and hospitals.
Click to expand...

(I searched the region's digital post room, but haven't been able to find any official documents about the decision yet.)

Sean · Feb 10, 2023

mango said: ↑

According to a news article today, the politicians of Region Stockholm (the local government responsible for healthcare among other things) have decided to terminate the contract for Exhaustion Disorder and Chronic Pain, because they think it's too expensive. They also note that some of the medical care that is currently being offered lacks evidence.
Click to expand...

Are the bean counters finally starting to swing their axes?

RedFox · Feb 10, 2023

It's gonna be hilarious when the accountants swing from calling biomedical treatment a waste of money to calling BPS treatment a waste of money.

mango · Feb 11, 2023

mango said: ↑

According to a news article today, the politicians of Region Stockholm (the local government responsible for healthcare among other things) have decided to terminate the contract for Exhaustion Disorder and Chronic Pain, because they think it's too expensive. They also note that some of the medical care that is currently being offered lacks evidence. [...]

We need more facts to know for sure, but it seems very likely that this will affect Bragée ME Center too. Bragée Clinics' main business is rehab for patients with exhaustion disorder and chronic pain. And the contract for ME specialist care in Stockholm is an add-on to the Exhaustion Disorder and Chronic Pain contract.
Click to expand...

So far no public comments have been published by Bragée, RME or RME Stockholm.

However, @MittEremltage has an informative post about this on their blog today, thank you! Excellent sleuthing, as always Please click through to the blog for links to source documents etc.

Är ME-vården i Stockholm på väg bort?
https://mitteremitage.wordpress.com/2023/02/10/ar-me-varden-i-stockholm-pa-vag-bort/

Auto-translate said:

Is ME care in Stockholm on its way out?

I have been in contact with the Stockholm region and have been told that what P4 Stockholm reported on belongs to a matter to be dealt with by the Health and Medical Committee on 21 February. The underlying investigation and proposed decision are already available on the Stockholm region website.

The draft decision contains several elements. There is talk of phasing out the care choice for ME with private providers by 2025, but also of securing future care for the patient group under the region's own management before phasing out takes place. The report is extensive and contains over a hundred pages, but there is also a summary in bullet point form:

"Proposal for a decision
The Health Care Board decides as follows:

The Director of Health and Medical Services is instructed to phase out the care option Specialised rehabilitation for long-term pain and for exhaustion disorder with termination in 2025 and to secure care for the patient groups.

The Director of Health is instructed to discontinue the additional mandate of Specialist Medical Care for ME/CFS from both care options to which it belongs, with termination by 2025 at the latest, and to secure care for the patient group.

The Director of Health is instructed to phase out the MMR1 supplementary mission associated with the GP service option by 2025.

The Director of Health is instructed to return with proposals for the location of a new in-house specialist investigation unit for ME/CFS in accordance with the proposals.

The Director of Health is instructed to come back with the location of a specialist investigation unit for long-term pain and a coordination mandate for pain care in accordance with the proposals.

The proposals concerning reinforcement in primary care and psychiatry, and the development of collaborative structures are approved."

It also says the following about future care:

"Based on the uncertain state of knowledge and the lack of evidence, elective care is not preferable for the diagnosis. In order to be flexible in the light of changing evidence, it is advocated that an investigation unit at specialist level be run in-house. This would allow a specialist level investigation unit to be set up in a hospital, for example, which would allow access to different specialties and ensure that the care environment is adapted to the patient group. During the pandemic, the Stockholm region has set up post-covid clinics in hospitals and similar staff categories and methods are in place for ME/CFS. It is possible that the region can benefit from the experience gained from this to ensure quality care for patients with ME/CFS."

So it seems that care for people with ME will cease in its current form. At the same time, it is also clear that people with ME will not be left without care - it will instead emerge in a new form under the region's own management.
Click to expand...

MittEremltage · Feb 13, 2023

Public comment from RME Stockholm about terminate the contract:

https://rme.nu/rme-regionforeningar...av-me-cfs-varden/?aiEnableCheckShortcode=true

And from Bragée:

https://m.facebook.com/story.php?st...oiU7L4cn9FfCbrgeHsTaKDv3wl&id=100055532378677

MittEremltage · Feb 13, 2023

MittEremltage said: ↑

Public comment from RME Stockholm about terminate the contract:
Click to expand...

Even Talla Alkurdi, one of the responsible politcans writes about the decision on Facebook:

https://m.facebook.com/story.php?st...yhMhPcrHkW4JGZe79RtAuzK7el&id=100063868876701

mango · Feb 23, 2023

mango said: ↑

According to a news article today, the politicians of Region Stockholm (the local government responsible for healthcare among other things) have decided to terminate the contract for Exhaustion Disorder and Chronic Pain, because they think it's too expensive. They also note that some of the medical care that is currently being offered lacks evidence. [...]
Click to expand...

A statement from Region Stockholm. The decision has now been made to terminate the contract for Exhaustion Disorder and Chronic Pain, which includes Bragée ME Center.

Förändringar inom vården för smärta, utmattning och ME/CFS
https://vardgivarguiden.se/nyheter/...-inom-varden-for-smarta-utmattning-och-mecfs/

Auto-translate said:

Changes in care for pain, exhaustion and ME/CFS

News item, published 21 February 2023

Patients with long-term pain, exhaustion disorder and ME/CFS will be cared for in primary care to a greater extent from 2025. Specialist units for pain and ME/CFS will be introduced in-house and patients with exhaustion disorder will be offered care in psychiatry. This is expected to lead to more equitable care, earlier interventions for patients and better alignment of care with the latest research.

A study carried out by the Health Administration shows the benefits of organising specialised care for long-term pain and ME/CFS in-house and in psychiatry for patients with exhaustion disorder. This means that the current specialised rehabilitation care for long-term pain and exhaustion disorder will be phased out. This will be done in conjunction with the additional mandate of specialist medical care for ME/CFS and the additional mandate of multimodal rehabilitation in family medicine.

In brief, the new organisation means that:

Primary care will be strengthened to ensure the care of patients.

Psychiatry will be strengthened to deal with patients in need of specialist care.

Specialist units will be set up for long-term pain and ME/CFS.

A co-ordination role is also introduced for pain care as a whole.

Collaborative structures are developed to provide patients with a coherent care chain.

Resources currently spent on care choice will be reallocated to primary care (GP services, primary care rehabilitation and specialised physiotherapy) and to specialised care.

Benefits for patients

Patients will be offered more treatment options and more personalised care tailored to their conditions and needs. Extended primary care with consultation support from specialised care will increase opportunities for early intervention that can shorten the course of illness and reduce sick leave. Closer links with research will, in the long term, improve the development of care and treatment for the target groups. The coordination of pain care will improve the conditions for offering patients a coherent chain of care.

In the current care option, the Stockholm Region has only commissioned one treatment method for the target groups, multimodal rehabilitation. Patients who do not fit into comprehensive group programmes are currently excluded from rehabilitation, even if they are deemed to be in need of specialist level care. This makes it more difficult for patients with interpreting needs or other circumstances that make it more difficult to participate in a group. The new decision means that more treatment options can be offered at specialist level, with multimodal rehabilitation being one of the possibilities.
Click to expand...

mango · Feb 23, 2023

mango said: ↑

A statement from Region Stockholm. The decision has now been made to terminate the contract for Exhaustion Disorder and Chronic Pain, which includes Bragée ME Center.

Förändringar inom vården för smärta, utmattning och ME/CFS
https://vardgivarguiden.se/nyheter/...-inom-varden-for-smarta-utmattning-och-mecfs/
Click to expand...

A comment from RME Stockholm, on Facebook. However, they have a long history of being less than transparent in their communications, so personally I'd prefer to get the facts from the primary sources rather than RME's interpretations and speculations. To me, RME's comment below doesn't seem to match up with the Region's public statements?

https://www.facebook.com/story.php?...SVrk9tscMFLpBUFB1TdWaAAESl&id=100054516336732
Click to expand...

Sean · Feb 23, 2023

Psychiatry will be strengthened to deal with patients in need of specialist care.

Not learning much, are they.

mango · Feb 23, 2023

mango said: ↑

A statement from Region Stockholm. The decision has now been made to terminate the contract for Exhaustion Disorder and Chronic Pain, which includes Bragée ME Center.

Förändringar inom vården för smärta, utmattning och ME/CFS
https://vardgivarguiden.se/nyheter/...-inom-varden-for-smarta-utmattning-och-mecfs/
Click to expand...

Bragée Clinics' comments on the decision:

Vårdavtalet avvecklas på sikt: Rehab och utredningar pågår som vanligt
https://www.bragee.se/namnlos-17

Auto-translate said:

Care agreement to be phased out in the long term
Rehab and investigations continue as usual

"We will keep on working". That is the message from the head of operations to both patients and referrers after the news that the region has decided to abolish the care choice. There is still time to apply for rehabilitation or investigation. "Trusted and safe" is still our motto.

A big news has been that the care choice under which we work, will be phased out. Patients with pain and/or fatigue as well as ME/CFS and referrers are probably wondering what happens now? Here are the answers we can give today, from Andreas Iwarsson, Bragée Clinics' Operations Manager:

- Firstly, we are working on as usual in all units: pain, fatigue and ME/CFS. Care choice will not end until 2025. This means that there is still a unique opportunity for patients with pain/exhaustion to participate in a rehabilitation programme that is comprehensive and that we know helps. Outcomes are recorded nationally in the NRS and we receive positive feedback from our rehab participants on a daily basis.

- Of course, we think it's unfortunate that the region doesn't choose to keep the care option, because pain rehab in this form has an up-to-date knowledge of long-term pain and how it is diagnosed and treated.

At the ME-Center, our specialist clinic for ME/CFS, investigations continue unabated, with referrals from all over the country.

- When it comes to ME, the ME-Center conducts qualified basic research on this difficult diagnosis and we are almost alone in the country in admitting these patients. We are in close dialogue with politicians, the administration and patient associations about the future and I hope we can contribute our unique knowledge and ensure a safe transition to the new.

- But we are also, of course, a little worried that the expertise built up here over a long time will be lost, and we don't want that to happen.

Late in 2022, new national guidelines for better care and care pathways for pain patients came out. The idea is to catch those at risk of long-term pain early on in primary care.

- The guidelines are very good and forward-looking and emphasise that different professional groups need to work together," says Andreas Iwarsson. My hope is that primary care will be able to make this transition, so that patients with long-term pain - and all the consequences it has on their lives - do not fall through the cracks. There is a lot to be done to make teamwork work, which is what these patients need - different professions coordinating and working together around the patient. But what I think will take the longest time to establish in primary care is the pain analysis that always takes place in a pain clinic and which is extremely important for how the pain is later treated.

- In conclusion, I would like to stress that the entire Bragee Clinic will continue to function as usual and that both patients and referrers can continue to feel trusted and safe - our watchword. I say as during the pandemic - we don't cancel, we reschedule. Everyone is still welcome with referrals and we still have short waiting times..
Click to expand...

mango · Feb 23, 2023

mango said: ↑

A statement from Region Stockholm. The decision has now been made to terminate the contract for Exhaustion Disorder and Chronic Pain, which includes Bragée ME Center.

Förändringar inom vården för smärta, utmattning och ME/CFS
https://vardgivarguiden.se/nyheter/...-inom-varden-for-smarta-utmattning-och-mecfs/
Click to expand...

Björn Bragée comments on Facebook:
https://www.facebook.com/argadoktorn/

Direct links to the relevant posts:

https://www.facebook.com/argadoktor...1Xy2wg8kRfxV5MCVGU1vUj9KJqCHyFz9WkYj5BzASK7Bl

https://www.facebook.com/argadoktor...9NwuVdkGSqxvqn9TQwUk9mrpvknugp7KW8L2MYjcGoEfl

https://www.facebook.com/argadoktor...oorR3aamM85xz35yGzhwfLiELnNxkGRAqdDd8nvRUTLsl

https://www.facebook.com/argadoktor...xqm9JmCjY9XrWqL5Ypv3ifzkmp9thH8nNndDYUfgKx1Nl
Click to expand...

mango · Feb 23, 2023

mango said: ↑

A statement from Region Stockholm. The decision has now been made to terminate the contract for Exhaustion Disorder and Chronic Pain, which includes Bragée ME Center.

Förändringar inom vården för smärta, utmattning och ME/CFS
https://vardgivarguiden.se/nyheter/...-inom-varden-for-smarta-utmattning-och-mecfs/
Click to expand...

Opinion piece by Björn Bragée (published 16 February, ie before the decision was made):

”Regionbeslut slår sönder forskning om ME/CFS”
DEBATT: ME-experten Björn Bragée larmar om följderna av stoppad privatvård för kroniskt trötthetssyndrom.
https://www.lakemedelsvarlden.se/regionbeslutet-slar-sonder-fem-ars-me-forskning/

Auto-translate said:

"Regional decision shatters ME/CFS research"

DEBATE: ME expert Björn Bragée warns of the consequences of stopping private care for chronic fatigue syndrome.

16 Feb 2023, 10:20 am

DEBATE. Under the campaign slogan "more research on ME is needed", the new left-wing majority now intends to discontinue the care option for long-term pain including the care option ME/CFS, formerly called chronic fatigue syndrome. These diagnoses account for more social costs than all hospitals, and sufferers have a lower quality of life than patients with cancer or rheumatism.

Within this care option there is the only specialist clinic for ME/CFS in Sweden, Bragée ME-Center, with successful research on the diagnosis.

But the unit, like others in the care choice, is private. And that is more important than the facts. We can see that the investigation is sloppy and inadequate, does not report submitted facts and, for example, hides research carried out. According to Jonas Lindberg, V, the politicians only receive the basis for the closure five days before the decision.

Tearing up five years of qualitative research

In fact, five years of carefully constructed research on a neuro-immunological disease that probably affects between 50,000 and 100,000 Swedes is now being smashed. This research is being carried out in collaboration with two Swedish and several foreign universities, most recently Yale University in the USA.

The Bragée Clinics' ME centre now has the world's largest well-defined and registered - and highly research-intensive - patient group with the diagnosis. It is the result of 4000 referred patients from all over the country, 2000 of whom have been diagnosed and are enrolled.

This private unit, with four full-time doctors, employs around 30 staff in a range of health professions; one full-time associate professor as research coordinator, two half-time research posts, two PhD students, nine postdoctoral doctors and two research nurses. Evaluation and monitoring permeate all activities.

Patients with ME/CFS have a high co-morbidity

Our study of the 229 first patients admitted shows that they have a very high degree of physical co-morbidities of various kinds, such as connective tissue disease. In the paper, published in the journal Frontiers of Neurology and the most widely read ever in the history of that edition, we have shown that these patients seek care five times more often than the normal population before diagnosis. On average, they had 9 years of medical history and 20 diagnoses!

In a recent paper from a collaboration with Linköping University on our patients, we have shown that a simple saliva test can show that patients with ME are different from healthy ones when they are affected by Covid-19. Dormant herpes and other viruses are reactivated, which has already initiated subsequent drug research.

Half a dozen projects are under way. These are now compromised by this almost obsessive attitude that clinical research can only take place in hospitals.

In a parliamentary hearing on ME/CFS in May 2021, incidentally the first ever on a diagnosis, there was total agreement in the Social Affairs Committee and among respondents that more clinical research on large, well-investigated patient groups is needed. It is now put off for many years, research takes a long time to build up, but only five days of political discussion to put down.

Björn Bragée, MD, specialist in anaesthesia/intensive care and pain management and founder of Bragée Clinics.

Editor's note: Opposition regional councillor Jonas Lindberg, V, has offered to comment but declined. The Social Democrats in the Stockholm Region plan to respond to the criticism.
Click to expand...

(Bragée writes a "disease that probably affects between 50,000 and 100,000 Swedes".
??? The current population of Sweden is approx 10,2 million...

"Half a dozen projects are under way."
Can I see the ethical approval applications for those projects, please?)

***

Reply from Talla Alkurdi, Region Stockholm:

”Vi vill skapa kunskaps-center för ME/CFS”
Regionrådet Talla Alkurdi, besvarar Björn Bragées kritik om att stoppad privatvård krossar forskning om ME/CFS.
https://www.lakemedelsvarlden.se/debattsvar-av-talla-alkurdi-om-forskningen-om-me-cfs/

Auto-translate said:

"We want to create a knowledge centre for ME/CFS"

Regional Councillor Talla Alkurdi, responds to Björn Bragée's criticism that stopping private care is crushing research on ME/CFS.

17 Feb 2023, 11:50

DEBATE. In a recent opinion piece, Björn Bragée criticised Region Stockholm's decision on ME/CFS, formerly known as chronic fatigue syndrome. The criticism focused, among other things, on how research is affected.

In response to this criticism, we would like to emphasise that care and research into ME/CFS must be strengthened, both nationally and in the Stockholm Region. Far too many patients today fall between the cracks and do not receive the care they need.

There are no plans to dismantle this care - on the contrary - and it is very regrettable that this type of misinformation is being spread. The investigation into ME/CFS care has been ongoing for most of 2022 and is based on solid evidence and a good dialogue with both patients and professionals.

Can promote evidence-based care across the country

The Centre Coalition is very pleased that the Stockholm Region is now taking a unified approach to rehabilitation for long-term pain, exhaustion disorder and ME/CFS. Bringing these different diagnoses together in a single care option has made care and treatment as well as research and development more difficult.

By setting up central investigation units and enabling research and the dissemination of knowledge, we can develop care and reduce the risk of patients falling through the cracks.

The Stockholm region currently lacks a centralised knowledge centre for ME/CFS. We want to create one, both to strengthen care in the region and to promote evidence-based development in a national context. This is not possible today.

A central unit that can be formed into a knowledge centre or academic specialist centre enables access to different specialties and ensures that it is a care environment adapted to the patient group. It also provides an option for hospital admission should this be required. This represents a major improvement from the current situation.

We will make use of the expertise

At the same time, we want to make it clear that this central unit will also be able to provide treatment. However, the exact form of the mandate should be defined in close dialogue with the business, patient organisations and the profession, as described in the report. Existing expertise needs to be utilised in the development work.

In conclusion, we regret the harsh tone given by the health care provider in the opinion article, which is also spread to worry patients. This makes it difficult to have a factual and good dialogue. We have no other ambition than to develop care for ME/CFS and have had a good and constructive dialogue with RME Stockholm and we share the patient association's problem descriptions. We hope that everyone involved will want to work together to strengthen and develop care for ME/CFS.

Talla Alkurdi, S, Regional Councillor for Health, Stockholm Region
Click to expand...

mango · Feb 23, 2023

mango said: ↑

A statement from Region Stockholm. The decision has now been made to terminate the contract for Exhaustion Disorder and Chronic Pain, which includes Bragée ME Center.

Förändringar inom vården för smärta, utmattning och ME/CFS
https://vardgivarguiden.se/nyheter/...-inom-varden-for-smarta-utmattning-och-mecfs/
Click to expand...

News article about the decision

Beslutet: Smärtkliniker tas bort som vårdval i Region Stockholm
https://www.svt.se/nyheter/lokalt/s...niker-tas-bort-som-vardval-i-region-stockholm

Auto-translate said:

The decision: pain clinics are removed as a health care option in the Stockholm Region

Updated 21 February 2023 Published 21 February 2023

On Tuesday, the centre coalition, supported by the Left Party in the Stockholm Region, decided that the care option for complicated pain problems should be removed as a separate care option.

- We are strengthening research and development in this area of care and expanding care so that we deliver good care under the region's management instead, says Talla Alkurdi (S), health and medical regional councilor.

Specialists and general practitioners have been able to refer patients with exhaustion disorder, long-term pain and ME/CFS and complex pain problems to special pain clinics that have signed a care agreement with the region. However, the Stockholm Region has now decided that in future patients will be treated primarily in primary care.

Talla Alkurdi (S), regional councillor for health and medical services, believes that the change is not about saving the approximately SEK 300 million a year that the care choice costs, but that more patients should receive care under the region's management.

Strong criticism from opposition regional councillor

According to the Stockholm Region, the dismantling of the healthcare choice will be completed in 2025. Désirée Pethrus, a member of the opposition regional council (KD), is critical of the dismantling of the care option and the risk that patients will fall through the cracks.

Hear more in the video above.

Patients with long-term pain and exhaustion syndrome

Around 2 800 patients undergo pain rehabilitation annually. About 900 patients are assessed in the study that preceded the decision to have such a large number of symptoms that the resources of primary care will not be sufficient. They will instead be cared for in psychiatry and hospitals.

Source : Stockholm Region Health Administration
Click to expand...

mango · Feb 23, 2023

Here are the official documents from Region Stockholm, the minutes of the meeting.

https://www.regionstockholm.se/poli...27581-c2a7e9293a885271146-0d7d594c75e55351843

Auto-translate said:

Board of Health

MINUTES HSN 2023-0132

2023-02-21

§ 27
Investigation of ordering form - Care choice Specialised rehabilitation for long-term pain and exhaustion disorder and additional assignment Specialist medical clinic for ME/CFS

HSN 2022-0525

Case description
The Health and Medical Services Administration was commissioned by the Contract Committee to investigate the most suitable form of ordering for the target groups currently cared for under the care option specialised rehabilitation for long-term pain and for exhaustion syndrome with the additional mandate of specialist medical consultation for ME/CFS. The target groups concerned are patients with long-term pain with very complex problems, severe exhaustion disorder and moderate to very severe ME/CFS. The Health Care Administration presents in this dossier the report of the investigation and proposals for further action. [...]

The Health Care Board decides as follows:

1. The Director of Health and Medical Services is instructed to phase out the care option of specialised rehabilitation for long-term pain and fatigue syndrome, which will end in 2025, and to secure care for the patient groups.

2. The Director of Health is instructed to discontinue the additional mandate of Specialist Medical Care for ME/CFS from both of the care options to which it belongs, with expiry by 2025 at the latest, and to secure care for the patient group.

3. The Director of Health is instructed to discontinue the MMR1 supplementary mission associated with the GP care option by 2025.

4. The Director of Health and Medical Services is instructed to submit proposals for the location of a new specialist investigation unit for ME/CFS under his own management, in accordance with the proposals.

5. The Director of Health is instructed to return with a proposal for the location of a specialist investigation unit for long-term pain and a coordination mandate for pain care in accordance with the proposals.

6. approves the proposals for strengthening primary care and psychiatry, and developing collaborative structures

7. The Director of Health and Medical Services is instructed to take account of the proposals for additional decisions from the Social Democrats, the Centre Party, the Green Party and the Left Party in the further investigation work, attachment
Click to expand...

Auto-translate said:

Proposal for a supplementary decision concerning investigation of the form of order - Care choice specialised rehabilitation in long-term pain and in exhaustion disorder and supplementary assignment Specialist medical clinic in ME/CFS

The Centre Coalition and the Left Party very much welcome the fact that the Stockholm Region is now taking a unified approach to rehabilitation for long-term pain, exhaustion disorder and ME/CFS. Bringing these dispersed diagnoses together in a single care option has made care and treatment as well as research and development more difficult. By setting up central investigation units and enabling research and the dissemination of knowledge, care can now be developed for patients and the risk of falling between the cracks reduced.

The Stockholm region currently lacks a centralised knowledge centre for ME/CFS. This is what we now want to be able to create, both for the region and to be able to operate in a national context. This cannot be done today if it is still a choice of care. A central unit that can be shaped into a knowledge centre or academic specialist centre enables access to different specialties and ensures that it is a care environment adapted to the patient group. It also provides an option for inpatient care if needed.

At the same time, we would like to clarify that this central unit should also be able to provide treatment. However, the exact form of the mandate should, as described in the report, be defined in close dialogue with the business, patient organisations and the profession, and in the light of developments in the state of knowledge. Existing expertise needs to be used in the development work.

The Social Democrats, the Centre Party, the Green Party and the Left Party propose that the Committee on Contracts propose that the Health and Medical Care Board decide as follows:

The Director of Health and Medical Services is instructed to take account of the above in the further investigation work
Click to expand...

mango · Feb 23, 2023

Here's another official document from Region Stockholm, published before the decision was made:

Utredning av beställningsform - Vårdval Specialiserad rehabilitering vid långvarig smärta och vid utmattningssyndrom samt tilläggsuppdrag Specialistläkarmottagning vid ME/CFS
https://docs.netpublicator.com/api/public/r01124007/document/2f3395b0ef49ce419145-b1c5-4601-a8e6-05c89345a776?hash=5588596f5ce449-3680ecec55663227581-c2a7e9293a885271146-fe279f9e2f335271158&cache=Sat%20Feb%2011%202023%2011:38:23%20GMT+0100%20(CET)

rvallee · Feb 23, 2023

Sean said: ↑

Psychiatry will be strengthened to deal with patients in need of specialist care.

Not learning much, are they.
Click to expand...

They almost seem addicted to wasting money on useless stuff that never delivers anything. It's baffling. As if this money needs to be burned for nothing. But then again, belief systems are always weird from the outside.

mango · May 31, 2023

Bragée Clinics have made the decision to close down ME Center, according to Björn Bragée on Facebook.

https://www.facebook.com/1000323592...uKog59a2HRKSveMkcCJBqToWXWVg6Zhzx2N3mCz4FYXl/
Click to expand...

Bragée Kliniker on Facebook auto-translate said:

And so came the day that we could not have imagined. With a heavy heart, we ourselves have had to make the decision to close the ME Centre. The decision has not been taken lightly, but it has become impossible to continue providing the care we want to offer. The Health Care Board had already decided to terminate our contract for ME/CFS until 2025 and we naturally planned to continue until then.

However, new challenges have arisen, reimbursement levels have been reduced and the basis for offering good care until 2025 no longer exists. At the same time, we understand that decision-makers in the region need to balance a variety of patient needs in a tight economic climate.

We understand that a new project group within the region has been formed. This project group will focus both on primary care, where most of the care for ME patients will be provided, and on the opening of a specialist clinic, where primary care will be able to refer ME patients for more specialised care. So there is hope for the many sufferers.

15 December 2023 will be our last day of operation at the ME Centre. Until 15 November 2023, we hope to be able to accept new referrals for assessment.

We fear that, at least in the short term, this will cause difficulties for our patients and we want to do everything we can to support you during this transition! Please read more on our website, bragee.se, which we will update in the future. The comment field for this post will be closed, we cannot answer questions here as we need our resources to contact the established channels. For patient matters, we refer to contacting us via 1177. The ME Centre can also be reached on 08 545 888 71.

NOTE - this post only applies to the Bragée ME Centre. Bragée Rehab's rehabilitation programme for pain and fatigue is not affected, as this activity will continue as previously planned until 2025.
Click to expand...

mango · May 31, 2023

As some of you perhaps remember, this is not the first time they threaten to/announce that they will close down.

https://www.s4me.info/threads/bragée-me-cfs-center-in-sweden-is-probably-closing.3702/

Kitty · May 31, 2023

mango said: ↑

Bragée Clinics have made the decision to close down ME Center, according to Björn Bragée on Facebook.
Click to expand...

Wonder if it's worth staking 100kr on the announcement of a brand new long Covid centre?

mango · May 31, 2023

Kitty said: ↑

Wonder if it's worth staking 100kr on the announcement of a brand new long Covid centre?
Click to expand...

I would not bet against you..!

Log in or Sign up

Sweden: termination of the contract for specialist medical care for ME in Stockholm, including the Bragée ME Center, 2023

mango Senior Member (Voting Rights)

Sean Moderator Staff Member

RedFox Senior Member (Voting Rights)

mango Senior Member (Voting Rights)

MittEremltage Senior Member (Voting Rights)

MittEremltage Senior Member (Voting Rights)

mango Senior Member (Voting Rights)

mango Senior Member (Voting Rights)

Sean Moderator Staff Member

mango Senior Member (Voting Rights)

mango Senior Member (Voting Rights)

mango Senior Member (Voting Rights)

mango Senior Member (Voting Rights)

mango Senior Member (Voting Rights)

mango Senior Member (Voting Rights)

rvallee Senior Member (Voting Rights)

mango Senior Member (Voting Rights)

mango Senior Member (Voting Rights)

Kitty Senior Member (Voting Rights)

mango Senior Member (Voting Rights)

Share This Page

Log in or Sign up

Sweden: termination of the contract for specialist medical care for ME in Stockholm, including the Bragée ME Center, 2023

mango Senior Member (Voting Rights)

Sean Moderator Staff Member

RedFox Senior Member (Voting Rights)

mango Senior Member (Voting Rights)

MittEremltage Senior Member (Voting Rights)

MittEremltage Senior Member (Voting Rights)

mango Senior Member (Voting Rights)

mango Senior Member (Voting Rights)

Sean Moderator Staff Member

mango Senior Member (Voting Rights)

mango Senior Member (Voting Rights)

mango Senior Member (Voting Rights)

mango Senior Member (Voting Rights)

mango Senior Member (Voting Rights)

mango Senior Member (Voting Rights)

rvallee Senior Member (Voting Rights)

mango Senior Member (Voting Rights)

mango Senior Member (Voting Rights)

Kitty Senior Member (Voting Rights)

mango Senior Member (Voting Rights)

Share This Page

Useful Searches