There was discussion about setting up a patient panel which could become useful if it evolved into a PPI steering type group but they scoped it as solely to discuss differences in lived experience of movement helping or hindering etc. And they seemed to expect patients to be leading it.
Just to pull this line out that I read over a while ago and now am thinking is a bit weird.
A patient panel solely to 'discuss the lived experience of movement helping or hindering etc'. Could they not be getting up to speed with what actually are the most pressing issues from different groups first to find out what is most urgent?
Where is this specific 'thing' coming from (?) - it does indeed seem a strange place to begin given it feels like the classic trope-line they should be clamping down on and putting in a trope list of 'I'd love to be lying in bed all day too'. It feels very old-fashioned as I thought the obvious answer is 'it depends' on what someone individually has severity wise and other conditions. And whether they are able to and what it is 'spent on' is dictated by circumstance and priority. This slightly feels like an informal re-run of the pace trial if done wrong.
But more to the point why is this the biggest priority? Of all the things.
with the ongoing issues there seem to be currently of making things accessible even to those who are severe, nevermind very severe so participation being limited. Particularly given if it relates to that article which waited until the penultimate para to add in a caveat of: 'of course there will be some who are too ill'. Rather than realising 'do no harm' was the most important thing of any article so such 'this doesn't apply' should have been the first para?
How someone uses their entire envelope for the day, if they have it, isn't to be dictated by people in entirely different circumstances with different responsibilities and privileges as safety nets - so you need circumstances that reflect what people will endure today, including those with no support. The size of their envelope is on the other hand medically determined. And it had been since the Nice guideline and the research showing 'pushing through' 'therapies' don't work agree that PEM exists I thought (?) so that increases as you get better, not the other way around.
The information from MEA used to be informed by medical knowledge and make a point of noting how individual things are. The Nice guideline covers this area. Is this to inform those within the MEA about the different circumstances others with each severity might live under (in which case how are they making sure they are making it possible for those more severe also with difficult circunstamces are being got in touch with and making it possible for them to contribute without it being wasted energy?) in order to enlighten what it is like on the ground for those with these situations different to them?
Why are we heading specifically again into this territory that would take incredible skill and nuance for it not to backfire in a way that will harm the most vulnerable? Particularly given what is currently happening with trying to get services etc suitable for those who are severe. We all know one person saying they like to or do x can be used by others to suggest why doesn't another person do it, even if it turns out person x ends up the worse for it 2yrs down the line. That 'longest timeframe' was underlined by Nice for very good reason. Are they going to be at least ensuring wht would need to be incredibly careful questions and input in making sure someone is 'qualified' (ie has completed that timeframe to be able to say the outcome of whatever they did/tried) to answer it etc.
As a side note, and another thread one day.
I agree they need proper experienced (ie with different levels and a large amount of years so they've gone through the 'hoping' phase and seen 2yrs on whether trying x, y, z actually did work) and knowledgeable patients, not some grab a few patients to tick a box, and that it should be informing everything they do in order to make sure we don't have more 'splaining'. And to direct the priorities as the biggest areas of crisis/horizon scan and be in the loop as to what seemingly small 'nudges' end up doing to certain groups (eg the straw breaking camels back). I'm a bit worried if they would be used for something else.
I also increasingly actually think it needs to be over-weighted with those more severe for various reasons including how hard it is for them to speak vs those less ill (and be heard) but also to give room for them just doing part of things and of course because there are probably more issues those will have encountered due to the nature of the condition meaning more support is needed (whether provided or not). It's 25% of all patients, it's hugely hard for them to communicate but harder if they are outnumbered by those with more energy, and any of those patients could have been or end up as part of that 25% so that level and how it is understood and treated affects everyone. Because it is one illness.
And it’s hard to imagine or even believe the level of debility + how much hands are tied behind your back and you are undermined by others due to misinformation and minimising until you’ve been there long enough to know you might be stuck there, yet if 4 severe people agree and back each other up it
is more heard than if it's one poor soul people assume it's just them and their 'individual situation' not an indicator eg of a service issue or a common symptom pattern etc - I know some people wit less severe ME are as bad at not getting the exponential impact and limitations as some who don’t have it at all. So less than 25% of all input is inappropriate.
I'm not sure what I'm thinking this would require and be is the same thing