Fatigue service


In October 2021, NICE (National Institute for Health and Care Excellence) released guidelines for the diagnosis and management of ME/CFS. To view the guidelines, please click here. The fatigue service welcomes the publication of these guidelines and continues to take steps to update the service based on their reccomendations.

The Royal Free London fatigue service provides assessment and treatment for people experiencing fatigue symptoms. Fatigue can present in different ways and the team is involved with the care and rehabilitation for people with:

Chronic fatigue syndrome (CFS), which is also known as:

  • Myalgic encephalopathy (ME)
  • ME/CFS
  • Post viral fatigue syndrome (PVFS)


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Referral details

The referral process

You might be aware that there is no test that confirms the diagnosis of CFS/ME, and therefore we have to exclude any other causes for your symptoms. In order to do this, you will need to have blood tests arranged via the GP. These blood tests will need to have taken place since the onset of your symptoms. Your GP will be aware of what these blood tests are and arrange them for you if you have not had them already.

Your referral will have to be made by your GP. Unfortunately, we are not able to accept self-referrals. We will assess the information your GP has provided and, if necessary, discuss your case with him/her. We will then either accept the referral or make suggestions for a referral to other services if we feel that this is more appropriate (for example, to a sleep clinic if a primary sleep disorder is the most likely diagnosis). We have a detailed transition protocol to ensure that if you are referred from children or adolescent services the transfer is as seamless as possible.

Once your referral has been accepted

You will be sent an appointment for an initial introduction to our service, which will most likely be delivered online. This introduction session will help orientate you to our service and explain the different treatment approaches that we offer. If you wish to work with us, you will then be offered an initial 1:1 assessment before engaging with our therapy team. Our appointments are made by a member of our administration team, if you have any queries you can call them directly: 020 7794 0500 extension: 31717.

Information for health professionals

If you wish to refer a patient to our chronic fatigue service, please use our referral form. Before referring a patient, please read through the guide for referrers.


Dear colleague,

We would like to inform you that our two clinical/counselling psychology posts will be vacant from 01-

04-2023. We are acting swiftly to fill these posts and have taken measures to reduce the impact of these

vacancies in the interim, such as sourcing a bank psychologist to cover our group-based Fatigue

Management Programmes and weekly MDTs. However, we will not be able to offer 1:1 psychology

therapy sessions until we have substantive staff in post.

We will of course update you once our psychology pathway is back at capacity.

The Team

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