Conditions we write for.
Every condition here is mapped to the NHS guideline your GP is expected to follow. Pick yours to see what they should already be doing, by guideline number, by section.
ADHD (adult assessment)
NHS guideline NG87 covers recognition, diagnosis and management of ADHD in children, young people and adults. Adult patients have a legal right under NHS Patient Choice Guidance (NHS England, 19 December 2023) to ask their GP to refer them to any NHS-contracted provider for assessment, this is the NHS Right to Choose pathway.
Autism (adult assessment)
NHS guideline CG142 covers recognition, referral, diagnosis and management of autism in adults. Adult patients have a legal right under NHS Patient Choice Guidance (NHS England, 19 December 2023) to ask their GP to refer them to any NHS-contracted provider for diagnostic assessment, this is the NHS Right to Choose pathway.
Long COVID
NHS guideline NG188 sets out how the NHS should assess, refer and manage people with ongoing symptomatic COVID-19 and post-COVID-19 syndrome. It explicitly covers fatigue, breathlessness, brain fog, post-exertional malaise, and autonomic symptoms.
ME/CFS
NHS guideline NG206 (2021) replaced the old CG53 guideline. It explicitly removes graded exercise therapy as a treatment, requires recognition of post-exertional malaise, and sets a clear diagnostic pathway.
Fibromyalgia
NHS guideline NG193 covers the assessment and management of chronic primary pain, including fibromyalgia. It sets out specific recommendations for assessment, shared decision-making, and which pharmacological treatments should and should not be offered.
POTS / dysautonomia
POTS is increasingly recognised, particularly post-COVID. NG188 covers autonomic symptoms in the post-COVID context; broader Royal College of Physicians guidance also exists. The letter cites the relevant authority for your situation.
EDS / HSD
Joint hypermobility is covered in the NHS Clinical Knowledge Summary. Diagnosis of hypermobile EDS (hEDS) and Hypermobility Spectrum Disorder (HSD) follows the 2017 international classification (Beighton score plus systemic criteria) maintained by The Ehlers-Danlos Society.
MCAS
MCAS is diagnosed against the international consensus criteria (Valent et al., 2012, updated 2019): (1) recurrent, severe multi-system symptoms typical of mast cell mediator release (the consensus framing assumes anaphylaxis-level episodes, not background symptoms alone), (2) objective evidence of mediator release, most commonly a rise in serum tryptase of at least 20% above baseline plus 2 ng/mL, measured within 1–4 hours of a symptomatic episode, and (3) response to mast-cell-directed treatment (H1/H2 antihistamines, mast cell stabilisers). NHS adult immunology and allergy services in major teaching hospitals do investigate and diagnose it where those criteria are met. The looser 'consensus-2' (Afrin) criteria used in some patient communities are not the standard NHS immunology will accept.
Endometriosis
NHS guideline NG73 sets out a clear pathway for assessment, investigation and referral of suspected endometriosis. It is explicit that diagnosis should not depend on transvaginal ultrasound being normal.
Perimenopause / HRT
NHS guideline NG23 covers identification and management of perimenopause and menopause, including when HRT should be offered, discussed, and reviewed. It is explicit that diagnosis in women over 45 with typical symptoms should not require blood tests.
Adrenal insufficiency
NHS guideline NG243 (2024) sets out how primary care should suspect, test for, and manage adrenal insufficiency, a condition that can be life-threatening if missed. The guideline is explicit about when a 9am cortisol and short Synacthen test should be requested.
Migraine
NHS guideline CG150 sets the diagnostic pathway for migraine and lists the preventive treatments that should be tried (propranolol, topiramate, amitriptyline, and candesartan as an off-label option). Once a patient has failed at least three preventives, separate NHS Technology Appraisals cover CGRP monoclonal antibody injections (TA682 erenumab, TA659 galcanezumab, TA764 fremanezumab, TA871 eptinezumab); TA260 covers Botox for chronic migraine.
Cluster headache
NHS guideline CG150 explicitly covers cluster headache. Acute attacks should be treated with 100% high-flow oxygen and subcutaneous or nasal sumatriptan. In practice home oxygen for cluster headache is specialist-initiated (typically by neurology) rather than prescribed directly by GPs, and the Home Oxygen Order Form (HOOF) is completed by the specialist service. Prevention is usually verapamil with ECG monitoring, with a short corticosteroid course as a bridge. Urgent neurology referral is recommended on first suspicion.
Pathway guides for each condition.
Long COVID · NG188
Long Covid clinic referral
NHS guideline NG188 pathway, sample wording, and what to do if your GP refuses.
Read the Long COVID pathway guide →
ME/CFS · NG206
ME/CFS diagnosis (UK)
NHS guideline NG206, the four core symptoms, and the NHS pathway.
Read the ME/CFS pathway guide →
Fibromyalgia · NG193
Fibromyalgia diagnosis (UK)
2016 ACR criteria, NHS guideline NG193, and the NHS pathway.
Read the Fibromyalgia pathway guide →
MCAS · Valent 2012/2019
MCAS diagnosis (UK)
The NHS immunology pathway, tryptase testing, and what to request from your GP.
Read the MCAS pathway guide →
Endometriosis · NG73
Endometriosis diagnosis (UK)
Use NHS guideline NG73 to compress the 7–9 year wait.
Read the Endometriosis pathway guide →
Free UK patient-rights guides.
Plain-English guides on your NHS rights, your GP's duty of care, and how to get every word of your record. Written for patients, not lawyers.
Your GP's duty of care
What your NHS GP legally owes you — and how to spot a breach.
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The NHS complaints process explained, Stage 1 to PHSO.
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