"Have you tried more exercise? Or is it depression?", what you've probably been told
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.
The wait: Diagnosis takes an average of 6.8 years across Europe, with large variation between countries. Source: European ME Alliance, pan-European ME patient survey, 2024, over 11,000 respondents
What GPs miss
GPs trained on older guidance sometimes still recommend graded exercise. NG206 explicitly says this should not be offered to people with ME/CFS. The letter makes this current obligation visible.
The letter asks for
- Recognition of ME/CFS where the four core symptoms are present
- A management plan consistent with NG206, not the withdrawn CG53
- No recommendation of graded exercise therapy
- Referral to a specialist ME/CFS service for confirmation where one is available locally, noting that specialist provision is not evenly spread and some areas have none
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Frequently asked questions
My GP wants me to do graded exercise, is that current?
No. NHS guideline NG206 explicitly states that graded exercise therapy should not be offered to people with ME/CFS. The letter cites this directly.
What you hear vs. what NG206 says
What's usually said in the room
"Have you tried more exercise? Or is it depression?"
What the guideline actually says
GPs trained on older guidance sometimes still recommend graded exercise. NG206 explicitly says this should not be offered to people with ME/CFS. The letter makes this current obligation visible.
What to do next
You have just read what the guidance says. The gap most people hit next is getting that in writing, on their record, in front of their GP.
Your GP has not acted on it
We draft a formal letter to your NHS GP citing NG206, built from a 3 minute assessment in your own words. £39. Free redraft if anything reads wrong.
You are claiming PIP for this too
PIP award rates, trend and mandatory reconsideration for ME/CFS, computed from the DWP's Stat-Xplore database.
The same page covers what to do if you have already been refused.
You send the letter, not us. General information, not medical advice.
Where ME/CFS sits in the DWP's PIP award-rate league table
Benefits and rights for ME/CFS
PIP for ME/CFS
PEM, the reliability test, and how to score.
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LCWRA on Universal Credit
Substantial-risk rule for PEM-driven crashes.
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ME/CFS diagnosis (NG206)
How the NHS should diagnose and manage ME/CFS.
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Motability scheme (UK)
Use Higher-Rate Mobility PIP to lease a car for ME/CFS energy limits.
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Outcomes from people with ME/CFS
One short email each Sunday, anonymised stories from people who put their case to their GP in writing.