occupational management of cfs for employers

8/14/2019 Occupational Management of CFS for Employers

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Occupational aspects ofthe management of

chronic fatigue

syndrome: evidence-

based guidance for

employers


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Introduction

This leaflet summarises the findings of areview of the scientific evidence on the

occupational aspects of the managementof chronic fatique syndrome (CFS*). It isintended for employers and summarisesthe evidence-based guidance on how tosupport individuals back into, and to

remain in, work.

* Occupational aspects of the management of chronic fatiguesyndrome: a national guideline. NHS Plus. London 2006.

What is CFS?

CFS is an illness characterised by severe,disabling fatigue (tiredness) and other

symptoms, which may include poorconcentration, sleep disturbance,headaches and musculoskeletal pain.These symptoms need to have beenpresent for at least six months, although

a presumptive diagnosis may be mademuch earlier.

CFS affects approximately four in 1,000

of the population. Although it can occurat any age, it is more common in peoplein their 20s, 30s or 40s and the illnessaffects women more than men.


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It is not unusual for people with CFS tosuffer from other conditions, such asdepression and anxiety disorders, andwhere these occur they should also be

treated.

A feeling of being tired all the time isvery common. Fatigue that persists for

six months or more is often referred toas chronic fatigue, but without thepresence of the other symptomspreviously mentioned it is not CFS.

Myalgic encephalomyelitis (ME) andpost-viral fatigue syndrome are termsthat people with CFS often use todescribe their condition; however, as

these imply a known disease process thathas not been proven, most healthcareprofessionals prefer the term CFS.

Will people with CFS get better?Published research into CFS suggeststhat, while not all sufferers recover fully,many improve enough to return to

work. Unfortunately, some sufferers mayalso relapse.


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Prompt delivery of appropriatetreatment increases the likelihood ofrecovery and a return to work.

What are appropriate treatmentsfor CFS?

Cognitive behavioural therapy (CBT)has been shown to be helpful for someindividuals. CBT is a structured form ofpsychotherapy. The duration oftreatment with CBT varies betweenindividuals and is generally undertaken

over a period of six to 12 months.

Graded exercise therapy (GET) alsoappears to be helpful for some

individuals. This is a carefully structuredprogramme designed to graduallyincrease aerobic activity. It is a moreplanned intervention than simple adviceto exercise more.

Pacing is a treatment in whichindividuals manage their energy levelswithin an envelope. However, there is

no published research yet to show justhow effective this is. Pacing is beingstudied in the UK and the results aredue in 2009.


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What should an employer do?

If an individual complains of fatiguethat is interfering with their work or

has been diagnosed with CFS, youshould refer them to an occupationalhealth professional (OHP).The OHP can ensure that illnessesthat can cause fatigue are treated,

give positive advice to helpindividuals avoid unnecessary restwhen it is not appropriate, andadvise on their fitness for full or

restricted work or assist in a return towork plan. The OHP will liaise withthe individuals GP, consultant ortreating practitioner.

You need to ensure that any workissues your member of staff perceivesto be contributing to fatigue aredealt with. This should cover all

aspects of work, including worksatisfaction and interpersonal issues.

In developing a return to work planthe following should be considered:

building up work, or work-related skills, at home at first

starting with shortened hours andgradually building them up


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starting with a reduced workload,as above, and gradually increasingit

ensuring that regular breaks aretaken

ensuring that the individual hasa regular review with an OHP.

Most people with CFS are likely tofall under the remit of the DisabilityDiscrimination Act 1995, wherethere is a requirement to makereasonable workplace adjustments.These may include measures such as:

changing locations of work

working from home

modifying work hours reducing workloads

reducing physical tasks.

Is ill-health retirement an option?

Ill-health retirement is a possibleoutcome although it should only be

considered if appropriate treatments(such as CBT or GET) have beenexplored. Where other conditions suchas depression or anxiety are present, theyshould be treated.


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Are there any other factors to

consider?

Recovery from CFS is rarely a

straightforward process, and there may betimes when the individual seems to havesetbacks or is not improving. It isimportant to encourage and supportindividuals to persevere with theirtreatment and rehabilitation plan.

Although relapses may occur, manyindividuals who develop CFS can be

rehabilitated back to work with acombination of the appropriatetreatment and good management.

For a full version of these guidelines, seewww.nhsplus.nhs.uk/clinical-

guidelines/index.asp
http://www.nhsplus.nhs.uk/clinical-guidelines/index.asphttp://www.nhsplus.nhs.uk/clinical-guidelines/index.asphttp://www.nhsplus.nhs.uk/clinical-guidelines/index.asphttp://www.nhsplus.nhs.uk/clinical-guidelines/index.asphttp://www.nhsplus.nhs.uk/clinical-guidelines/index.asp


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Crown copyright 2006

277151 1p 0.5k Oct 06 (CWP)

Produced by COI for the Department of Health

Iwww.nhsplus.nhs.ukwww.facoccmed.ac.uk
http://www.facoccmed.ac.uk/http://www.facoccmed.ac.uk/

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