Myalgic Encephalomyelitis and Chronic Fatigue Syndrome ME-CFS Pathway Refer to the Suffolk and Norfolk service provided by East Coast Community Healthcare Patients aged under 16 years must also be under the care of a paediatrician For more details see the ECCH website https://www.ecch.org/our-services/services/adults-mecfs-team/ ECCH referral form ECCH.access@nhs.net New Patient Patient attends ECCH service If the patient is aged over 18 yrs, has completed a course of treatment with ECCH and has not responded to treatment or shown minimal improvement then referral can be made for specialist review to the Suffolk ME & CFS service provided by the Suffolk GP Federation and Dr Luis Nacul. Tests required Urinalysis, FBC, U&E, LFT, TFT, ESR, CRP, glucose, Coeliac serology, CK and ferritin Consider Hypopituitarism if the patient has a history of acquired brain injury or concussion Specialist Review Practice Briefing Additional blood tests required Please provide all tests as for new patients, (glucose or HBA1c are acceptable) plus Bone Profile and Rheumatoid Factor or Anti CCP Any other relevant tests Gluten sensitivity, Rheumatoid Factor, Anti-CCP and any other relevant tests to be within the last 6 months Suffolk GP Federation / Dr Nacul referral form July 2018