CFS/ME service coverage in England
In total, 12/152 PCTs in England, representing a population of 2.08 million adults, did not commission a specialist CFS/ME service in 2010. There was a sixfold variation in service provision between the specialist CFS/ME services, with assessment rates varying from 0.09 to 0.55 assessments per 1000 adults per year (table 1, figure 2). The median assessment rate was 0.25 per 1000 adults per year, interquartile range (IQR) 0.17 to 0.35 per 1000 adults per year. Approximately 11.85 million adults lived in the 40 PCTs in the bottom quartile of assessment rates (overall rate=0.14 per 1000 adults per year); 6.33 million adults lived in the 25 PCTs in the top quartile of assessment rates (overall rate=0.45 assessments per 1000 adults per year). The median proportion of adults assessed out of those referred was 92.2% (IQR 81.4%, 100.0%). The median proportion of adults diagnosed with CFS/ME at assessment was 91.9% (IQR 76.5%, 100.0%). These proportions varied considerably between services: range 33–100% for assessments as a proportion of referrals and range 60–100% for diagnoses as a proportion of assessments. The four services with the lowest proportion of assessments were in the bottom quartile of assessment rates.
The median assessment rate in 2010 was 0.25 (IQR 0.17, 0.33) per 1000 adults. In the same year, the median referral rate was 0.30 (IQR 0.22, 0.36) per 1000 adults, and the rate of confirmed CFS/ME diagnoses was 0.20 (IQR 0.16, 0.24) per 1000 adults. Applying these rates to the adult population covered by specialist CFS/ME services (35.9 million people) indicates that each year in England ∼11,000 adults are referred, ∼9000 are assessed and ∼7000 adults receive a diagnosis of CFS/ME.