Chronic Fatigue Syndrome

What is it?

Chronic Fatigue Syndrome (CFS)/myalgic encephalomyelitis (or encephalopathy) (ME) is a relatively common condition. It is characterised by a range of symptoms which include, fatigue, malaise, headaches, sleep disturbance. Although this can be a very disabling condition the cause of CFS/ME is unknown, in some but not all cases it is triggered by a viral type illness

How does it affect people?

The severity of symptoms varies from day to day and from one person to another, the four main symptoms are;

Feeling extremely tired all the time (fatigue), which can make daily activities like taking a shower, or going to work or school, difficult

Sleep problems, including insomnia, sleeping too much, feeling like you have not slept properly and feeling exhausted or stiff when you wake up

Problems with thinking, concentration and memory (brain fog)

Symptoms getting worse after physical or mental activity, and possibly taking weeks to get better (also called post-exertional malaise, or PEM)

Often people will experience other symptoms which may include, flu like symptoms, headache, joint pain, muscle pain, poor concentration, mood problems such as depression.

How is it treated?

No single treatment has been shown to be a cure for CFS/ME although medication may help to manage some of the symptoms.

Cognitive Behavioural Therapy (CBT) is used to help the individual to sustain or gradually improve their symptoms and to help them to manage their symptoms.

CBT is often used alongside an energy management programme under the care of a specialist in this area.

How might it affect work?

The majority of people with CFS/ME will have a prolonged absence away from work while they recover.

On their return to work individuals with fatigue may need to pace their work and take regular breaks. They may need to work reduced hours and then build this up gradually. It is common for individuals to experience a temporary increase in their symptoms with each increase in activity. Individuals with chronic fatigue can experience relapses in their condition but it is not possible to predict the severity or frequency of these.

Individuals with chronic fatigue may never regain their previous levels of physical or cognitive capacity and may require permanent modifications to their job role.

As the condition is likely to be long term and have a significant impact on an individual’s ability to undertake normal activity then it is likely that it would be considered a disability under the relevant UK legislation.

What do I need to do as the Manager?

If an employee complains of severe or disabling fatigue that is interfering with their ability to fulfil their role then you should refer them to Occupational Health. Occupational Health will advise on any adjustments or modifications required to support the employee at work or develop a phased work plan to support their return, where appropriate Occupational Health will undertake this in conjunction with the individuals GP or Specialist.

Examples of modifications that could help include:

Pacing work with regular breaks
Setting targets to build up activities.
Gradually building up activities over time

It is likely the individual will experience an increase in the severity of symptoms as they increase their activity levels, this is normal and does not mean that they have caused themselves harm or will relapse further.

Points to remember

Fit notes

If an employee produces a fit note indicating that they require modified duties, discuss this with them and consider if the modification recommended can be reasonably accommodated.

Job tasks and risk Assessments

Review the risk assessment for the employee’s job role and work tasks including the ability to drive safely where required. Take into consideration any temporary modification that may be required to accommodate their reduced ability to undertake certain tasks.

General guidance

If you require further information, refer to the general advice on managing absence.