Challenging Harmful and Out-of-Date DWP Training on M.E./C.F.S.

A serious issue that has recently come to our attention, which poses a direct threat to the wellbeing of the M.E./C.F.S. community.

Through a series of Freedom of Information requests, we have obtained the training materials used by the Department for Work and Pensions (DWP) to train healthcare professionals who conduct Work Capability Assessments for M.E./C.F.S.

We have serious concerns about the content of this training. The document promotes an outdated and discredited biopsychosocial view of M.E./C.F.S., contains information that directly contradicts the 2021 NICE guideline (NG206), and encourages assessors to doubt the physical reality of symptoms. This guidance is not only factually incorrect but is actively harmful, risking flawed assessments, unjust denial of support, and causing significant harm to often vulnerable individuals.

This situation creates a damaging policy conflict where one government department (the DWP) is actively undermining the expert clinical guidance championed by the Department of Health and Social Care (DHSC).

Given the gravity of the situation, we have taken formal action. In our letter to the Secretary of State for Health and Social Care, we stressed that since the clinical standard is set by his department (Health and Social Care) while the flawed training is delivered by the DWP, a cross-departmental solution is essential. We have urged Mr. Streeting to work directly with the Secretary of State for Work and Pensions to ensure this harmful training is immediately withdrawn. We have also shared our findings with the All-Party Parliamentary Group (APPG) for Disability to ensure this issue is raised at the highest levels.

As a social enterprise and a CPD-accredited training provider, Stripy Lightbulb CIC was founded to challenge misinformation and provide evidence-based, high-quality education on M.E./C.F.S. Our mission is to improve the lives of the M.E./C.F.S. community by ensuring that professionals have the correct knowledge to provide appropriate support.

It is deeply concerning to see a government department disseminating training that perpetuates the very stigma and misunderstanding we work so hard to correct. To have our efforts to educate and inform undermined by official, yet dangerously flawed, government guidance is unacceptable. It is a direct contradiction of our social purpose and a disservice to the community we are committed to serving.

We will continue to advocate for evidence-based policy and will keep you updated on any progress made.

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Below is an extract from our letter to the Secretary of State for Health and Social Care.

Our primary concerns focus on the following dangerous discrepancies:
1. Mischaracterisation of the Illness: The DWP training document promotes a  biopsychosocial model of M.E./CFS that has been discredited and rejected by the 2021 NICE guideline. For example, on page 8, the document lists “not attributing the illness to a physical cause” as a “good prognostic feature.” This implies that the illness has psychological drivers, a viewpoint that is not only factually incorrect but also deeply stigmatising. NICE guideline NG206 is unequivocal that M.E./CFS is a complex medical condition. The DWP’s guidance encourages assessors to view patients’ understanding of their physical illness as a barrier to recovery, which is a perilous foundation for an assessment.

2. Promotion of Harmful Exercise Regimes: On page 11, under “Physical activity and exercise,” the training advises that an individual should “maintain exercise successfully at that level before increasing”. This is a description of Graded Exercise Therapy (GET). NICE guideline NG206 explicitly states: “Do not offer people with M.E./CFS… any therapy based
on physical activity or exercise as a cure for M.E./CFS… [or] graded exercise therapy (GET)”. This is because of overwhelming evidence that GET causes significant harm and relapse. By instructing assessors in the principles of GET, the DWP is actively promoting a harmful and abandoned practice.

3. Inaccurate Framing of Psychological Therapies: The DWP document (page 14) presents Cognitive Behavioural Therapy (CBT) as a “rehabilitative therapy” aimed at “improving function”. This is a misrepresentation of the role of CBT as defined by NICE. The NICE guideline is clear that CBT is not a cure and should only be offered to help people manage the psychological distress of living with a chronic illness. The DWP’s framing encourages assessors to believe that M.E./CFS can be overcome by changing thoughts and behaviours, a central tenet of the now-rejected biopsychosocial approach.

4. Encouraging Psychological Attribution of Physical Symptoms: Perhaps most alarmingly, page 18 of the document states: “…skill is required to assess the degree to which stated difficulties in persisting with tasks is due to the physical component of the illness, and which is due to psychological factors.” This is an explicit instruction to assessors to doubt the physical reality of the claimant’s symptoms. This directly contradicts the cardinal symptom of M.E./CFS: Post-Exertional Malaise (PEM), a debilitating physiological response to minimal exertion.

The consequences of this flawed training are severe. It creates a damaging situation where one government department (DWP) is actively undermining the expert clinical guidance championed by another (DHSC). This training is causing harm to a vulnerable patient population and pushing them further from any hope of stability, let alone a return to work.

Given that the clinical standards for the NHS fall under your remit, while the training in question is delivered by the DWP, it is clear that a cross-departmental approach is essential to resolve this dangerous inconsistency. We therefore urge you to work collaboratively with the Secretary of State for Work and Pensions to take the following actions immediately:

1. Ensure the immediate withdrawal of the “Overview of ME/CFS” (MED-OVCFS~001) training document from use in all DWP and contracted WCA services.

2. Establish a formal cross-departmental process to ensure all DWP training and guidance for assessing individuals with M.E./CFS is rigorously checked for compliance with the latest NICE guidelines before publication.

3. Initiate a joint review, led by both the DHSC and DWP, of the WCA process for M.E./CFS claimants. This review must be co-produced with ourselves (A CPD accredited M.E./C.F.S. training provider – social enterprise), M.E./C.F.S. patients, M.E./CFS patient representative organisations and clinical experts to ensure it is fit for purpose and evidence-based.

4. Commit to a cross-departmental review of past WCA decisions for M.E./CFS claimants where this flawed guidance may have resulted in an incorrect and unjust outcome.

 

You can see the DWP training document for yourself here

We have written to the APPG on Disability rather than the APPG on M.E. because in recent months we have had private conversations with individual people living with M.E., carers, and advocates. They have each raised concerns with us about the closeness of a national charity to BACME (BACME co-created this training document and have offered ‘alternatives’ to the NICE guideline). This national charity is also a key part of the APPG on M.E. We don’t want to get into internal politics and so to avoid that, we have gone to an APPG which deals with wider disability issues ,and is currently actively working on welfare system-related issues (which this is).

Of course, we can’t raise this issue with the Minister for Social Security and Disability, due to his conflict of interest. Our options are limited but we have covered as many bases as possible.

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Thank you to Hannah Sharland from The Canary for writing about this issue, the article was published yesterday, click HERE to read the article.

Extract –

This junk science theory posits that it’s patients’ own misguided beliefs about the physical cause of their ME that’s preventing recovery. Needless to say, the disgusting idea has therefore been a central pillar of the disease’s psychologisation for many years.