This is an HTML version of an attachment to the Freedom of Information request 'Training, briefing and knowledge-base materials for WCA assessors regarding certain conditions'.

MEDICAL SERVICES 
PROVIDED ON BEHALF OF THE DEPARTMENT FOR WORK AND PENSIONS 
 
 
 
 
 
Training & Development  
 
Chronic Fatigue Syndrome (CFS) and 
Fibromyalgia 
 
 
 
MED-CMEP/ODMMSLS~0069 
(Learning Set) 
 
 
MED-CMEP~0087 
 
 
Version: 3 Final 
24th March 2011 

 
 
 
 

 
Medical Services 
 
 
 
 
 
Foreword  
 
 
 
 
This training has been produced as part of a Continuing Medical Education 
programme for Health Care Professionals (HCPs) approved by the Department for 
Work and Pensions Chief Medical Adviser to carry out assessments. 
 
All HCPs undertaking medical assessments must be registered practitioners who in 
addition, have undergone training in disability assessment medicine. The module 
includes theory training in a classroom setting, supervised practical training, and a 
demonstration of understanding as assessed by quality audit. 
 
This must be read with the understanding that, as experienced practitioners and 
disability analysts, the HCP will have detailed knowledge of the principles and 
practice of relevant diagnostic techniques and therefore such information is not 
contained in this module. 
 
Furthermore, the training module is not a stand-alone document, and forms only a 
part of the training and written documentation that the HCP receives. As disability 
assessment is a practical occupation, much of the guidance also involves verbal 
information and coaching. 
 
Thus, although the training module may be of interest to non-medical readers, it 
must be remembered that some of the information may not be readily understood 
without background medical knowledge and an awareness of the other training 
given to HCPs. 
 
 
 
 
Office of the Chief Medical Adviser 
 
 
 
 
24th March 2011 
 
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Document control 
Superseded documents  
Version history 
Version Date 
Comments 
3 Final 
24th March 2011 
Final version signed off by CMMS 
3a draft 
28th February 2011 
Updated following Schedule 28 review, by Dr 
Amina Hussain 
2 Final 
9th 
March 
2010 
Signed off by Medical Services Contract 
Management Team 
Changes since last version 
Included reference to availability of online evaluation – p.7 and p.19 
Suggestions for Study updated – p.8 
Removed reference to WFHRA (amongst other component parts of WCA process 
referred to) – p.13 
References to DDA removed (now referred to as disability-related legislation in the 
Equality Act 2010) 
Minor typos, grammar and formatting throughout 
Outstanding issues and omissions 
 
Updates to Standards incorporated 
 
Issue control 
Author: Linda 
Burke 
 
Owner and approver: 
Dr A Graham 
 
Signature: Date: 
 
Distribution: 
 
 
 
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link to page 9 link to page 11 link to page 13 link to page 13 link to page 15 link to page 16 link to page 16 link to page 16 link to page 24 link to page 25 link to page 25 link to page 25 link to page 25 link to page 27 link to page 29 link to page 29 link to page 31 link to page 31 link to page 33 link to page 33 link to page 35 link to page 35 link to page 35 link to page 37 link to page 39  
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Contents 
 
Introduction 
5 
Learning Set Process 

Learning Aims 

Suggestions for Study 

Essential Content 10 
Recommendations for Learning Set Activities 11 
Opening the Learning Set 11 
Advice on selection of activities 11 
Closing the Learning Set 19 
Appendix A  Chronic Fatigue Syndrome (CFS) and Fibromyalgia 
 20
Learning Set Event Fact Sheet
 
Learning Aims 20 
Suggestions for Study 20 

Appendix B 
 22
- Essential Content
 
Appendix C  – Learning Set Review Form (to be completed by Medical 
Manager) 23
 

Appendix D  - Guidance on Quality of Activity(s) / Material and 
Facilitatio

 25
n ratings
 
Appendix E  - Individual Learning Set Review Form (To be completed 
by the learner to aid reflective practice) 26
 

Appendix F  - Level 1 and Level 2 Evaluation Sheet Internal Events 
NOT delivered by Training & Development / External Events / Distance 

 28
Learning
 
Appendix G 
 29
Learning Aims
 
Observation form 30 
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Introduction 
A Learning Set is dedicated to the sharing of team knowledge, and must be 
conducted using internal resources only.  External speakers are not acceptable at 
these events; the team should make wise use of relevant in-house skills and 
experience.  In this instance any member of the team with particular expertise 
and interest in Chronic Fatigue Syndrome (CFS) or Fibromyalgia (FM) may 
provide a valuable contribution to the Learning Set.   
 
However, the manager of the event should not overlook the opportunity to 
develop those who may wish to make their first presentation, or wish to use 
fledgling facilitation skills in this "safe" environment.   
 
This Learning Set is designed to encourage competency based study on the 
subject of CFS and FM and the functional effect of these conditions on the 
claimant. In particular, the effect on health and employment outcomes make this 
pertinent to all Health Care Practitioners, including the Disability Analyst.  
 
The learning aims are defined and the 'manager' of the Learning Set is 
encouraged to ensure that these are kept prominently to the fore-front throughout 
the event, keeping them in view of all participants.  In this way they will serve to 
maintain a focus on discussions.   It is essential that participants are informed of 
the learning aims and essential content well in advance of the Learning Set to 
ensure they focus their self directed preparation for the event.   
 
To avoid using PowerPoint, which may generate a non-interactive environment 
during the Learning Set, the learning aims are provided in A4 format. 
 
This pack provides guidance on activities that can be used during the Learning 
Set; however, these are not designed to be prescriptive and are offered as 
suggestions to help structure the event.  The only absolute givens are that the 
essential content is adhered to and the Learning Set aims achieved.   
 
Advice is provided on the gathering of suitable documentation to facilitate and 
confirm both individual and team participation.  This will allow an impartial 
verification that the learning aims have been satisfied.  This is essential to 
establish the status and quality of the Learning Set should Practitioners decide to 
make use of the reflective practice data for revalidation purposes.  It is also 
necessary to demonstrate that the outcomes of the Learning Set satisfy the 
requirements of the Continuing Professional Development programme for Atos 
Healthcare and allows registration of participation on MSD.
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Learning Set Process 
 
The Medical Manager is responsible for ensuring the following process is 
adhered to. 
 
Sufficient copies of all the forms required for this Learning Set must be produced 
at local Level. 
 
 
Time period 
        Tasks 
Prior to the CME year  
Select 4 Learning Sets in total. 3 should 
 
be chosen from the clinical topics. The 
fourth should be selected from a learning 
set focussing on softer skills. Dates 
should be scheduled for all 4 of the 
Learning Sets during the first 8 months of 
the calendar year and dates 
communicated to the employed 
Healthcare Professional Team 
 
At least 8 weeks prior 
Identify a Learning Set Manager (2 will be  Complete Learning Set Event 
to each event 
trained from each site, neither should be 
Fact Sheet and distribute to all 
the Medical Manager) and brief 
participants (see Appendix A) 
accordingly  
 
At Least 7 weeks prior 
Identify / seek Learning Set activities and 
Issue Essential Content 
to each event 
facilitators  
Information Sheet to facilitators 
(see Appendix B) and where 
appropriate agree a personal 
development plan for Learning 
Set activity facilitators (at the time 
of agreeing the facilitation role). 
This should be formally added to 
the PDP at the next appropriate 
review 
 
At least 2 weeks prior 
Learning Set Manager quality assures all 
 
to each event 
Learning Set materials confirming they 
cover essential content and will enable 
achievement of the Learning Aims.  
Where problems arise support should be 
sought from the Medical Manager. 
 
 
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Time period 
        Tasks 
 
 
Run the Learning Set 
Organisation of the set 
Each Learning set should 
Learning Set Manager to ensure 
comprise no less than 7 and no 
communication of the learning 
more than 11 participants, this to  aims to all participants, to allow 
include the Learning Set 
appropriate preparatory reading 
Manager and all facilitators. 
The Medical Manager should 
attend each set, since it will be 
his/her sole responsibility to 
“sign off” individual participation 
 
Immediately upon completion of 
25% of attendees complete a 
Medical Manager completes a 
event 
Level 1 & 2 evaluation form 
Learning Set Review Form (see 
(usually completed online; but if 
Appendix C) and forwards to 
unavailable, use Appendix  F).  
Angie Rhodes, Training & 
Collect these and forward to 
Development, BBP 
Angie Rhodes, Training & 
Development, BBP 
Following completion of event 
Attendees complete an 
 
Individual Learning Set Review 
Form (see Appendix E) for their 
own personal development 
Following completion of event 
Any agreed follow-up actions 
 
are undertaken 
Following completion of event 
Medical Manager reviews 
 
facilitator(s) PDPs where 
appropriate 
 
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Learning Aims 
  To define Chronic Fatigue Syndrome and Fibromyalgia 
  To consider the possible causes and functional effects of these 
conditions  
  Consider current management and treatment guidelines  
  Consider benefit issues in children and adults with CFS or FM  
  To consider effects of these conditions on work/occupation and effect of 
work on these conditions. 
Suggestions for Study 
 
The following references and texts would help the student prepare for this event. 
These are no more than suggestions - individual textbook and journal preferences 
are acceptable. 
  Any preferred medical textbook (such as the Oxford Textbook of 
Medicine) 
  Any suitable journal articles (e.g. Journal of Community Psychology) 
  Med S2 CMEP0017 – Chronic Fatigue Syndrome Guidelines for the 
Disability Analyst 
  MED S2 CMEP 0035 – Fibromyalgia – Guidelines for the Disability 
Analyst 
  DWP publication, What is Chronic Fatigue Syndrome (CFS)/ Myalgic 
Encephalomyelitis (ME)?  
  NICE guidance, Chronic fatigue syndrome/ Myalgic encephalomyelitis  
  Action for ME is a charitable organisation in the UK dedicated to 
improving the lives of people with CFS (sometimes referred to as ME); 
further information can be accessed at www.afme.org.uk/ 
  NHS Choices provides information on Fibromyalgia in an easily 
digestible format 
  FMA UK was established in order to provide information and support to 
people with fibromyalgia, and to their families. In addition, the 
Association provides medical information for professionals and operates 
a national helpline.  Further information can be accessed at 
http://www.fibromyalgia-associationuk.org/ 
 
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Interested parties may wish to look at the BBC website and refer to a series of 
programmes addressing CFS issues on Radio 4 (12-16th November 2007). 
All participants are advised to document their learning sources using an 
Individual Learning Set Review form (see Appendix E).   Any presentations or 
other exercises employed by participants in the Learning Set must include 
references to the source documents.  Portfolio activity should be based on 
reflection on usual practices and work based evidence to show when new 
learning has been implemented to improve those standards.   
  
 
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Essential Content 
 
This is a relatively broad ranging subject which allows participants to develop study 
into various medical conditions and relevant links.  The opportunities for 
presentations and other activities are flexible. It will be impossible in the time 
allowed to cover all aspects of both conditions. However, since both are commonly 
seen in the context of disability assessment, the Learning set should as a minimum 
cover the similarities and critical differences between the two conditions. Thereafter 
best use of time may be made by focussing the efforts of the team in addressing 
one condition or the other. 
 
Consider: 
 
   Clinical features (consider likely level of disability) 
   Recommended treatment guidelines 
 
   Review of aetiological factors  
 
   Benefit issues. 
 
 
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Recommendations for Learning Set Activities 
 
It is important that the assembled team make best use of the time devoted to the 
Learning Set.  Their involvement in the early organisation of the event will help 
them to take ownership of the activities and outcomes.  Thoughtful choice of 
exercises will ensure the team holds an interest in the outcomes and also 
confidence that they will gain either knowledge or skill during the experience.  At 
the preparation stage the manager should encourage innovative ideas from the 
team members and be prepared to adopt an alternative approach provided the 
essential content is covered and the learning aims can be satisfied. 
 
The purpose of the Learning Set is not to simply repeat the salient points which 
emerge at individual study.  The Set should be organised so that all the team can 
share and expand on the information and ideas that flow out of their individual 
preparation/study. There will be extensive knowledge and differing experiences 
within a team, and through interactive exercises this can enrich the team as a 
whole.  
 
Where appropriate Personal Development Plans should be utilised for those 
team members who volunteer or who are delegated to present or facilitate 
exercises in the Learning Set, but only where this activity forms part of their 
personal learning. 
Opening the Learning Set 
 
It is essential that the Learning Set achieves its learning aims and covers the 
essential content.  Preparation by all those participating is a key contributor to 
this, as is a positive and encouraging opening of the session.  It is recommended 
that all attendees are reminded of the purpose of the Learning Set, the 
responsibilities of all those present and the learning aims reinforced. 
It is also important to remind everyone of the process relating to the Learning Set 
initiative; the Learning Set Process on page 6 could be referred to at this 
juncture. 
Advice on selection of activities 
 
The Learning Set should be designed to last 1 to 1.5 hours; anything longer is 
likely to undermine the learning for this type of development tool.  A common 
problem when such Sets are first prepared is to include too many activities.  For 
that reason it is unwise to arrange more than two activities per Set, and in certain 
instances one may be enough.  Avoid one long presentation; this will prevent full 
team participation. Do not allow a single view to dominate.   
 
The following pages provide some suggestions for possible Learning Set 
activities, though none are mandatory: 
  
 
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Activity 1: A presentation on Chronic Fatigue Syndrome / Fibromyalgia  
 
These are subjects which lend themselves to a presentation of current 
understanding of the conditions. It is particularly important that participants be 
aware of any perceived and defined distinctions between the conditions 
indicated.  
 
As all participants will have studied to refresh their knowledge, the presenter 
should take pains to go a step beyond the basic understanding of the group. It 
would be helpful in the initial stages of the set to invite the individuals in the group 
to give definitions of the conditions.  
 
Once this is established, a group ‘brainstorm’ session with the use of flipcharts or 
whiteboard facility to note down key issues and concepts discussion would be 
helpful. 
   
 
Tip(s) 
 
While it is essential to avoid mere fact-listing, it will be extremely helpful to keep 
the learning aims in mind – two or three mental ‘hooks’ upon which participants 
can hang the main aims will enable them to recall and apply the contents of the 
Learning Set effectively.  
 
Management Action 
 
Dependent on prior experience, the Medical Manager may wish to agree a 
personal development plan with the presenter.  This may include support from 
the Learning Set Manager to write a few PowerPoint slides and use of the LCD 
projector if appropriate.  Try to avoid PowerPoint ‘teaching’ and encourage 
facilitative discussion. 
 
The Learning Set Manager must quality assure the presentation and any 
facilitation materials prior to the Learning Set. 
 
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Activity 2: Facilitated discussions of the impact of the condition on benefit 
claims 

 
 
The presenter/facilitator will need to encourage a discussion that should explore 
factors such as: 
  Ways in which relevant functional problems can present in a claim 
  The likely functional effects of CFS or FM  
  Attitudes amongst the team towards the condition 
  Likelihood of Care and Mobility needs in DLA 
  Impact on function categories in relation to Personal Capability 
Assessment (PCA) and Work Capability Assessment (WCA) 
  Physical and psychological factors leading to disability 
  The claimant’s perceptions of their disability and barriers to recovery 
The session should remain interactive throughout, ensuring that there is a 
parity of contribution from all those present. 
 
The facilitator will help draw out any conclusions, again using a flipchart or 
whiteboard to maintain interaction. 
 
 
Tip(s) 
 
 
It would be advisable for all participants to identify suitable cases in the course of 
their work over a week or two in advance of this learning set to support the 
exchange above. 
 
Management Action 
 
It will be critical in this learning set for participants to discuss, explore and 
challenge perceptions and prejudices. The challenge for the facilitator is to 
ensure that all participants are engaged and prepared to commit to the 
consensus conclusions. This is likely to require a very experienced and confident 
Facilitator. 
 
The Medical Manager may wish to agree a PDP with the facilitator of this 
discussion exercise.   
 
Evidence of preparation with a suitable question bank, a brief team exercise and 
identification of a small number of suitable discussion cases must be quality 
assured by the learning Set Manager prior to the Learning Set.  
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Activity 3: A written Question and Answer Session  
 
This activity is useful for a team who are not comfortable with debate and 
possible disagreement. You may wish to use a True/False format or style. Allow 
the group to divide into two groups or into pairs and complete the MCQ as an 
inter-team challenge. It may be useful to include ‘rogue’ questions to stimulate 
discussion. Warn the 2 teams that such questions are present. 
 
Tip(s) 
 
Questions such as the following would be appropriate: 
  Treatment for CFS is based on management of physical symptoms only 
 
 
 
 
 
 
 
 
T/F 
  Higher rates of recovery in CFS are associated with an initial 
presentation 
of 
viral 
illness 
 
    T/F 
  CFS is considered to be relatively rare in children    
T/F 
  Claimants will require a multi-disciplinary approach to the resolution of 
CFS 
disability 
      T/F 
Management Action 
 
The Learning Set Manager for this event should quality assure the questions and 
answers before the Learning Set. 
 
Dependent on prior experience, the Medical Manager may wish to agree a 
personal development plan with the facilitator of this session.   
 
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Activity 4: A case discussion 
 
This activity requires vigilance to secure a suitable case for discussion, and may 
be a useful alternative to the use of case histories suggested in Activity 2.  PCA, 
WCA and DLA cases should be a valuable source of such case examples. 
The facilitator should ensure coverage of DLA Mobility and Care, and PCA and 
WCA functional categories.   
 
If a suitable case does not emerge, consider creating an example with a series of 
questions. 
 
An example is offered to assist the facilitator to create his/her own case. 
 
Mr B is a 47 year old man who has suffered from CFS for 6 years. He is claiming 
DLA.  He reports that he is able to walk only 20 metres in 2 mins. He also report 
that he needs assistance to dress his lower half and to rise from the toilet and 
chair. 
 
His typical day includes accounts of help with all housework and a very inactive 
life style as his wife drives him to and from the supermarket. He uses the trolley 
to lean on around the shop and rarely completes the shopping as he rests in the 
shop restaurant whilst his wife stands at the checkout. Otherwise he rarely goes 
outdoors and never does so alone. 
 
The claimant plans his activities in order to conserve energy, and is no longer 
able to sustain hobbies such as golf and gardening. He also finds it hard to 
concentrate generally and is unable to read. He rarely watches television. 
 
He has tried a range of treatments, including CBT and graded exercises, but has 
not found these to be helpful. He is on oral medication for depression and 
considers the latter has arisen as a consequence of the lack of understanding he 
has received in regard to his treatment, and does not recognise a psychological 
component to his health problem. 
 
Observations show he is reluctant to mobilise and uses walking aids and a 
wheelchair to help conserve energy. 
Clinical examination is unhelpful. 

 
Tip(s) 
 
A suitable case from the live load is to be preferred, but some facilitators may 
wish to create more testing examples. An experienced HCP will be able to create 
a number of alternate scenarios to elucidate particular points. 
Advise at the outset that there is unlikely to be a model answer in cases of this 
nature, as the conditions and their symptoms are diverse in nature and range of 
severity. The activity organiser should not take on the responsibility for ‘having all 
the answers’; the members of the Set should be encouraged to draw agreed 
conclusions as far as this is possible. 
 
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Management Action 

 
Dependent on prior experience, agree a personal development plan with the 
facilitator.   
 
The Medical Manager should agree a suitable case and quality assure all 
materials prior to the Learning Set. 
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Activity 5: An Occupational health case for discussion  
 
Again vigilance is necessary to capture a suitable case (please see the advice in 
the activities given above) taking care to ensure that any copies arranged for the 
Learning Set are anonymised. 
 
Discussion around the disability-related legislation in the Equality Act, and its 
implications in the case, should be invited; as should discussion on suitable work 
place adjustments. 
 
Tip(s) 
 
If a case does not emerge consider creating a scenario with a bank of questions 
for group debate. 
 
An example is provided: 
You are an Occupational Health Adviser to a medium sized factory where 
furniture is made. Mr B has worked for this company for 12 years and his role 
involves lifting chairs, and stools, upholstering these and packing. He is required 
to lift rolls of fabric and spends his day standing at a workstation.  

 
He has become progressively slower over time and is less able to lift heavy loads 
or sustain physical activity for any length of time. 
 
His manager requests your advice as he is observed to have reduced productivity 
and has increased sickness absence with episodes cited as "fatigue" and "joint 
pains". He has advised his manager that he has just found out that he has CFS. 
His doctor has started him on regular painkillers and anti-inflammatory 
medication and he has been given a graded exercise regime. 
 
How would you conduct your investigation? He has provided consent for access 
to his GP and agrees to see you. 

What are the risks to this employee in this work place? 
What will you tell the manager? 
Has the management any responsibility to support his treatment plan? 
Would the disability-related legislation in the Equality Act 2010 apply in such a 
case? 

Discuss the ethics of this case. 
 
Again ensure the Set members take the responsibility for creating a consensus 
response to these issues. 
 
 
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Management Action 
 
Dependent on prior experience, the Medical Manager may agree a personal 
development plan with the facilitator.  The Learning Set Manager should agree a 
suitable case and quality assure all materials prior to the Learning Set. 
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Closing the Learning Set 
 
 
As with the opening of the Learning Set, the closing should be a positive and 
encouraging element.  Refocus attention on the learning aims and ask if 
everyone is satisfied that through individual preparation/study and participation 
during the Learning Set that the aims have been achieved. 
 
The Medical Manager is responsible for documenting a review of the event 
including comment on the quality of activities and the level of participation within 
the team. For that reason the Medical Manager (or exceptionally a deputy) must 
attend every event. The Learning Set Review Form, at Appendix C of this 
document, should be used for this purpose and must be completed for every 
Learning Set. For guidance on quality of activity(s) / material and facilitation rating 
achieved see Appendix D of this document. 
Level 1&2 Evaluation is usually completed online, and the link to the form will be 
provided to all Medical Managers prior to the start of the CME Year. Should the 
on-line version be unavailable, then clerical completion (using the form in 
Appendix F) is acceptable - it must be issued to 25% of participants at each 
Learning Set. The evaluation forms must be issued randomly, but it is essential 
that all participants complete at least one Level 1&2 Evaluation Form during the 
course of the year. 
 
Both the Learning Set Review Form and the Level 1 & 2 Evaluation Forms must 
be forwarded to Angie Rhodes at Atos Healthcare, Training & Development, 3300 
Solihull Parkway, Birmingham Business Park, Birmingham, B37 7YQ at the end 
of each Learning Set. 
 
An attendance list should be completed in the same way as currently happens for 
facilitated learning events and given to the relevant person for MSD update.   
An Individual Learning Set Review Form, contained at Appendix E of this 
document, should be given to all participants.  This form is designed to provide 
the basis for self-reflection and is for the individual's use.  It is therefore optional 
whether the individual uses it or not, however it is recommended that for 
revalidation or continued registration or appraisal purposes reflective practice is 
used. 
 
 
 
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Appendix A  Chronic Fatigue Syndrome (CFS) and 
Fibromyalgia Learning Set Event Fact Sheet 

  
 
 
 
 
Date 
Time 
 
 
Venue 
 
Learning Aims 
  To define Chronic Fatigue Syndrome and Fibromyalgia 
  To consider the possible causes and functional effects of these 
conditions  
  Consider current management and treatment guidelines  
  Consider benefit issues in children and adults with CFS or FM  
  To consider effects of these conditions on work/occupation and effect of 
work on these conditions. 
Suggestions for Study 
 
The following references and texts would help the student prepare for this event. 
These are no more than suggestions - individual textbook and journal preferences 
are acceptable. 
  Any preferred medical textbook (such as the Oxford Textbook of 
Medicine) 
  Any suitable journal articles (e.g. Journal of Community Psychology) 
  Med S2 CMEP0017 – Chronic Fatigue Syndrome Guidelines for the 
Disability Analyst 
  MED S2 CMEP 0035 – Fibromyalgia – Guidelines for the Disability 
Analyst 
  DWP publication, What is Chronic Fatigue Syndrome (CFS)/ Myalgic 
Encephalomyelitis (ME)?  
  NICE guidance, Chronic fatigue syndrome/ Myalgic encephalomyelitis  
  Action for ME is a charitable organisation in the UK dedicated to 
improving the lives of people with CFS (sometimes referred to as ME); 
further information can be accessed at www.afme.org.uk/ 
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  NHS Choices provides information on Fibromyalgia in an easily 
digestible format 
  FMA UK was established in order to provide information and support to 
people with fibromyalgia, and to their families. In addition, the 
Association provides medical information for professionals and operates 
a national helpline.  Further information can be accessed at 
http://www.fibromyalgia-associationuk.org/ 
 
Interested parties may wish to look at the BBC website and refer to a series of 
programmes addressing CFS issues on Radio 4 (12-16th November 2007). 
 
All participants are advised to document their learning sources using an 
Individual Learning Set Review form (see Appendix E).   Any presentations or 
other exercises employed by participants in the Learning Set must include 
references to the source documents.  Portfolio activity should be based on 
reflection on usual practices and work based evidence to show when new 
learning has been implemented to improve those standards.   
CFS/FM 
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Medical Services 
 
Appendix B  - Essential Content 
 
This is a relatively broad ranging subject which allows participants to develop study 
into various medical conditions and relevant links.  The opportunities for 
presentations and other activities are flexible. It will be impossible in the time 
allowed to cover all aspects of both conditions. However, since both are commonly 
seen in the context of disability assessment, the Learning set should as a minimum 
cover the similarities and critical differences between the two conditions. Thereafter 
best use of time may be made by focussing the efforts of the team in addressing 
one condition or the other. 
 
Consider: 
 
   Clinical features (consider likely level of disability) 
   Recommended treatment guidelines 
 
   Review of aetiological factors  
 
  Benefit issue.
CFS/FM 
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Page  22 
 
 

 
 
 

 
 
Appendix C  – Learning Set Review Form (to be completed by Medical Manager) 
Learning Set Title 
 
Number of Attendees 
 
Medical Manager 
 
MSC 
 
Date of Learning Set 
 
Learning Set Manager 
 
 
Learning Set Activities 
Facilitator 
Quality of Activity(s) / Materials 
Quality of Facilitation 
(Please indicate your rating 1 is poor 5 is 
(Please indicate your rating 1 is poor 5 is 
outstanding refer to Appendix D for guidance 
outstanding refer to Appendix D for guidance on 
on rating). 
rating). 
1. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  1
 
2
 

 
4
 
5  
 
1
 
2
 
3
 
4
 
5
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
2. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
1
 
2
 

 
4
 
5  
  1  2  3  4  5  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
3. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  1   2   3   4   5    
1
 
2
 
3
 
4
 
5
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CFS/FM 
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Learning Set Aims (To what extent were these 
 
achieved)? 
 
 
 
Learning Set Challenges 
 
(What could have worked better, why and how?) 
 
 
 
 
 
 
 
 
 
 
Follow-up 
 
(Any actions required as a result of this Learning 
 
Set?) 
 
 
 
 
 
 
 
Any other comments 
 
 
 
 
 
 
 
Return to: Angie Rhodes, Atos Healthcare, T & D, 3300 Solihull Parkway, Birmingham Business Park, Birmingham, B37 7YQ
CFS/FM 
3 Final 
MED-CMEP~0087 
Page  24 
 
 

 
Medical Services 
 
Appendix D  - Guidance on Quality of Activity(s) / 
Material and Facilitation ratings 

 
Achieved 
Qualifying criteria 
Rating 

  Activities not delivered or only partially delivered. 
  Unfocused or few discussions. 
  Aims not achieved. 
  Participants have not read recommended materials. 
  Poor feedback for manager and presenters. 
  Likely that no-one gains “sign off” for MSD. 

  Activities poorly presented or do not stimulate debate. 
  Little participation in discussions. 
  Some participants may not gain “sign off” for MSD. 
  Limited opportunities for reflective practice. 
  Poor feedback and evaluation. 

  All organised presentations are delivered. 
  All participants take part in debate. 
  Aims are achieved. 
  “Sign off” for all involved. 
  Average/Good evaluation and feedback to Set manager. 

  Aims are achieved. 
  Open discussion of issues arising at activities. 
  Participants are confident and informed after researching the topic. 
  Enthusiastic response at evaluation and in feedback to presenters 
and Set manager. 
  Stimulates some active change in standards or established 
practices or in mentoring of sessional doctors. 
  Development of individuals through PDPs. 

  Innovative activities well used to achieve all Aims of the Set. 
  Keen discussions which arrive at an agreed outcome. 
  Consistently high rating at evaluation and in feedback for 
presenters and Set manager. 
  Issues lead to further research or efforts to gain clarification. 
  New skills established through completed PDP s. 
  Team agreement in relation to complex benefit issues. 
CFS/FM 
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Page  25 
 
 
 

 
 
 
 

 
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Appendix E  - Individual Learning Set Review Form 
(To be completed by the learner to aid reflective practice) 

 
Name 
 
 
Learning Set Title 

 
 
Date attended 

 
 
Learning Set Preparation 

 
What did I do to prepare for the Learning Set? 
What source(s) of information did I use/access? 
How useful were these? 
 
 
 
 
 
 
 
 
 
 
 
 
 
Learning Set Participation 
 
To what extent did I participate? 
What value did my participation bring to me and 
other attendees? 
Could I have brought more value, if so what and 
how? 
 
 
 
 
 
 
 
 
 
 
 
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Learning Achieved 
 
What were the key points of learning for me? 
What impact will this learning have on my 
performance? 
 
 
 
 
 
 
 
 
 
 
 
 
Application of Learning
 
 
How will I show that I have implemented this 
new learning in my every day role? 
 
 
 
 
 
 
 
 
 
 
 
 
 
Any Other Reflections? 
 
 
 
 
 
 
 
 
 
 
 
 
CFS/FM 
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Page  27 
 
 

 
Medical Services 
 
Appendix F  - Level 1 and Level 2 Evaluation Sheet 
Internal Events NOT delivered by Training & Development / External Events / 
Distance Learning 

Participants Name: 
 
Base Location: 
 
Date 
Event Title: 
 
 
Attended/Completed: 
1. Were the event/distance learning product 
Please tick a box below 
objectives met? 
Yes No 
2. How enjoyable was the event/distance 
Very 
Moderately 
Not at all 
learning product? 
3. How relevant was the event/distance 

Extremely 
 
Not at all 
learning product to your role? 
Relevant 
Relevant 
 
Please circle a number below 
 
1 2 3 4 5 6 7 8 9 10 
4. (a) Was this the right learning tool for you i.e. trainer led/distance 
Yes No 
learning for this particular development? 
(b) If you have answered NO please comment. 
 
 
5. Please list at least two key learning points. 
 
 
6. Describe how you will apply this learning to your workplace. 
 
 
7. Describe what you or anyone else could have done to make the event/product more effective. 
Suggested Improvement(s) 
Responsibility 
 
 
8. Standard of the facilitator (trainer led 
Very good 
Good 
Adequate 
Poor 
events only) 
9. Indicate your overall rating for the 

Very Effective 
Effective 
Ineffective 
event/distance learning product 
 
Please circle a number below 
 
1 2 3 4 5 6 7 8 9 10 
 
Please Return to: 
Angie Rhodes 
Atos Healthcare 
3300 Solihull Parkway 
Birmingham Business Park 
Birmingham 
B37 7YQ
CFS/FM 
3 Final 
MED-CMEP~0087 
Page  28 
 
 

 
 
 


 
Medical Services 
 
Appendix G  Learning Aims 
 
 
 
CFS/FM/ME 
3 Final 
MED-CMEP~0087 
Page  29 
 
 

 
 
 
 

 
Medical Services 
 
Observation form 
Please photocopy this page and use it for any comments and observations on this 
document, its contents, or layout, or your experience of using it. If you are aware of 
other standards to which this document should refer, or a better standard, you are 
requested to indicate this on the form. Your comments will be taken into account at 
the next scheduled review. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Name of sender: 
________________________ Date: _____________ 
 
Location and telephone number:____________________________________ 
 
Please return this form to:    Angie Rhodes 
                                   
Training and Development Co-ordinator 
 
 
 
 
 
Atos Healthcare 
     3300 
Solihull 
Parkway 
     Birmingham 
Business 
Park 
     Birmingham 
B37 7YQ 
 
 
 
CFS/FM/ME 
3 Final 
MED-CMEP~0087 
Page  30 
 
 

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