13 March 2008
We received a petition asking:
"We the undersigned petition the Prime Minister to ensure that doctors are educated about fibromyalgia and myofascial pain."
Details of Petition:
"Research shows that between 5-8% of the population suffer from fibromyalgia and chronic myofascial pain, yet most sufferers are not diagnosed until they have suffered for at least 2 years. We need awareness to be increased so that patients will be diagnosed earlier on and be able to start treatment sooner. Patients should not have to wait for more than 2 years for a diagnosis of a condition that is so common! Most medical degrees include only 1 or 2 lectures about fibromyalgia and myofascial pain, despite the fact that more than 1 in 20 people suffer from these painful conditions! Doctors need to learn more about fibromyalgia."
Read the Government’s response
The Government recognises fibromyalgia as a serious condition and appreciates the effect it has on the lives of those with the condition. There is currently no cure for fibromyalgia, so treatment aims to ease the symptoms as much as possible and to improve the patient’s quality of life. Fibromyalgia can be successfully managed within the primary care setting. However, in cases where there is some difficulty with the diagnosis, or there are complicating factors, the patient will normally be referred to a rheumatologist or neurologist.
Nevertheless, the Government is committed to ensuring better services for people with fibromyalgia. In October 2006, it launched the Musculoskeletal Services Framework, which sets out new guidance to provide high quality and integrated services for people with musculoskeletal conditions, including fibromyalgia. The framework has been developed in consultation with patients themselves, and with organisations representing them.
The framework aims to improve assessment, diagnosis and treatment for fibromyalgia and other musculoskeletal conditions. It will encourage more support for people to manage their own conditions and get access to better information and advice. It will also provide a clearer focus on the needs of children and their families, and sets an 18-week target for referrals from GPs to the start of hospital treatment.
Diagnosing fibromyalgia can be difficult as there is no specific diagnostic test that can be used, and the symptoms can vary from person to person. A diagnosis is usually made by taking a medical history, checking the symptoms and carrying out a physical examination. Blood tests, X-rays and other scans may be used to rule out medical conditions with similar symptoms to fibromyalgia.
In August 2003, the Chief Medical Officer (CMO) issued a newsletter which was sent to all doctors in England, specifically addressing the problem of fibromyalgia information dissemination. The CMO acknowledges the condition and the extent to which it affects the population. He raised awareness of a leaflet about fibromyalgia, which has now been made available to all GP surgeries throughout the UK. The leaflet offers guidance on the main symptoms, diagnosis and treatment of fibromyalgia together with a brief summary of the current ideas for the underlying pathogenesis.
The Medical Advisory Board of the Fibromyalgia Association UK produced the leaflet, Fibromyalgia Syndrome, which preceded a more comprehensive medical pack on the management of fibromyalgia for the multi-disciplinary team, which can also be requested on the website. Both these documents are available from the Association’s website at: www.fibromyalgia-associationuk.org (click on the ‘Fibromyalgia’ option, then on ‘Doctor’s Medical Pack’).
Information on the care of people with fibromyalgia, specifically for use by health professionals, is now included in the musculoskeletal specialist library of the National Library for Health. This document, Standards of Care - Regional Musculoskeletal Pain, was produced by the Arthritis and Musculoskeltal Alliance, and is available from the National Library for Health website (enter the document’s title in the search bar).
A patient information leaflet on fibromyalgia, suitable for use by health professionals and those newly diagnosed with this condition, is also available from the Clinical Knowledge Summaries website (enter ‘fibromyalgia’ in the search bar).
Turning to concerns about the training GPs receive in dealing with fibromyalgia and myofascial pain, the Department of Health is not responsible for setting curricula for health professional training. Each university determines its own curriculum in the light of recommendations from employers and the regulatory bodies. However, the Department of Health shares a commitment with statutory and professional bodies that all health professionals are trained to have the skills and knowledge to deliver a high quality health service to all groups of the population with whom they deal, whatever their condition.
In addition to this, the General Medical Council (GMC), which is independent of Government, sets the standards and outcomes for basic education in the UK. This covers undergraduate education and the first year of training after graduation. More information on the GMC’s role is available at its website.
.
Education and training for both health and social care workers are, and always have been, priorities for the Department of Health. However, we do accept that there is room for improvement. Lord Darzi’s interim report Our NHS Our future: NHS next stage review, published in October 2007, sets out a ten year vision for the NHS, reflecting on feedback from patients, staff and the public. It looks at how the NHS can become fairer, more personalised, effective and safe, acknowledging progress made so far and setting out immediate and longer term priorities in these areas.
The report recognises that our approach to education and training needs an overhaul. As a result, we intend to look at the content of curricula in undergraduate and postgraduate training for both health and social care. Fibromyalgia diagnosis and care will be considered as part of the wider context of this work.
Relatively little is currently known about the causes of fibromyalgia. Despite a great deal of commitment on the part of professionals and voluntary organisations, there are still considerable gaps in our knowledge about the diagnosis and treatment of this condition.
The Department of Health supports research and development of relevance to the NHS in hospitals, general practice and other healthcare settings. It also funds the NHS Research and Development Programme, which is managed on its behalf by the Medical Research Council (MRC). The MRC is the main Government agency for research, and receives its funding through the Department for Innovation, Universities and Skills.
Currently, the MRC has no specific research on fibromyalgia, although the basic research that the MRC supports in areas of pain and neurobiology is relevant to developing our understanding of the condition. There is now a Medical Advisory Board attached to the Fibromyalgia All Party Parliamentary Group, and one of its tasks will be to look into research on fibromyalgia.
The MRC does not directly commission research projects or earmark funds for particular research areas. Funds are allocated by a process that requires investigators to submit proposals for rigorous peer review. The MRC always welcomes high quality applications for support into any aspect of human health and these are judged in open competition with other demands on funding. The key factor in deciding whether a proposal is funded or not is quality of the science and its potential contribution to human health. In addition, the MRC identifies priorities for medical research in a number of ways, including strategic reviews of specific areas of science and by responding to Department of Health priorities.