Fatigue Service: RFL

NCL Wide

The Royal Free provides an out-patient only, diagnostic and management service for adults experiencing mild to moderate chronic fatigue symptoms; such as for those individuals where the following diagnoses are suspected:

  • Myalgic Encephalopathy/Chronic Fatigue Syndrome (ME/CFS)
  • Post Viral Fatigue Syndrome (PVFS).

Please note that this excludes long-COVID and patients experiencing fatigue dominant long-COVID should be referred to the CNWL COVID rehab service via email:
e: cnwl.covidrehabilitation@nhs.net.

Patients are initially screened for suitability for the service, based upon the referral form received and our service’s referral criteria. They will then be invited to a service information session, which outlines the diagnostic process and therapy options available to them. Should patients wish to engage with the service, they will then be offered an initial assessment and diagnosis.

Our subsequent therapy options include a group-based Fatigue Management Programme, or, 1:1 therapy, which includes access to physiotherapy, psychology and peer support. We also offer the co-development of care plans. 

Our Fatigue Management Programmes are formulated on an Acceptance and Commitment Therapy (ACT) and Compassion Focussed Therapy (CFT) approach, supported by other key interventions such as:

  • Peer support
  • Energy Management
  • Communication Skills
  • Sleep Hygiene and Advice
  • Diet and Nutrition.

Please note that urgent referrals are usually not seen immediately as, by definition, rapid deterioration is due to a cause other than ME/CFS.

Eligibility criteria


  • Aged 18+
  • Mild to moderate severity
  • Persistent fatigue symptoms for at least three months
  • Other pathology/causes for fatigue ruled-out as recommended by NICE (please see referral form blood test requirements for primary care).

How to refer

Editable PDF / Word document Download Form

Referral methods: e-Referrals

1. Use the referral form (press the blue Download Form button)

2. A guidance document to support referral  is included in the Download section (scroll up / right).


Marlborough Clinic, Royal Free Hospital

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Review date: Friday, 20 January 2023