Collin, Simon M, Sterne, Jonathan A C, Hollingworth, William et al. · BMJ open · 2012 · DOI
This study examined how fairly ME/CFS specialist services were distributed across England between 2008-2010. Researchers found that some areas had no specialist services at all, while others had very different numbers of patients being seen and diagnosed. In some regions, people living in poorer neighborhoods were less likely to access services than those in wealthier areas, even when services existed.
This study documents significant gaps in ME/CFS specialist care access across England, affecting millions of patients. It provides evidence that geography and socioeconomic status create barriers to diagnosis and care—important advocacy data for patients seeking equitable services and informing policy discussions about NHS service provision.
This study does not establish why variation in service provision exists or prove that deprivation is the primary driver of inequitable access. The cross-sectional design captures a snapshot and cannot determine causation. It also does not measure the quality of services provided or patient outcomes, only referral and assessment rates.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Collin, Simon M, Sterne, Jonathan A C, Hollingworth, William, May, Margaret T, & Crawley, Esther (2012). Equity of access to specialist chronic fatigue syndrome (CFS/ME) services in England (2008-2010): a national survey and cross-sectional study.. BMJ open. https://doi.org/10.1136/bmjopen-2012-001417
BibTeX
@article{mecfsatlas-collin-2012-equity-access,
author = {Collin, Simon M and Sterne, Jonathan A C and Hollingworth, William and May, Margaret T and Crawley, Esther},
title = {Equity of access to specialist chronic fatigue syndrome (CFS/ME) services in England (2008-2010): a national survey and cross-sectional study.},
journal = {BMJ open},
year = {2012},
doi = {10.1136/bmjopen-2012-001417},
note = {PubMed: 22899647},
url = {https://www.mecfsatlas.com/evidence/collin-2012-equity-access},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/collin-2012-equity-access
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