A comprehensive service re-evaluation of the UK's first NHS generic fatigue clinic four years following its inception: a mixed methods study

Deborah A Webster, Victoria Strassheim, Julia L Newton, Katie L Hackett

D.A. Webster, V.Strassheim, J.L.Newton, K.L.Hackett, A comprehensive service re-evaluation of the UK's first NHS generic fatigue clinic four years following its inception: a mixed methods study(2017)SDRP Journal of Cellular and Molecular Physiology 2(2)p:121-128

Objective: To identify if the Newcastle CRESTA (Clinics for Research in Themed Assessment) fatigue clinic continues to meet patient expectations, two years since an initial evaluation in 2015, following changes to the original service model.

Background: The CRESTA fatigue clinic was established in 2013 to fulfil the unmet needs of patients with long-term conditions and the symptom of chronic fatigue who did not have access to fatigue management support. The service was previously evaluated using a group concept mapping (GCM) approach and found to successfully meet patients’ expectations. To ensure these needs continued to be met following change to the original service model, we re-evaluated the service using a similar approach. GCM is a mixed method approach. Statements are generated from stakeholders, sorted into themed clusters, and then rated.

Method: 146 assessment tools were posted to consecutive clinic patients containing statements generated during the original study. Patients rated each statement for ‘current success’ on a 1-5 Likert scale and provided for free-text feedback.  Unpaired t-tests were used to compare cluster success scores from both the previous evaluation and the current cohort of patients. Thematic analysis was used to evaluate the qualitative comments.

Results: 46 questionnaires were returned. Comparison of the cluster success scores revealed the clinic has maintained its previous success and made significant improvements in peer support (p≥0.001). The free-text comments were mainly positive and patients found the service to be invaluable.

Conclusion: The CRESTA fatigue clinic continues to successfully meet patient expectations and has made significant improvements in peer support.

1. Wessely, S., Chronic fatigue: symptom and syndrome. Annals of internal medicine, 2001. 134(9 Pt 2): p. 838. PMid:11346319

   View Article      PubMed/NCBI     

2. Ng, W.F. and S.J. Bowman, Primary Sjogren's syndrome: too dry and too tired. Rheumatology (Oxford), 2010. 49(5): p. 844-53. PMid:20147445

   View Article      PubMed/NCBI     

3. Hewlett, S., et al., Patients' perceptions of fatigue in rheumatoid arthritis: Overwhelming, uncontrollable, ignored. Arthritis Care & Research, 2005. 53(5): p. 697-702. PMid:16208668

   View Article      PubMed/NCBI     

4. Goldstein, D., et al., Fatigue states after cancer treatment occur both in association with, and independent of, mood disorder: a longitudinal study. BMC Cancer, 2006. 6(1): p. 240. PMid:17026776

   View Article      PubMed/NCBI     

5. Aaronson, L., F. Crighton, and L. Pallikkathayil, A qualitative investigation of fatigue among healthy working adults. Western Journal of Nursing Research, 2003. 25(4): p. 419-433. PMid:12790057

   View Article      PubMed/NCBI     

6. Newton, J.L., et al., The Newcastle NHS Chronic Fatigue Syndrome Service: not all fatigue is the same. The journal of the Royal College of Physicians of Edinburgh, 2010. 40(4): p. 304. PMid:21132135

   View Article      PubMed/NCBI     

7. Hackett KL, L.R., Strassheim V, Gotts Z, Deary V, Newton JL., A concept mapping study evaluating the UK's first NHS generic fatigue clinic. Health Expectations. Health Expectations?: An International Journal of Public Participation in Health Care and Health Policy., 2015. 6(5): p. 1138-1149.

8. Hannon, K., et al., Developing resources to support the diagnosis and management of Chronic Fatigue Syndrome/Myalgic Encephalitis (CFS/ME) in primary care: a qualitative study. BMC Family Practice, 2012. 13(1): p. 93. PMid:22998151

   View Article      PubMed/NCBI     

9. Altogether Better. Altogether Better: unlocking the power of communities to transform lives. . 2015 04/06/2017]; Available from: .

   View Article           

10. DOH, Healthy Lives Healthy People; our stratergy for public health in England, D.o. health, Editor. 2010, HM Goverment: Department of health.

11. Trochim, W.M.K., An introduction to concept mapping for planning and evaluation. Evaluation and Program Planning, 1989. 12(1): p. 1-16. 90016-5

    View Article           

12. Trochim, W. and M. Kane, Concept mapping: an introduction to structured conceptualization in health care. International Journal for Quality in Health Care, 2005. 17(3): p. 187-191. PMid:15872026

    View Article      PubMed/NCBI     

13. Braun, V. and V. Clarke, Using thermatic analysis in psychology. Qualitative Research in Psychology, 2006. 2: p. 77-101.

    View Article           

14. Mossabir, R., et al., A scoping review to understand the effectiveness of linking schemes from healthcare providers to community resources to improve the health and well-being of people with long-term conditions. Health and Social Care in the Community, 2015. 23(5): p. 467-484. PMid:25494621

    View Article      PubMed/NCBI     

15. Lambson. R, N.J., Strassheim. V, Hackett K, The evolution of the Newcastle CRESTA Fatigue Clinic: a unique NHS multidisciplinary approach to fatigue. Journal of Rheumatology, 2015. 29(1): p. 7-11.