NICE (National Institute for Health and Care Excellence) has recently published its first guideline for the diagnosis and management of Lyme disease in the NHS. The guideline has been in development for the past couple of years, during which time UK Lyme disease organisations (including About Time for Lyme) have offered contributions and recommendations based on their experience.
The guideline should hopefully lead to much better awareness of the problem of Lyme disease amongst doctors. Other positive advice includes: longer courses of treatment in acute cases if symptoms persist, the need to provide treatment straight away if an Erythema Migrans (Bull's-Eye) rash is present, encouraging doctors to use clinical judgment where necessary, stronger treatment for Lyme Neuroborreliosis and acknowledgement of the need for more research.
However, unfortunately the guideline falls short in other crucial areas. Most notable is the repeated advice that ‘difficult cases’ should be referred to a ‘specialist’, despite there being an absence of specialists in the NHS. Failure to make recommendations or provisions for a specialist clinic – one where the various potential complex symptoms of Lyme can be considered and where doctors have an understanding of all the common tick-borne diseases in the UK, not just Lyme - is another major downfall. Without specialists in tick-borne diseases, ‘difficult cases’ will continue to be passed from consultant to consultant in different medical fields, with the focus continuously being on individual symptoms rather than the collection of symptoms as a whole.
About Time for Lyme are now working closely alongside the charity, Vis-à-Vis Symposiums, who work towards improving understanding of tick-borne diseases amongst UK medical professionals. The UK will not be fully equipped to respond to the growing problem of tick-borne diseases unless both the general public and doctors understand what to look out for and how best to respond. The NICE guideline represents a step in the right direction but there is still a huge amount to be done in order to adequately respond to this increasing threat to public health.