The wilderness of medically invisible disability

The Wilderness of Medically Invisible Disability. Portrait photos of speakers Catherine Hale and Alison Allam

Disbelief and disregard in relation to medicine, chronic illness and disability

This video, with transcript below, was part of a webinar held by Liverpool University on 24th May 2022.


Hi, I’m Catherine Hale. I’m the Founder and Director of Chronic Illness Inclusion. My colleague Alison and myself are very excited to be embarking on a two-year research project, a collaboration with Bethan Evans at Liverpool University and other colleagues. My colleague Alison is going to talk you through the research on healthcare experiences of women with chronic illness, chronic pain and other energy limiting conditions.

This research was the catalyst for the project that we’re going to be embarking on. But first I want to give you some background on why this research was so important to our community. So the title of our talk, “The wilderness of medically unexplained, [sorry] medically invisible disability” is taken from an article in the British Medical Journal by Lisa Steen in 2016 and her article was called “The wilderness of the medically unexplained”.

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Act Now on disability poverty

Join the Disability Poverty Campaign. Write to your MP using our campaign too. Demand an emergengy uprating of benefits of at least 8% to match inflation

by Joel Lamy

The other day a work colleague told me she had finished at 5pm, instantly fell asleep then woke up just in time to start again the next day.

She has a hidden disability – and her experience is not unique – for many, the need to work full-time leaves them shattered and without the energy to even cook their food, never mind leave the house.

Not only is this an isolating and mentally-draining experience, it also means higher fuel energy usage – a problem when bills are soaring and unlikely to come down any time soon.

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Webinar on disbelief and disregard in healthcare

Challenging Disbelief and Disregard in relation to Medicine, Chronic Illness and Disability

photo of a stethoscope resting on top of a medical textbook

Free webinar 24th May 1-3pm BST

Chronic Illness Inclusion is jointly hosting a webinar with Dr Bethan Evans and colleagues at Liverpool University’s Centre of Health, Medical and Environmental Humanities.

This event brings together academics and activists working in relation to disbelief and disregard in medicine, chronic illness and disability. It will focus in paticular on the relationship between disbelief/disregard and energy, understood in two ways: first in relation to chronic illness/disability that involves energy limitation, and secondly in relation to the ways in which activism and advocacy in relation to medicine, chronic illness and disability takes, and depletes, energy.

The event will involve two roundtable discussions, with opportunities for the audience to ask questions.

Organised by: Dr Bethan Evans, Catherine Hale and Alison Allam (Chronic Illness Inclusion), Dr. Lioba Hirsch and Dr Morag Rose (University of Liverpool), Dr Ana Bê Peirera (Liverpool Hope University).

Speakers include (in addition to the organisers):

Brianne Benness (No End in Sight),

Dzifa Afonu (Healing Justice London),

Leonora Gunn (University of Leeds and Leeds Disabled People’s Organisation),

Katherine Cheston (Durham University),

Aaliyah Shaikh (City University, London),

Dr Emma Sheppard (Coventry University)

Aleyah Babb-Benjamin (National Voices),

Jenny Ceolta-Smith (Long Covid Support).


Recorded presentations from speakers will be made available ahead of the event for people to watch at their own pace.

BSL interpretation and auto-captions will be enabled.

To read more about the event visit The Centre for Health, Medical and Environmental Humanities website

To register for this event click here 

Will the future of work include people with energy limiting conditions?

We need to ensure that the flexible working future includes disabled people

photo of an open laptop and a phone on a bed

Flexible working is the future; most businesses as well as workers seem to agree. We need to make sure that this future benefits and includes disabled people, especially those of us with energy limiting conditions (ELCs).

Our research with Leeds University Business School demonstrated what people with ELCs want, and need, in order to be able to hold down a job. In short, they need adjustments are to the time, pace and place of work. Indeed, working from home, working reduced hours and having autonomy over the time and pace of work are the main components of ‘flexible working’ as defined by the government.

We were so used to our requests for various elements of flexible working to be refused by employers before the pandemic. It was too difficult, they said. Then, almost overnight, working from home became the new normal in March 2020.

This digital transformation opened up so many new horizons and opportunities for those of us who live in permanent lockdown due to an ELC. If home working and flexible working move to a more permanent footing, will this translate into more job opportunities for us in future?

Making flexible working the default

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2021 – a year at Chronic Illness Inclusion


Our mission at CII is to shape policies, perceptions and practices to improve the lives of people with energy limiting conditions.

Our vision is a world in which our experience of disability is heard, believed and understood, our rights as disabled people are upheld, and our lives have equal value.

We took a look back at everything we did 2021 to realise this vision and take forward our mission. Bearing in mind we are a grassroots organisation, run entirely by volunteers living with chronic illness and energy limiting conditions, we have a lot to be proud of.


Here’s a round up of our activities over the year:

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Changing society’s reponse to energy limiting conditions

Results from a survey by Disability Rights UK and Chronic Illness Inclusion

Disability Rights UK and Chronic Illness Inclusion are pleased to present the results of a survey of 1,710 people living with energy-limiting chronic illness (ELCI).

The high volume of responses to our survey provides us with a mandate, as well as a roadmap, for social justice and change from this large, but often neglected, group of disabled people.

Our findings clearly show that the vast majority of disabled people with ELCI encounter socially constructed barriers to wellbeing and participation in society, beyond the impact of their symptoms or impairment. Many of the barriers are unique to this group.

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ELCI, cognitive dysfunction and disability benefits

Chronic Illness Inclusion responds to the Department of Work and Pensions’ Green Paper on Health and Disability.


Summary: disability benefit assessments must be redesigned to account for the cognitive fatigue and dysfunction that limits work and daily living with ELCI.

In October CII submitted a comprehensive response to Shaping Future Support, the government’s proposals on the future of disability benefits. We also contributed to a response by the DPO Forum, a coalition of Disabled People’s Organisations, of which CII is a member.

Both of these responses addressed key concerns with the systems for PIP and ESA (and its equivalent under Universal Credit) that affect all disabled people. We responded to proposals about advocacy support and for making the claims process less burdensome. We especially highlighted the lack of any mention of the need to alleviate poverty and destitution among disabled people who are too unwell to work or are excluded from employment through discrimination. We argue that the level of financial support for disabled people in the social security system must be urgently and substantially increased.

In our own response we also highlighted an issue that particularly affects disabled people with ELCI and other energy limiting impairments. That is the fact the assessment criteria, known as the ‘descriptors’, used by both PIP and WCA are not designed to capture and account for our lived experience of impairment and disability. This is widey known.

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Making employment work for energy-limiting conditions

Chronic Illness Inclusion has influenced a report on disability employment by the Work and Pensions Committee

In April this year Catherine Hale gave evidence to a committee of MPs. She spoke about the measures needed to create more job opportunities for people with energy-limiting chronic illness (ELCI).

A graph showing the gap between the number of disabled people in work and those out of work

Source: Disabled people in employment, Briefing Paper 7540, House of Commons Library, May 2021

In July, the Work and Pensions Committee, chaired by the Rt Hon Stephen Timms, published its report into the disability employment gap. The disability employment gap is the difference between the proportion of disabled and non-disabled people in employment. It currently stands at nearly 30 percentage points.

The Committee based its recommendations on evidence from a number of experts and charities. The report includes recommendations on the collection of data about disabled people in work; employment support and Jobcentre Plus; the Access to Work scheme; the impact of Covid-19 on disabled people in work; and the disability benefits system, and more.

The fact that CII was included among the large national charities giving evidence was a big step forward for the chronic illness community. ELCI, or energy impairment, has not previously been considered by politicians or policy makers as a distinct group of disabled people, or ‘impairment group’,  with specific needs.

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Long Covid, ELCI and workers’ rights

Chronic Illness Inclusion responds to a report on workers’ experiences of long Covid

The recent Trade Union Congress (TUC) report on workers’ experiences of long Covid marks a milestone in our response to the Covid-19 pandemic.

The TUC’s survey of more than 3,500 workers finds that a third had symptoms of long Covid for more than a year. It is now clear that long Covid can be a life-changing illness. For some, it is creating enduring disability.

Just as importantly, this report is the first time we have talked about disability equality in relation to long Covid. The focus until now has rightly been on improving medical understanding and treatment of the condition. But the time has come to look beyond fixing individual bodies, and focus on changing society’s response to long Covid, Addressing employers’ legal duties towards disabled workers is a key place to start.

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Remote access, ELCI and co-production

Inclusive co-production means using remote access technologies to reach some groups of disabled people in their homes if needed.

Chronic Illness Inclusion is proud to feature in an exciting new open access volume from Policy Press on Covid-19 and co-production.

“Groups most severely affected by COVID-19 have tended to be those marginalised before the pandemic and are now being largely ignored in developing responses to it,” say the editors of Covid-19 and co-production in health and social care research policy and practice.

For this ‘rapid response’ publication, Catherine Hale and Alison Allam were invited to share learning from the Chronic Illness Inclusion Project on digital research methods designed to include hard-to-reach communities. Their contribution: ‘A place where we could listen to each other and be heard:’ Enabling remote participation spaces for research and co-production among disabled people with energy impairment beyond COVID-19 forms chapter 14 of Volume 2.
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