Integrated care model for patients with functional somatic symptom disorder – a co-produced stakeholder exploration with recommendations for best practice

Abstract Background: Functional somatic symptoms and bodily distress disorders are highly prevalent across all medical settings. Services for these patients are dispersed across the health care system with minimal conceptual and operational integration and patients do not currently access therapeutic offers in significant numbers due to a mismatch between their and professionals’ understanding of the nature of the symptoms. New service models are urgently required to address patients’ needs and to align with advances in aetiological evidence and diagnostic classification systems to overcome the body-mind dichotomy. Method: A panel of clinical experts from different clinical services involved in providing aspects of health care for patients with functional symptoms reviewed the current care provision. This review and the results from a focus group exploration of patients with lived experience of functional symptoms were explored by the expert advisory group and conclusions summarised as recommendations for best practice. Conclusion: We propose a novel, integrated care pathway for patients with ‘functional somatic disorder’, which delivers care according to and working with patients’ explanatory beliefs. The therapeutic model should operate based upon an understanding of the embodied nature of patient’s complaints and provide flexible access points to the care pathway.