Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what support is available for patients with Postural Orthostatic Tachycardia Syndrome awaiting specialist assessment, including access to interim treatments and prescribed medical compression garments.

Integrated care boards (ICBs) are responsible for commissioning end‑to‑end postural orthostatic tachycardia syndrome (PoTS) pathways that meet local population need and, where neither paediatric nor adult secondary care is accessible, this reflects a local pathway gap rather than an absence of national guidance, with equity of access remaining a core National Health Service principle.

ICBs are expected to: understand local population need; commission pathways that cover assessment, diagnosis, and management; ensure safe and effective transition between paediatric and adult services; and address gaps where referral criteria unintentionally exclude patients. ICBs are expected to commission interim treatments and prescribed medical compression garments, where appropriate.

General practitioners (GPs) may appropriately refer patients with suspected PoTS to secondary care for diagnostic assessment, as confirmation often requires specialist investigations and expertise beyond primary care. The Royal College of General Practitioners Syncope Toolkit provides information to GPs, including the use of the active stand test, to rule out other conditions and potentially diagnose PoTS more quickly. Management of PoTS typically involves lifestyle changes and medications to help control symptoms, and can involve support from a multidisciplinary team.

The NHS website provides information on symptoms, causes, diagnosis, treatment and self-management, while resources from the National Institute for Health and Care Excellence, including its clinical knowledge summary on blackouts and syncope and its guideline on myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), offer evidence-based information that is relevant to PoTS.

In July 2025, the Department published the Final Delivery Plan for ME/CFS. While this Plan is focused on improving care for people with ME/CFS, it is designed to support a more joined-up and holistic approach to managing complex, multi-system conditions. As PoTS often overlaps with ME/CFS and shares similar challenges around diagnosis, symptom management and coordination of care, the plan’s emphasis on multidisciplinary working, clearer care pathways and improved clinician awareness is expected to benefit people with PoTS. By promoting more integrated services and reducing fragmentation between specialties, the Plan will help ensure that people with PoTS experience more consistent, coordinated and person-centred care.