NICE CKS Round-Up — May 2026: Recent Updates for UK Primary Care

NICE Clinical Knowledge Summaries (CKS) are updated on a rolling basis, and several primary-care topics have changed recently. This round-up gives a one-line takeaway for each of the most clinically relevant, with a link to the source. The authoritative record is the NICE CKS site; this is a summary for awareness, not a substitute for the topic page itself.

This is the first in a recurring monthly series. We summarise the changes; we do not replace NICE, and clinical decisions remain the responsibility of the treating clinician.

The updates that matter this month

• Immunisations — seasonal influenza. Updated for the 2025–26 season. Takeaway: check the current at-risk groups and the season's recommended vaccines before your autumn clinics plan.
• Anaemia — iron deficiency. New information on normal haemoglobin with low ferritin in menstruating pre-menopausal women. Takeaway: a low ferritin can warrant action even when haemoglobin is normal — worth revisiting your threshold for treating.
• Addison's disease. Recommendations from the NICE adrenal insufficiency guideline incorporated. Takeaway: sick-day rules and steroid-cover advice now align with the NICE guideline — re-check your patient-facing guidance.
• Myalgic encephalomyelitis / chronic fatigue syndrome (new topic), and Tiredness/fatigue in adults. A new ME/CFS topic, with the tiredness/fatigue topic updated to match. Takeaway: the assessment pathway for unexplained fatigue has a clearer ME/CFS branch.
• Sciatica / lumbar radiculopathy. New information on bilateral radicular pain and referral to musculoskeletal triage. Takeaway: bilateral radicular pain has specific red-flag and referral implications — know the route.
• Insomnia. Information added on SNRIs, ADHD, autism spectrum disorder, menopausal symptoms and tinnitus as contributors. Takeaway: widen the differential for the causes you screen for before reaching for a hypnotic.

How to use this

CKS is a point-of-care reference, not a reading list — but the changes month to month are a useful signal of where guidance is moving. The fastest way to use this round-up is to scan the takeaways, then open the full CKS topic for anything that touches your regular caseload.

For the bigger picture on staying current across guidance and the journals, see our pillar guide on how to keep up with the medical literature.

A note on what this post is — and is not

This is a summary for awareness. It is not a substitute for the NICE CKS topic pages, which are the authoritative and current source. Always confirm the recommendation on the CKS topic page before acting on it. Clinical decisions remain the responsibility of the treating clinician.

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