Dr Andie Siggers
Co-founder, Mosaic Medical · BMBS MRCP MRCGP IFMCP DipBSLM
I wanted to be a doctor from the age of seven.
Almost thirty years later, I still believe the NHS is one of the finest things this country has ever built. I spent fifteen of those years as a GP inside it. I loved the work. I loved the patients.
But I left. Because for people with chronic illness, I couldn’t give them what they actually needed within its constraints.
The BBC’s recent piece on falling healthy life expectancy stopped me in my tracks. Not because it surprised me. Because I see it every day.
Angie, who features in the article, has ME and an autoimmune thyroid condition. She’s leaving the UK for Bulgaria — partly for the mountains, mostly because she feels the healthcare system there is more responsive than the one she’s leaving behind.
“Once you’re diagnosed, that’s it, you’re left to your own devices.”
— Angie, BBC interview, 2025
That line. It’s not a criticism of bad medicine. It’s a description of a system doing exactly what its structure allows. Nothing more.
The NHS is extraordinary. And it has a blind spot.
It was built for a different era. Infectious disease. Acute injury. Surgical emergencies. It is still world-class at all of those things.
But fifteen million people in England now live with at least one long-term chronic condition. And the NHS’s architecture — ten-minute appointments, specialist silos, diagnosis followed by prescription — was never designed for this. It was designed for an episode of illness with a beginning, a middle and an end.
Chronic illness does not have that shape.
The GPs working within that system are remarkable. Compassionate, committed, trying so hard with the tools they have. This is not about them. It’s about the framework they’re working within. You cannot investigate the root causes of complex chronic illness in ten minutes. No amount of dedication changes that.
So patients get a label. And then they’re largely left to manage it.
Healthy life expectancy in the UK now stands at 60.9 years for women. The lowest since records began. We are one of only five wealthy nations where it is falling. 37% of people with a long-term condition say they don’t feel supported by the NHS to manage their health.
Why does this person have fibromyalgia?
It’s the question we always ask. The NHS pathway rarely gets to ask it.
Fibromyalgia affects one in twenty people in the UK. Mostly women. Mostly during their working years. Widespread pain, crushing fatigue, disordered sleep, brain fog. The standard pathway offers analgesia, a pain clinic referral, and a long wait. Since NICE restricted many of those painkillers in 2021, some patients are left with very little at all.
When we look properly — and we have the tools and specialist training to do so — the answers are almost always there.
Nutrient insufficiencies disrupting pain signalling and energy production. Thyroid function that looks normal on standard testing but isn’t, when assessed more fully. Gut dysbiosis driving systemic inflammation. HPA axis dysregulation from years of chronic stress. Mitochondrial dysfunction producing a fatigue that no amount of sleep can touch.
These are not alternative medicine ideas. They are physiological mechanisms with solid evidence behind them. Routinely uninvestigated in standard care.
When we find them and address them, people improve. Some recover fully.
Recovery. Not just management. There’s a difference.
The economics nobody is talking about
Pain medications impair sleep. Poor sleep worsens pain. Fatigue makes exercise impossible. Without movement, metabolic health and mood decline. Side effects pile up. Depression deepens. Work becomes unsustainable. Each of these generates its own appointments, prescriptions, referrals.
It compounds. Year after year.
Cost comparison: fibromyalgia management
Symptomatic management: £6,600 estimated annual societal cost per patient, recurring indefinitely. 42% of patients eventually leave employment entirely.
Root-cause approach at Mosaic: ~£3,000 for a full year of care — initial consultation, functional testing, and follow-ups every 6–8 weeks. Aimed at resolution, not repetition.
Less than half the annual cost of the alternative. And the alternative repeats.
It’s not GP medicine with more time. It’s different medicine.
Functional medicine is a specialty in its own right. Just as surgery and cardiology are different disciplines from general practice — not better, different — functional medicine requires its own training, its own tools, its own framework.
We use advanced gut microbiome analysis, nutrigenomics, comprehensive functional testing. We ask different questions. We look for different things.
And we work with our patients, not on them. First names. No hierarchy. A shared goal. We want to teach people what is driving their illness — because understanding it is part of recovering from it.
Many people arrive at Mosaic having felt dismissed for years. Normal test results waved as proof that nothing is wrong. Symptoms attributed to stress, to anxiety, to getting older.
They arrive feeling alone. Unheard.
You can’t ask someone in that position to change how they eat, rewire habitual patterns, process old trauma, build entirely new habits — unless they feel safe first. That safety is the foundation. Everything else builds on it.
The part that sits uncomfortably with me
We are self-pay only. Which means there are people we cannot help. Not because they wouldn’t benefit — but because the financial barrier is too high.
That isn’t right.
Private insurers will currently fund years of repeat appointments, painkillers and sick notes — the very cycle that doesn’t resolve anything. The case for funding a year of root-cause medicine instead is simple: it costs less, and it aims to end the cycle rather than perpetuate it.
We’d welcome that conversation with any insurer willing to look at the evidence.
And we’d dearly love to see this approach become part of how the NHS manages chronic illness. There are clinicians within the NHS who believe in this too. Some trusts are beginning to pilot lifestyle medicine approaches. It’s a start.
But it won’t come quickly enough for the millions of people currently in Angie’s position.
The BBC asks why a country with a system designed to give everyone equally good care is falling behind.
Part of the answer is this: for chronic illness, we have a system that is expert at naming what is wrong. But rarely asks why.
We can do better. That’s what we try to do at Mosaic. We’d love to see it become the norm.
If you’ve been diagnosed with a chronic condition and feel your care has named your illness without explaining it, we’d love to talk.
References
- Office for National Statistics: Healthy life expectancy in the UK, 2022–2024
- National Voices charity survey, 2025: 37% of people with long-term conditions do not feel supported by the NHS to manage their physical health
- Annual societal cost of fibromyalgia: approximately €7,813 per patient — Boonen et al., Annals of the Rheumatic Diseases, 2005
- 42% of fibromyalgia patients leave employment due to disability — ISPOR systematic review, 2024
- Fibromyalgia patients have more than twice as many GP visits and prescriptions per year — Hughes et al., Arthritis & Rheumatism, 2006
- Pharmacological treatment accounts for only 8% of total fibromyalgia costs — Sicras-Mainar et al., Arthritis Research & Therapy, 2009
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