Rheumatology

Rheumatology covers the investigation, diagnosis and medical management of more than 200 rheumatic and musculoskeletal disorders (RMDs) that primarily affect joints, bones, muscles and tissues.

More than 10 million people in the UK are affected by RMDs, with rheumatology teams supporting the long-term management of complex chronic conditions.

As a predominately outpatient-based specialty, rheumatology services provide more than two million appointments in England every year.

Reflecting on lessons learned from the first wave of the COVID-19 pandemic, the GIRFT national report makes recommendations which will benefit patients by improving care and access to services, as well as reducing the number of unnecessary hospital visits. Among them are a recommendation for the redesign of services for patients with non-inflammatory painful musculoskeletal (MSK) conditions, enabling more treatment in primary or community settings instead.

Dr Lesley Kay

Clinical Lead for Rheumatology

Consultant rheumatologist at the Newcastle upon Tyne Hospitals NHS Foundation Trust and former Chair of the British Society for Rheumatology Clinical Affairs Committee

Lesley Kay is a consultant rheumatologist in Newcastle upon Tyne. She trained in rheumatology and public health in the North East and Cambridge and has worked as clinical director for musculoskeletal services and clinical director for patient safety and quality. She is a former Chair of the British Society for Rheumatology’s Clinical Affairs Committee, vice-chair of the Northern Clinical Senate Council and is a GenerationQ Fellow with the Health Foundation.

Dr Peter Lanyon

Clinical Lead for Rheumatology

Consultant rheumatologist at Nottingham University Hospitals and past president of the British Society for Rheumatology

Peter Lanyon has been a consultant rheumatologist at Nottingham University Hospitals NHS Trust for the last 18 years and is a past president of the British Society for Rheumatology.

After graduating from the University of Birmingham in 1986, he started his career in general practice; this provided an unique insight into the challenges of musculoskeletal disease and included research demonstrating unmet educational needs among doctors training in primary care.

Subsequently, he went on to train in rheumatology, obtaining an MD from University of Nottingham for research into the genetics of osteoarthritis. After completing this training, he undertook a fellowship in Clinical Immunology.

In 1999 he was appointed consultant rheumatologist at Nottingham University Hospitals. In addition to general rheumatology, he has a particular interest in complex autoimmune rheumatic disease, integrating clinical research into service delivery.

He has experience of service leadership and redesign and has previously led development of regional rheumatology audit and peer review within the East Midlands.

Between 2013 and 2016, he chaired the NHS England Specialised Rheumatology Clinical Reference Group, whose work championed the needs of people living with rare rheumatic diseases, delivered commissioning policies to enable access to high-cost treatments and established levers for delivery of care in regional networks.

From 2016 to 2019 he was president of the British Society for Rheumatology, whose mission is to support its multidisciplinary membership to deliver the best care, to improve the lives of children and adults with rheumatic and musculoskeletal disease.

Useful information

Implementing patient-initiated follow-up (PIFU) in adult rheumatology services: This tailored guide is now available from the NHS England Outpatient Recovery and Transformation team in conjunction with GIRFT, helping to reduce outpatient appointments that may not be needed, supporting elective recovery.

GIRFT rheumatology report outlines how service change could reduce waiting times and improve access to care

Patients with painful conditions such as osteoarthritis and fibromyalgia could be seen faster and closer to home to help reduce delays in their treatment – and provide better access to additional support services when they need them, according to a new national report.
The specialty report for rheumatology by the Getting It Right First Time (GIRFT) programme highlights challenges faced by many units, including rising demand for services, limited resources and an overstretched workforce; this results in many patients with painful non-inflammatory musculoskeletal conditions having to wait a long time for assessment.
Aside from service reconfigurations, there are also opportunities to better maximise the value and efficacy of the medications used to treat rheumatology.