Telford Community Rheumatology Service

Rheumatology TeamA new, 3 year £1.2 million contract was awarded for the delivery of community based Rheumatology services across the borough. The contract was awarded to a consortium involving NHS Telford & Wrekin Community Health Services and its partners Shropdoc and the Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust.

The base of the Community Rheumatology Service is Hollinswood, a former GP surgery in a residential area of central Telford.  Patients have access to the Rheumatology Team comprising two Consultant Rheumatologists, one of whom is the lead consultant, Dr Al-Ansari, and one a visiting consultant, Dr Askari, plus two Nurse Specialists; Alison Meadows, the clinical lead, works four days a week at Hollinswood and Sarah Bird one day a week to provide full time cover. A GP with a special interest in rheumatology, Dr Louise Warburton, does three sessions per week, and there is one OT clinic weekly and four physiotherapy clinics weekly. All the administration staff and healthcare assistant are based at Hollinswood. Once a month the lead Nurse Specialist and GPSWI provide a clinic at Newport.

The local DGH can refer to the community service and Consultants visit the hospital to see in-patients as required and can also provide telephone advice.

The service provides a Helpline for patient and healthcare professional queries and monitors patients starting DMARDs for the first two to four months.

There are key performance indicators (KPIs) that are monitored regularly to ensure a high quality and responsive service. An early arthritis clinic, ultrasonography, regular DAS assessments by specialist nurses have all been implemented to comply with NICE best practice recommendations.

The overall aim of the CRS is to provide a Consultant led community based service with rheumatology care equivalent to secondary care, but with the advantage of a friendly, quiet and patient-centered location compared to the previous service, which was in a  crowded hospital setting.

Our unique selling point is a full time Consultant service with the necessary support team providing a community based service. We provide a range of services from day to day consultations to urgent reviews, telephone advice and education to GPs, and education for staff. We aim to empower local GPs to enable them to manage less complex patient problems in their surgeries using protocols. This will allow faster and more efficient treatment for patients, and avoid unnecessary appointments. We engage with local GPs to work together to provide seamless care for our patient population.

Two Nurses SeatedA recent patient satisfaction questionnaire showed encouraging results in terms of satisfaction with reception, administration and clinical staff, however the survey showed there is a car parking problem and expansion is required.

Within the first year we have been a great success story, but we always hope to provide an improved service in the future; this would require a bigger building. This has been discussed at board level and a genuine search has been started. Our aim is to provide even more support services like X-ray and DXA and better on site physiotherapy equipment. The vision is to establish a mini day case unit.

Additionally, and as part of our community role, the CRS has supported many patients’ groups like NRAS, NASS and forthcoming Lupus UK patient group meetings, which proved very popular and were well attended.

The CRS is still new and there are improvements to be made; we have already made substantial progress with the arrival of the new consultant, to lead the service into a greater future.