Rheumatology

Our outpatient clinics are held at Warwick and Stratford Hospitals.

All new patient appointments other than for the osteoporosis clinic will be face to face.

Follow up appointments may be by telephone or face to face depending on the clinical circumstances and you will be advised of the appointment type on the appointment letter.

Every effort will be taken for telephone consultations to run to time. If your appointment is delayed we will aim to call you within 1 hour of your appointment time.

For telephone appointments, you may receive a call from a 'private number' or 'unknown number', so please disable any functions on your mobile phone which block these calls.

Contact number for appointments queries: 01926 600036.

If you need to contact the department for clinical advice please contact the rheumatology advice line. This advice line is not answered by clinical staff and therefore they will not be able to give immediate medical advice. A member of the clinical team will contact you as quickly as possible but please be aware this may not be the same day.

Please note the Rheumatology advice line service can help you manage your joint symptoms or answer questions about your arthritis medications. For all other medical concerns please contact your GP as we will not be able to advise.

Advice line number: 01926 963023 (line is open 06:00 to 12:00 noon, please leave a message and a nurse will call you back within one working day).

Rheumatology Advice Line Leaflet

If you obtain you prescription for your medications from the rheumatology department then please e mail us with your request:
​​​​​​​swg-tr.requestprescriptions@nhs.net

If you cannot or prefer not to use email, please telephone the Prescriptions number 01926 963907 (line open 09:30 to 16:30, Monday to Friday, excluding bank holidays).

For those patients receiving home delivery of their biologic medications, other telephone numbers that may be helpful include:

• Healthcare at Home 0333 1039499
• Lloyds Pharmacy Clinical Homecare 0345 263 6148

If you have blood tests taken at the hospital then you will need to book an appointment.

For patients living out of area (and therefore the blood results are not automatically available to us) please could we request that you telephone 01926 963907 once you have had a blood test performed so we can contact your GP for the results.

N.B. The prescriptions telephone number is 01926 963907 (line open 09:30 to 16:30, Monday to Friday, excluding bank holidays).

What is Patient Initiated Follow Up (PIFU)?

Patient Initiated Follow Up is part of a national plan for specially selected patients with inflammatory arthritis such as Rheumatoid (RA), Psoriatic (PsA) or Axial Spondyloarthritis (AS/Ax-SpA) that have had stable disease and are on established medications prescribed by the rheumatology team at the hospital.

Patient Initiated Follow Up describes when a patient (or their carer) can initiate their follow-up appointments as and when required, e.g. when symptoms or circumstances change. As well as giving patients timely access to support, this avoids unnecessary routine ‘check in’ appointments when your Inflammatory Arthritis is stable and your blood monitoring is entirely satisfactory.

Patient Initiated Follow Up makes it easier and more convenient for you to receive care and support when you need it, while avoiding unnecessary trips to hospitals and clinics, saving you time, money and stress. It helps empower you to manage your own condition and plays a key role in enabling shared decision-making and supported self-management in line with your personal set of circumstances, for example living abroad for part of the year or in another part of the UK.

When should I get in contact between appointments?

This is not an Emergency Service (e.g. medical emergency, other non-rheumatology problems)

But, it is for you to use if you are worried about any of the following problems:

• If you have a ‘flare-up’ of your symptoms and these have not responded to your usual self-help treatments and you feel that you need further advice.
• If you are experiencing side effects that you think may be caused by the medication prescribed for your arthritis.
• If you experience an adverse reaction to a treatment given at the rheumatology clinic.
• If you have been asked by one of the rheumatology team to report on your progress.
• If you have any urgent worries or concerns about your inflammatory arthritis that cannot wait until your next appointment.

How do I make contact?

Please call the advice line on 01926 963023 (line is open 06:00 to 12:00 noon, please leave a message and a nurse will call you back within one working day).

What happens if I am feeling well?

You will simply have an annual review with an appropriate clinician.

What can I expect from Patient Initiated Follow Up?

• An annual review with a clinically-trained member of the rheumatology team.
• A telephone call-back by the end of the next working day in a flare of your Inflammatory Arthritis.
• Quality of care – there will be Patient Initiated Follow Up clinic slots available each week if you need to see someone and your query cannot be dealt with over the telephone.
• Communication with your General Practitioner when we make any changes to your treatment plan.
• Remember, you can ‘opt-out’ at any time from Patient Initiated Follow-Up.

What do we need from you?

Regular blood tests as directed in clinic for your particular set of treatments.

Attendance at your annual review appointment (this will usually be alternating with your Consultant Rheumatologist and Senior Nurse Specialist).

Tell us when you are having a flare of your Inflammatory Arthritis once you have followed the self-management guidance that has been provided in clinic or viewed online.

What about my quality of care?

Your quality of care is important to us. We pride ourselves on our ‘Outstanding’ rating by the Care Quality Commission and we strive to retain it. Patient Initiated Follow Up is here to ensure that your care is more tailored and bespoke to you but within a framework that still meets the standards of care set out by the British Society for Rheumatology (BSR) and Arthritis and Musculoskeletal Alliance (ARMA) for your Inflammatory Arthritis.

Contact information

Changing Rheumatology Outpatient Appointments
Please telephone – 01926 600 036

Changing Rheumatology Day Case Treatment Appointments
Please telephone – 01926 495 321 ext 4922

Contacting other departments
Please telephone the hospital main switchboard on 01926 495 321 and then ask for the relevant department.

To find out more about Patient Initiated Follow-Up, there are two videos. You will need to enter the password video2021 to access this page. The videos sit alongside a number of others and it is the sixth and seventh videos that talk about PIFU specifically.

Suspected Giant Cell Arteritis

Patients aged over 50 with headaches or other features suspicious of giant cell arteritis should be referred urgently to the acute medical team for same day review, investigation, and treatment where necessary. Referrals should go through the GP liaison service during normal working hours and through the on call medical registrar out of hours. The acute medical team have an agreed pathway to follow and they will inform the Rheumatology team of any patients likely to have giant cell arteritis, after their review and investigation. Please do not send referrals directly to the Rheumatology department as this will delay the review and management of this emergency condition.

Helpful Resources

Helpful resources regarding the diagnosis and management of common conditions can be found here:

Gout
Gout is typically managed in primary care- you may find the following resources helpful.

Criteria for referral to rheumatology include: diagnostic uncertainty; recurrent gout or development of complications despite appropriate prophylaxis with Allopurinol or Febuxostat aiming for a uric acid level < 300 umol/L; young age (< 30); pregnancy; severe renal impairment.

If you are concerned regarding septic arthritis, this requires urgent referral to the on call Orthopaedic team.

Fibromyalgia Syndrome
This diagnosis can be made in primary care without specialist input. Further advice on reaching a diagnosis.

If the diagnosis is confirmed and guidance about management is required, you may wish to consider a referral to community pain team if appropriate.

Joint Hypermobility Syndrome
Please note, we do not routinely see patients with Joint Hypermobility Syndrome. Please consider physiotherapy or if appropriate clinical genetics referral.

• Drug Information
• What is Arthritis
• Rheumatoid Arthritis (RA)
• Ankylosing Spondylitis (AS)
• Psoriatic Arthritis
• Juvenile Idiopathic Arthritis (JIA)
• Lupus
• Polymyalgia Rheumatica (PMR)
• Diet
• Gout
• Find a private Occupational Therapist
• Find a private Physiotherapist
• Living with arthritis - work
• Managing Symptoms like Pain, Fatigue, Sleep, Joints, Emotional Wellbeing

• Understanding Osteoporosis
• Living with Osteoporosis
• Bone Health Checklists including Vitamin D
• Osteoporosis Treatments

• Independent Helpline from Versus Arthritis
• Royal Osteoporosis Society
• National Rheumatoid Arthritis Society (NRAS) Speak to someone else with RA
• Lupus UK - need to talk to someone

• The Psoriasis and Psoriatic Arthritis Alliance - PAPAA
• National Axial Spondyloarthritis Society (NASS)
• National Rheumatoid Arthritis Society (NRAS)
• Lupus UK