Clinic details

The Connect Health Community Rheumatology service was implemented to provided well needed capacity relief to East Kent Hospitals (EKHUFT). Patients who are deemed as their condition is stable, now receive their care from a Clinical Nurse Specialist which prevents the need for them to travel to a main hospital site for routine medical consultant care. This has freed the medical consultants to manage complex, sick patients and to speed up the process for new patients who were awaiting an initial diagnosis. As a new service, it has given us a unique opportunity to design and deliver care differently, with the needs of the Rheumatology patients at the forefront of our minds. Connect Health work closely alongside primary care and EKHUFT to deliver seamless transitions of care, allowing patients to be transitioned from each service as appropriate.

We want to make sure you’re able to contact us if you have any questions to ask regarding the rheumatology service or your care, or if you are having a flare and need some advice or support. We will always aim to provide an answer or solution as quickly as possible. Please contact our Referral Management Centre on 01223 603 986 who will ensure you receive a call from a rheumatology nurse within 24-hours or a face to face appointment within 48 hours*. The telephone service is manned Monday-Friday, 08:30-17:00. We are currently in the process of implementing a voicemail facility outside of these times.

A flare can be defined as any of the below symptoms;

• increased stiffness in joints.
• pain throughout the entire body.
• increased difficulty doing everyday tasks.
• swelling, such as causing shoes not to fit.
• intense fatigue.
• flu-like symptoms.

*Please note – 48-hour face to face appointments may be offered at a different clinic to a patient’s usually allocated venue, subject to venue availability.

If you are prescribed a disease-modifying antirheumatic drug(s) (DMARD) you may need to have regular blood tests.  All DMARDs other than Hydroxychloroquine, require blood monitoring, your nurse will advise you of the required frequency.  A shared care agreement is in place with your GP and it is their responsibility to provide you with blood forms and check your blood results.

Regular blood tests will help your doctor, nurse or pharmacist check how well your body is coping with your prescribed DMARD and will help to decide whether you can continue on your current treatment.

You will also be required to have a blood test every year, two weeks prior to your annual review; you will be sent the relevant blood forms ahead of your appointment by a member of the Connect Health team.

It is your responsibility to ensure that you attend regularly for your blood tests, if you do not, you may not be issued with a repeat prescription.

If you have any difficulty in obtaining blood tests or prescriptions, please contact Connect on 01223 603986.

As with blood monitoring, it is your GP’s responsibility to prescribe your DMARD; a shared care agreement is in place.

The only exception to this rule is if your DMARD is changed or the dose increased by us; in this case, we will provide you with blood forms and prescriptions until you have stabilised. Afterward, it will once again be the responsibility of your GP to resume blood monitoring and prescription management. Please note, there is a slight difference with Folkestone GP’s.

Your GPs have agreed that all blood monitoring and DMARD prescribing will be done by White House Surgery, unless you are seen by Hawkinge Surgery. If you require blood forms or a prescription, please contact the reception desk at White House/Hawkinge Surgery and explain that you are a rheumatology patient and require blood forms/prescriptions.

If you require X-Ray, paper forms will be requested and sent to you through the post.  Please take this form to your nearest hospital with an X-Ray department, no appointment will be necessary.

If you require a scan or a bone density examination, these requests will be sent direct to the relevant hospital department, and they will contact you with an appointment.

If you do not receive an X-ray form within one week of your appointment or do not receive an appointment for a scan/bone density test within six weeks of your appointment, please contact us on 01223 603986.

Translation Support: If you require a translator, please advise us which language you require when you book your appointment.

Patients with additional needs: If the Patient is vulnerable, or has a disability, or mobility problems, then please advise us when you book their appointment.

If you have been recently transferred into the service, and you are continuing to manage your condition well, you will hear from our Referral Management Centre to book your next appointment, ahead of your due date.

After an initial appointment, patients can typically expect an annual review, unless advised otherwise by the Clinical Nurse Specialist during the appointment. Examples of this would be in cases of diagnostic reviews, or if deemed as clinically appropriate by the Clinical Nurse Specialist.

Patients will also have access to a telephone appointment provided by a Clinical Nurse Specialist within 24-hours or a face to face appointment within 48 hours* in cases of flares.

*Please note – 48-hour face to face appointments may be offered at a different clinic to a patient’s usually allocated venue, subject to venue availability.

The clinics will run in a similar fashion to those previously offered in a traditional out-patient setting and will be coordinated and managed by a nurse-led team. During these clinics the specialist nurse will be able to offer the following services as appropriate:

• Patient education and information.
• Clinical assessments of your joints.
• Monitoring of the safety and efficacy of your rheumatology drug treatments.
• Evidence-based treatments, including nurse prescribing and intra-articular joint injections.
• Review of your blood tests.
• Height, weight, body mass index (BMI) measurements, blood pressure and urine tests.
• Calculation of your risk of developing cardiovascular disease (CVD) over the next 10 years using a validated tool. This takes into account several risk factors, for example, diagnosed medical condition(s), systolic blood pressure, smoking history and total cholesterol/HDL ratio and can be applied to those aged between 35-84 years of age. Those with a score of 20% or more are considered to be at a high risk of developing CHD.
• Assessment of your risk of having an osteoporosis-related fracture in the next 10 years. We use a tool that is validated to be used in untreated patients with risk factors, such as, previous fragility fracture, parent who had a hip fracture, alcohol intake and diagnosis of rheumatoid arthritis.
• Referral for investigations, for example, x-ray or ultrasound scans.
• Referral to other appropriate services.

Following your clinic appointment, you may need to start new medication. You will usually be given a prescription which can be dispensed by any pharmacy, or you may be advised to consult your own doctor for this. You will generally only be issued with a small supply of medication and will need to obtain repeat prescriptions from your GP.

Sometimes conditions will not require further follow-up from the rheumatology team and if this is the case you will be discharged back to the care of your own GP. More often, a further appointment will be arranged.

Within 1-2 weeks following your appointment you should receive a copy of the letter which has been written to your GP.  This will remind you of what has been discussed during your appointment and detail any changes to your treatment plan.