Annual Rheumatology appointment : I've been trying to... - NRAS

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Annual Rheumatology appointment

Sebastian247 profile image
58 Replies

I've been trying to remember when my annual Rheumy appointment might be due so asked a GP this week whilst seeing them about another matter.Turns out my last appointment was in November, so its overdue.

The GP said he was aware the rheumatology dept had problems with recruitment so he wasn't surprised.

He suggested I wait and if I've heard nothing by July....to chase it up. This would have been my first annual review since getting diagnosed and treatment.

I wondered if this was typical for rheumatology and what others experience of their annual appointment has been, if they have one.

Also waiting until July, 7 months late, seems a pretty relaxed approach. But I'm generally well apart from MTX side effects (I think it's the MTX anyway). So maybe I should wait a while and see if they contact me.

Any thoughts or advice gratefully received.

Seb.

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58 Replies
Peptink profile image
Peptink

Just wanted to comment on my experience. I see my rheumatologist every 3 months. Often times blood work is done. Also, I get a complete eye exam once a year just to make sure everything is well. Good luck moving forward with your RA. 🌻

AgedCrone profile image
AgedCrone in reply toPeptink

Where do,you live to get such regular appointments.

Most here struggle to get appointments.

Bootoo profile image
Bootoo in reply toAgedCrone

I am in the north west and get regular appointments with my consultant, about once every 4 -6 months. I've never had a problem .....( touch wood )

AgedCrone profile image
AgedCrone in reply toBootoo

You are very fortunate

ABwn profile image
ABwn in reply toBootoo

You are very fortunate. I'm lucky to have an annual phone call.

Sebastian247 profile image
Sebastian247 in reply toPeptink

Thanks for sharing your experience. Best wishes. Seb

bunnycaramel profile image
bunnycaramel in reply toPeptink

You are really fortunate as down south you are lucky to be seen once in 2 years or even longer

preith17022 profile image
preith17022 in reply tobunnycaramel

We live in FL and that is not the case for us. My husband is seen twice a year and if need be he calls to get in for any need to be seen now appointments

Spanelmad profile image
Spanelmad

Contact your nurse specialist for advice about an appointment.

Sebastian247 profile image
Sebastian247 in reply toSpanelmad

Thanks. I'll do that. Seb

Boxerlady profile image
Boxerlady

My last two "annual" appointments have been overdue and both times I rang the department to be told that they were behind with appointments but they were able to give me a time scale; they emphasised that I could ring the nurse helpline if I had any concerns but as I hadn't, I was happy to wait. When I last saw the consultant she said that she would put me down for six months but that it would probably be more like a year. I think that most rheumatology departments are struggling for staff but my nurse helpline is still good so I count myself lucky.

Sebastian247 profile image
Sebastian247 in reply toBoxerlady

Thanks for sharing your experience. At least I'm not the only one to experience a delay. Seb.

Boxerlady profile image
Boxerlady in reply toSebastian247

If I were you, I would contact the department (mine has an appointments line) to ask for news. On one occasion I was told that they were running a few months behind and to ring back after that, on another occasion they looked to see where I was on the list and then offered an appointment a month or so away which meant that I could choose a good time for me rather than having one allocated.

Sebastian247 profile image
Sebastian247 in reply toBoxerlady

Thanks. I'll do just that. Seb

Sebastian247 profile image
Sebastian247

Sorry, yes I meant November 2022. So it's now 14 months since my last appointment. And as you say it would be 20 months if I waited until July. Thanks for the advice and support. Seb.

KittyJ profile image
KittyJ

I haven’t had an annual appointment for a long time. It used to be 6/12 monthly but that’s all gone to pot. If I need to be seen because I have a problem then I call the helpline or get my GP to chase up an appointment for me. If you’re doing ok and your bloods are ok then do you really need to be seen, a lot depends on what you want from an appointment, me I’m happy to wait and not drive an hour there unless needed but that’s just me and I’ve been diagnosed a lot longer 😊

Sebastian247 profile image
Sebastian247 in reply toKittyJ

I get what you're saying. I'm only quering it because the rheumatologist said he wanted to see me in a year. And as I'm relatively recently newly diagnosed it seemed like a good idea. But your approach makes absolute sense to me. Thanks.

helixhelix profile image
helixhelix in reply toSebastian247

I agree that since newly diagnosed you should be seen face to face and have an opportunity to discuss how treatment is going and whether any tweaks needed.

welsh12 profile image
welsh12

Seems a long time would ask the nurse. Telephone reviews with nurse seems to be the way they cope with shortages in my hospital in London.

bunnycaramel profile image
bunnycaramel in reply towelsh12

I find the nurse appointments are useless

Can’t make any changes

Boxerlady profile image
Boxerlady in reply tobunnycaramel

Mine have always been useful; yes, they have to feedback to the consultant but each time their recommendations have been implemented.

welsh12 profile image
welsh12 in reply toBoxerlady

Yes I think that's the point of them to feedback to consultant

BoneyC profile image
BoneyC

Annual appointments are a thing of the past at my hospital. I was seen in September 2019 and had to chase and complain to PALS to get seen, which I was in September 2023.

Scottishlad profile image
Scottishlad

I haven't had a face to face appointment since the start of COVID. I have had at least one video call since then. Previously I used to see the consultant about once a year and the specialist nurse between those appointments However my RA is stable and well controlled with no side effects from the medication. I don't think at the moment there would be much benefit for me in seeing the rheumatology team.

If the situation I just have to contact them and I'm sure an appointment would be arranged.

In your case as a more recently diagnosed patient I would expect some kind of check by consultant or specialist nurse on a regular basis.

joycen60 profile image
joycen60 in reply toScottishlad

I am in the same situation as you. Had another telephone appointment yesterday in which I said that I was fine and have been for quite a few years now. He said they would not be sending me another appointment but if I needed one to phone direct to make one and still have the helpline if needed urgently. Fine by me as I did feel that appointments were a bit of a waste of time for both of us.

welsh12 profile image
welsh12 in reply tojoycen60

Yes if I get to that point I would be fine with that however the so called helpline is no good goes through admin takes days to get any responses from nurse going to take it up with them in telephone appointment

rmros profile image
rmros in reply toScottishlad

Same here - I've been doing okay for a while and would rather not have routine appointments, but have the option of requesting to be seen when/if needed.

But they seem to have increased my appointments instead. I wish they'd been so keen when I was newly diagnosed and struggling and couldn't get seen for love nor money.

janmary profile image
janmary

Are you able to use a helpline/ see a specialist nurse if you have a problem?

I know that there is a particular problem with recruitment of both medical and nursing rheumatology staff at the moment As well as increased demand.

CagneysMum profile image
CagneysMum

It would seem that there is no standard schedule from reading people’s replies to your question. My hospital says that my consultant review appointments should be every 6 months but in reality are probably every 10 months. I do have a nursing team/help line that I can call if I need advice or access to my consultant though. That’s enough for me because my RA is well controlled at the moment, but I’d be making a fuss if that wasn’t the case.

Jackie1947 profile image
Jackie1947

I live in the South West and I've always either had a face to face or video if I don't need examining every 6 months or sooner if there is a problem. The helpline or email system works well too .Like most hospital departments there are staff shortages and with bugs around a testing time of year

Flinda profile image
Flinda

Like others, my last face to face appointment was back in early 2019, so 5 years ago! I had a phone call consultation in May 2020 but, since then, nothing whatsoever. Their helpline is just an answerphone but nobody ever rings back. I think they've lost me!

I know I should contact PALS to get an appointment, but why is everything such a fight these days? So many simple processes are broken. Even getting a GP appointment is such an awful ordeal - I'd much prefer not having to put myself through the process, so don't.

Yes, at the end of the day, we can all stand up for our rights, but when this includes something as simple as getting an appointment, I do wonder how we (as a society) have allowed this to happen. I think it's an extremely sad reflection of the deterioration of what we used to value.

welsh12 profile image
welsh12 in reply toFlinda

That is really poor

bunnycaramel profile image
bunnycaramel in reply toFlinda

I have had the same called in but no reply. I have heard a lot of the consultants have left

aliplayspiano profile image
aliplayspiano

Theoretically I am supposed to see either the rheumatology nurse or the consultant every six months but since covid it hasn’t been that frequent. I last saw the nurse in February 2023 and she did say that it would most probably be a year before my next appointment and indeed that’s the case as I have an appointment for February 2024. She did also say that if I was struggling to contact them and they would see me sooner. As I’m pretty stable on my medication I am ok with this. I have regular blood tests done by rheumatology and the nurse will always ring me if there’s a problem with them.

Pepperpot22 profile image
Pepperpot22

My first consultant appt was when I was diagnosed in October ‘22. Nxt one is March ‘24, so 17 months between. However I hav had regular appts with RA nurse, usually every 3/4 months in between. It’s very much a postcode lottery isn’t it? Hope you get to see them soon!

cyberbarn profile image
cyberbarn

There is a lot of variation across the country and one possible reason for this is that some areas use what is know as tight control. This is where people in the early stages of disease are seem more frequently until the disease is under control at which point it often switches to PIFU which is patient initiated follow up. This could be why in some areas people are seen more often in the first few years of their journey until they are stable with their treatment, and then only receive appointments when they request one.

ncbi.nlm.nih.gov/pmc/articl...

Of course it would help if this was explained to patients!

cathie profile image
cathie

My experience since 1999 in RA departments in Oxford and now in Edinburgh has varied enormously so I dont think there is a 'normal'. It might depend on how your RA is being controlled, or the staffing situation in the department. When a new consultant was appointed in Oxford coinciding with a new building opening, things were transformed.

I'd expect early on in your diagnosis to see the consultant quite often, at least twice a year. Some of the treatments take a while to kick in, so more frequently might not be useful. But more than a year before you're happily established on a regular medication feels inadequate. Hope you can get somewhere with this.

oldtimer2 profile image
oldtimer2

Many areas are going over to a system where you only get an appointment if you request one.

I would firstly contact the appointment line to find out when it's scheduled. You could have been lost to follow up, been sent an appointment that you haven't received (and even taken off the list becasue of this), or there may just be a backlog (most likely).

It isn't satisfactory that, so soon after your diagnosis, you are so unsupported in your journey managing this condition. Long term conditions should be a partnership between BOTH parties, the patient and the medical team, not just the patient struggling on by themselves.

nincompoop profile image
nincompoop

I was diagnosed around 4 years ago and was never even told that I should have annual reviews!!!!! GP confirmed Arthritis and prescribed Algesal cream on repeat prescription and that's it. Never been given a review.

Plumcrumble profile image
Plumcrumble in reply tonincompoop

Oh my goodness, you should have been referred to a rheumatologist, contact your Gp to refer you, best wishes Sarah

KittyJ profile image
KittyJ in reply tonincompoop

What type of arthritis do you have though, OA or RA, that would be a difference in approach

Plumcrumble profile image
Plumcrumble

Hi I would contact them it will prob be a while before you get a appointment. I thought the same as you but its very nearly 2 yrs since seeing a rheumatologist and I feel like I've been forgotten, since getting RA 43 yrs ago it's the longest I've waited for a check up, it was usually about 6mths and you were given a date for your next appointment before you left the hospital.That changed a few years ago before covid. Anyway your post has spurred me on to contact mine 😁 hope you don't have to wait too long best wishes Sarah

Sebastian247 profile image
Sebastian247 in reply toPlumcrumble

Thanks Sarah. Wondering if I've been forgotten is partly my concern too. If the rheumatologist hadn't said he'd see me in a year i wouldnt be thinking about it, but he did. Even just a letter or text explaining there was a delay would be ok. I hope you get an appointment sorted too. Seb

Plumcrumble profile image
Plumcrumble in reply toSebastian247

Yes I totally agree it's the not knowing, I get bloods done at the gp but would like to see a rheumatologist, hope you get sorted soon aswell, best wishes Sarah

KittyJ profile image
KittyJ in reply toSebastian247

If you’re concerned I’d give them a call, allay your worries 😊

Mmrr profile image
Mmrr

I'm 7 years in from diagnosis and see my rheumatologist approximately every 6 months. I do have ongoing issues.

Angie2212 profile image
Angie2212

Im fortunate to see my RA nurse twice a year and my RA specialist doctor twice per year too. I fall under Greater Glasgow area although I live outside Glasgow.

I do find if I have issues inbetween I can call and talk to my RA nurse and they will see me if need be. Maybe worth calling them.

LondonLinda profile image
LondonLinda

My experience with my RA Consultant has been superb since my very first appointment following diagnosis in 1999. I have always had regular appointments - no pain a voice call, in pain a face to face with no delay. Having read some of the experiences, I know I’m lucky and I live in the South, in Kent. Please push for your consultations, perhaps find out the Consultant's secretary’s phone number and call her. It works. Good luck

helixhelix profile image
helixhelix

Reading this thread is deeply depressing. So many of you have substandard care, and have had very poor explanations of what you shoukd expect. I knew things had gone downhill since Covid, but not this badly. Occasionally I think about going back to the UK, so will pin this to the fridge to remind me not to!

Yes the NHS is in trouble and there are not enough rheumatologists, but by patients taking this without pushing back doesn’t help in the long term.

If you think you need to be seen then tell your medical team as assertively as you can.

The NICE guidelines say this:

“We want this guideline to make a difference to people with rheumatoid arthritis by making sure:

- you are offered the right medicine to slow the condition as quickly as possible after you are diagnosed, as well as medicines to ease your symptoms

- you and your doctor agree a goal to work towards so that you have good control of your symptoms – to help you reach this goal you should have regular monitoring so that your doctor can adjust your treatment if needed

- you can see a specialist quickly if you need to when your symptoms are worse

- you can have other therapies to help you live with rheumatoid arthritis, like hand exercises, advice about footwear and insoles, support with everyday tasks, and help to cope with stress and negative feelings.

Decisions about treatment and care are best when they are made together. Your healthcare professionals should give you clear information, talk with you about your options and listen carefully to your views and concerns.”

If this not what you are getting then tell your local Health Watch, and PALS.

welsh12 profile image
welsh12 in reply tohelixhelix

Interesting the other help through therapies wasn't offered anything but have spoken up and have referrals made mainly through asking the physio. My GP is really not getting involved. Even down to not offering vaccine despite hospital writing saying what I needed have been to pharmacy a day received some of them.

Sebastian247 profile image
Sebastian247

It's worrying RA sufferers experience of services and treatment varies so widely, from great to virtually non existent.I also have hearing problems associated with RA and the audiology dept is fantastic, couldn't expect better care. I wonder why there are such variations in service, even within the same hospital.

The NICE guidelines seem like a distant dream for many RA sufferers.

Thanks for all the comments. It's been eye opening. I appreciate I've more fortunate than many with the treatment I've received.

Seb

helixhelix profile image
helixhelix in reply toSebastian247

Just because you feel you’ve been “more fortunate” doesn’t mean you shouldn’t push to get an annual review. That is what clinical experts think is the basic standard of care, and no-one else will fight for you but you!

welsh12 profile image
welsh12 in reply toSebastian247

I think they are often in silos boxs that protect their bit of service. I worked for a council that's what happens sadly.

embroy profile image
embroy

You can call your hospital for your Rhumey appointment, I called the hospital, you will get your appointment, I have my appointment on Monday (coming). Speak to your Nurse and he/ she will sort it for you.

Retirednhs profile image
Retirednhs

Hi that seems to be a common theme in some areas due to shortage of staff, if your concerned you could always ring the appointments dept to ask if there is one pending or the RA help number as sometimes patients do slip through the net for appointments . I should have been seen by another department in December for results of a scans l l rang the secretary to ask and found that my records had been pulled as l was an inpatient for another problem and had been returned for records dept on discharge so l had been missed and now have my appointment. It's worth ringing good luck .

Sebastian247 profile image
Sebastian247 in reply toRetirednhs

Thanks. I will call them next week. Seb.

Sebastian247 profile image
Sebastian247

Just a final update to this thread. I've finally been contacted by Rheumatology (unprompted) for an annual appointment. It's over the phone, apparently due to Covid (I would have preferred it to be in person to be honest). It's four months late but that's probaly not bad under the currrent NHS circumstances.

Thanks - seb

KittyJ profile image
KittyJ in reply toSebastian247

Good news Seb, over the phone isn’t ideal but happy you’ve got an appointment.

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