View conference programme - The British Society for Rheumatology

11:30 – 13:00 BSR: Interface of rheumatology with the community
Pentland/Sidlaw
Chair: David GI Scott
11:30 Community interface with secondary care Elaine Hay
Increasingly, it is recognised that there is a significant gap in the provision of
clinical care for patients with non-inflammatory and non-surgical
musculoskeletal problems, who often access services in an ad-hoc manner.
There are a number of key principals to consider when developing a clinical
service for such patients at the primary / secondary care interface.
1. Delivering an effective and efficient musculoskeletal service that meets
the needs of the community has less to do with geographical location of
clinics than with developing a cohesive patient centred model of care.
2. Local strategies need to be developed to breakdown barriers and
facilitate coherent care between professions, between settings and
organisations and between different models of care (medical model versus
“patient centred” model).
3. To be effective, the service must incorporate clinical services
(“New Ways of Working” and cohesive clinical teams), training and
education, and audit and research.
Some form of triage by practitioners with special interests (usually general
practitioners or physiotherapists) is increasingly popular as a way to try to
improve the efficiency and appropriateness of the referral process for patients
with musculoskeletal problems. This approach has tangible benefits including
reduced wait times, convenient access, high levels of patient satisfaction and
increased conversion rate for surgery. However, it is important that practitioners
with special interests work as part of a multidisciplinary team, providing an
integrated service spanning primary and secondary care. The importance of
robust, transparent procedures to ensure appropriate training and experience;
evidence of continuing professional development; adequate clinical facilities,
support and accountability as well as a commitment to clinical governance,
audit and evaluation have recently been highlighted (A Musculoskeletal
Clinical Framework for GPs with special interests
www.doh.gov.uk/pricare/gp-specialinterests ).
11:55 The GP’s perspective on the role of rheumatology Michael Dixon
• How do we commission effectively? Primary and secondary care clinician
leadership and frontline involvement in designing services. Ensuring cost
effective use of services commissioned. Clinical leadership at the
interface between secondary care and general practice.
• Service redesign - how much rheumatology can be done in primary care?
• Improving the patient experience - the role of PCTs and the impact of
patient forums and practice patient participation groups.
• Patient choice - the effect on rheumatology services of moving the locus
of control from Whitehall to the patient and his chosen practitioner.
12:15 GPs with special interests in rheumatology Steven Longworth
12:35 Rheumatology serving the community Carol Black
The demographics of the population are changing, we are living longer and
chronic diseases are on the increase. These changes plus those embodied in
shifting the balance of power require the rheumatological community to
examine how, where and with whom care will be delivered in the future.
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