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ANY WELSH SUFFERERS OF RA AWARE OF NEW DIRECTIVE FROM WELSH ASS GOV Options
Jane-o
#1 Posted : Sunday, September 25, 2011 10:05:18 AM Quote
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Dear all

I hope I am using the correct section to ask if any Welsh RA sufferers have heard about the latest Directive by the Welsh Assembly Government regarding continuity of care for RA patients on the NHS.

Just to give you some background, I attended my 6 monthly check-up with my (foot consultant) a really nice and understanding man who has been great, during the appointment he said he would be making another appointment for me for 6 months - during that time should I feel I need to see him sooner just to ring and make an appointment. But should I feel that I do not need to see him prior to the 6 monthly appointment or the have a need for any treatment other than new foot supports I will be removed from his patient list !!!!!! this appears to be a new Directive from the Welsh Assembly Government. (obviously another cost cutting exercise again).

Should I then need to see him because of any problem I would need to be referred again through my GP or RA consultant (can you believe it) the only patients that will remain on a waiting list irrespective of their condition/progression are cancer patients and heart patients, whilst I appreciate the need for these patients to be monitored - once again RA seems to have been disregarded as a serious chronic illness which requires equal monitoring ie flare ups and pain control etc - surely preventative treatment/monitoring is better than eventual surgery !!!

I intend to contact the WAG under the Freedom of Information Act to ask for a copy of this Directive to confirm it is correct. It will be interesting to know if anyone else has heard about this ?



Jane
jenni_b
#2 Posted : Sunday, September 25, 2011 6:24:47 PM Quote
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Jane,

My cousin is a GP in Wales- I can ask her to try and find out if that would be helpful?

Jenni x
how to be a velvet bulldoser
jeanb
#3 Posted : Sunday, September 25, 2011 6:50:31 PM Quote
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What?!? Look foward to hearing what Jenni's cousin has to say.
jewelrhi
#4 Posted : Monday, September 26, 2011 1:26:30 PM Quote
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Did he say this was across the board for all - ie appointments with the consultants and nurses or is this directive applying to his type of work alone?
Jane-o
#5 Posted : Monday, September 26, 2011 2:45:20 PM Quote
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Hi - thanks for getting back to me - I am assuming this would be across the board as he said that only cancer and heart patients would be exempt from this directive.

Jenni - it would be interesting to know if your cousin has heard anything regarding this.

Jane
suzanne_p
#6 Posted : Monday, September 26, 2011 2:57:30 PM Quote
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hi Jane,

well hard to believe that this could happen !!

i know when i attended an NRAS meeting last year they said the care varies all over the Country,

talk about scary if this does apply right across the board,

one other thing i might do if i were you is give the NRAS helpline a call i am sure they would be interested to hear this and they might have news on it.

Suzanne x

jenni_b
#7 Posted : Monday, September 26, 2011 4:11:20 PM Quote
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Hi

Jane, I have spoken to my cousin and she was saying that it seems that as you have a follow up (or have I misunderstood) that this covers the rules.

She is unaware of any new directives.

Can you be really specific with what you think has changed and is now not at all good enough? (sorry- im a bit dense!)

Jenni x
how to be a velvet bulldoser
Jane-o
#8 Posted : Monday, September 26, 2011 8:04:23 PM Quote
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Jenni - my understanding is that if there is no medical input prior to or at my next follow-up appointment I will be taken off his patient list - if I should develop a further problem after the six month follow up I will have to be referred again by my GP.

Just to let you know, he is an orthapedic consultant and looks after my foot problems, I also have my RA consultant and have my next appontment with him in a couple of months.

Jane
LynW
#9 Posted : Tuesday, September 27, 2011 8:27:09 PM Quote
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Hi,

Recently I have seen both an orthopaedic consultant and a rheumatology consultant. From my experience their terms of care and ongoing treatment are very different. I appreciate that in Wales things may differ from those of England, although I'm not entirely sure why this should be!

Orthopaedics is regarded as 'acute care'. So for example last year I was referred for a knee problem brought on by the RA. The Orthopod took X-Rays and scans and decided on an arthroscopy which resulted in debridement and cartilage repair. After surgery I was reviewed and as the operation was considered by them to be successful their input ended and I was discharged. If I require further referral I will be treated as a 'new' patient. With regard to Rheumatology, chronic care, I think the guidelines are (I may be wrong and it could be a local decision!) for a 6 monthly review appointment, or earlier at the discretion of the team. Patients with RA are not discharged from the consultants list and we now have an additional consultant on the team to cope with increasing patient numbers.

I have significant foot problems (lots of surgery) due to the RA but these are dealt with by Podiatry and Orthotics and I phone when I need an appointment! I am wondering why a consultant orthopaedic surgeoon might be fiddling about with orthotics?? Is this what we pay them huge sums of dosh for?! In our hospital Orthotics comes under the umbrella of the Physiotherapy department!

This new directive all sounds rather a pickle to me!! Hope you can clarify matters Jane ThumpUp

Lyn x
My son, Ian, completed the BUPA Great North Run on 15th September running for the National Rheumatoid Arthritis Society (NRAS). You can read his story at http://www.justgiving.com/ianlukewilson

annamaria
#10 Posted : Tuesday, September 27, 2011 10:18:38 PM Quote
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Hi Jane

Down here in the South, my experience has been as follows:

Five surgeries (fusions) to my feet, all done by Consultant Orthopaedic surgeons, referred by Rheumatologist. Each has been followed up once or twice after being well out of plaster (sometimes 5 months), but then when healed, I have been discharged from the clinic. Then when requiring further surgery, I am re-referred as a 'new' patient to the same surgeon(but an old friend!)

My shoulder problems have been referred out of area as several surgeries have proved problematic, so beyond the remit of local hospital. These appointments are ongoing over the years.

My neck surgeries follow the same pattern as the shoulders. They will always constantly need review and monitoring and further procedures and surgeries onthe cards.

Main thing is that you are kept with your rheumy and he/she makes regular checkups. They have close links with the Orthos and some even have joint clinics (excuse the punRollEyes ).

I was told that the Orthos get paid for each new referral - maybe the reason for discharge and re-referral?

Do hope that some of the replies have helped a little.

Take good care,
Lizx

Jane-o
#11 Posted : Wednesday, September 28, 2011 4:46:11 PM Quote
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Hi everyone - thank you for your views/advice you have all been really helpful. I have just had a telephone call from my RA OT, for a follow up appointment - so it appears that my other appointments seem to be going along as normal - it will be interesting to see what happens with with Ortho appointment and my podietary appointment.

I will keep you updated !!

Jane
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