In fact one of the things that we're doing in the charity is we're working with doctors and other patient groups to evolve and create standards of care for rheumatoid arthritis and inflammatory arthritis for the UK because there is no NHS, sorry, there is no NSF, National Service Framework, for rheumatoid arthritis and so we are effectively trying to create an equivalent if you like because the, the different standards of, of care and delivery of service that you get across the country in different areas is quite disparate so we felt this was a, a very necessary a very necessary thing to do.
We had to put down what do we think is a reasonable period for an urgent follow up. So if you are having a flare and you do need to get to your consultant for some treatment, what's reasonable? We've put a month down because the doctor that we were working with at the, at the time, I said “A week” and he said “A week, you're joking”, you know “A month”.
But if you're having a really bad flare, being told that you've got to wait a month before you can see anybody or you can get a Depo-Medrone injection or something like that, it's, it's totally unacceptable from a patient perspective so these are difficult questions and I don't know that there is actually an acceptable answer as far as patients are concerned.
This is one of the reasons why devolving some of the decision-making processes into the nurse practitioner's hands and getting that out into the community in the way that they've done in certain areas. For example, in one of the areas in, in the UK they have outreach clinics that one of the clinical nurse specialists does in the community and that works really well because she can prescribe, she can alter people's dosages and drugs and so on, she can even refer to an orthopaedic surgeon, without having to go back to the consultant.
Now that's what we patients need because you can ring a nurse up and, you know, get yourself slotted in to a nurse clinic probably a lot more easily than you can get to see the consultant. So that would be great if we could get that model replicated and going in lots of other areas. |
