GP case study: Rheumatology

A GP in Lambeth used Telephone Advice & Guidance to get A&G from the Rheumatology Team at her local trust for an elderly patient with swollen lower legs and joint pain.

“It was easy to get through, and a few minutes on the phone meant we could work in an integrated way across primary and secondary care.” Dr Rowley-Conwy

GP case study: Rheumatology

Dr Emma Rowley-Conwy works at The Exchange Surgery in Lambeth, London, and has been a GP for over 25 years. Dr Rowley-Conwy has access to Telephone Advice & Guidance from both Guy’s and St Thomas’ and King’s College Hospital. The service is commissioned by three local clinical commissioning groups (CCGs) – NHS Lambeth CCG, NHS Southwark CCG and NHS Bromley CCG, and delivered by Consultant Connect.

We asked Dr Rowley-Conwy to provide us with an example of when a recent clinical issue prompted her to use the service with a patient.

Elderly patient with swollen lower legs and joint pain
“Our patient was an elderly man in his 80s who presented with swollen lower legs and joint pain. Our registrar had referred to Musculoskeletal (MCATTS) Team and arranged bloods. I saw him with his results which showed a strongly positive rheumatoid factor and raised ESR. I did an early arthritis referral form and started him on anti inflammatories and Furosemide. However, I was a bit concerned as to the diagnosis as he was not a typical presentation for Acute Rheumatoid Arthritis, being male and elderly, and I thought that the positive rheumatoid factor was possibly misleading. At a review 10 days later, he was still very incapacitated and had quite severe swelling in his lower legs, despite the Furosemide. It wasn’t clear from looking at records what appointments he had. I also felt more nervous about whether I was making the right diagnosis.”

How Telephone Advice & Guidance helped:
“I spoke to a Rheumatology Consultant at Guy’s and St Thomas’. He confirmed he was seeing the patient himself the next week. The consultant reviewed the blood results and confirmed a likely diagnosis of Rheumatoid Arthritis and advised they would most likely give Depomedrone injection and then consider DMARD. I was able to relay this information to the patient and his wife, which I believe made them feel less anxious. I saw the patient after he had seen Rheumatology, and this was the care he had received. He was much, much better – a really dramatic improvement. Speaking to the consultant made me feel confident to continue to support the patient and his wife, and meant they knew what was likely to happen. They had a chance to read preparatory patient information so could make an informed decision regarding starting a DMARD in that first outpatient appointment.“

Dr Rowley-Conwy also commented that:

“It was easy to get through, and a few minutes on the phone meant that we could work in an integrated way across primary and secondary care. Together we were able to deliver good quality care to this vulnerable patient.”

Click here to view and download PDF version of this case study.

Related case studies

NHS Area Case Study: Teletriage service for two-week wait referrals

NHS Area Case Study: Teletriage service for two-week wait referrals

We are delighted that our Consultant Connect project in County Durham and Darlington NHS Foundation Trust was mentioned in the NHSX Dermatology Digital playbook.

GP case study: Cardiology

GP case study: Cardiology

A GP in North East Essex CCG used Telephone Advice & Guidance to get A&G from the Cardiology Team at her local trust, resulting in an admission avoided for an elderly patient.

GP case study: Answering SCAS calls

GP case study: Answering SCAS calls

Dr Steve Doyle explains why he answers Telephone Advice & Guidance calls from 999 ambulance crews and clinical support desk staff during COVID-19.

GP case study: Answering SCAS calls

GP case study: Answering SCAS calls

Dr Simon Hodes describes how answering Telephone Advice & Guidance calls from 999 ambulance crews and clinical support desk staff saves NHS resources.

Contact us

For more information about how we work with commissioners, hospitals & mental health trusts to improve patient care, please get in touch.

Join a webinar

Listen to health experts from the comfort of your desk as we bring the experts to you in our series of online webinars.

Join our mailing list

Join our mailing list and we'll keep you informed of our latest blogs, project news, and upcoming webinar dates and topics.

Recent tweets

Contact us

Permissions

You can view our Terms & Conditions here.

Most Read Articles

Area Case Study | Front door Triage in Northamptonshire

It’s been over two months since Northampton General Hospital started using Consultant Connect’s Referral Triage service. In this blog article Deputy Chief Operating Officer, Carl Holland shares how the project started and is now performing. This article also includes a patient case study example.

read more
Consultant Connect In Mental Health

We provide services in Mental Health, two ways we are doing so is better connecting Mental Health Inpatients with physical care and linking Primary Care clinicians to Mental Health specialists at South London and Maudsley (SLaM). Read more about these services and their current performance in this article.

read more
5 minutes…. with our Customer Success Lead

Delegates at our COVID Recovery webinar listened to how we are working with 80 areas to help accelerate their COVID-19 recovery. We’ve edited the discussion into a weekly 3 blog article series, this week we are focussing on the use of Advice & Guidance.

read more
5 minutes…. with our Dermatology Lead

Delegates at our COVID Recovery webinar listened to how we are working with 80 areas to help accelerate their COVID-19 recovery. We’ve edited the discussion into a weekly 3 blog article series, this week we are focussing on Dermatology.

read more