This is the place to discuss the 'Calderdale & Huddersfield - LTC Rheumatology' LHC demonstrator site. Post your comments, observations, queries or matters arising in this thread.

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Could you please explain the ad hoc therapy input, especially podiatry, and how that is organised?

Thank you for your enquiry. We in the core team on the HRI site have always been most satisfied with the podiatry services provided by yourself and your colleagues, predominantly at the Princes Royal site. Howwever we recognise that we do not refer all our patients and are unclear as to whom and when we should and should not refer - a somewhat "ad hoc" situation you would agree. Fundamental to our undertaking is to establish effective evidence based care pathways that effectively integrate all disciplines involved in the care of RA patients. If we move our out-patient clinics into primary care settings where podiatry services are also supplied we need to be certain that the patients are getting to the right professional in a timely manner and that resources are not squandered. The core clinical team is delighted with you interest and would like to involve you and your colleagues very closely with our endeavours. We are currently finalising our communication strategy and will be in touch shortly.

Thank-you very much for your reply. Opportunities are appearing across the Trust for those brave enough to take up the challenge to embrace them. I am sure that these individuals will be able to make a difference for patients if communication allows it. I will pass this link on to the person with the power to enable discussions to take place. However, from a personal point of view I am so pleased that you took the time to answer my query a sure sign of inivative future workings. Any information regarding Podiatry ask away I'll endeavour to answer, or find someone who can!

Dear Calderdale and Huddersfield
It is with interest that I have been following the development of this project.
In Western Cheshire PCT we have developed a multi-disciplinary approach to the annual review of patinet with rheumatological conditions.
Patients attend for their annual review in their local Community Hospital and are assessed by the team which includes a podiatrist.
Funding across the secondary-primary care organisations could become an issue and evaluating outcomes of the service is an issue that we have not addressed.
I will continue to watch and learn with the intention of gleaning information that will support the continuation of our service
Regards
Paula Freeman
Specialist Podiatrist
Western Cheshire PCT

Thanks for the interest Paula. I am very interested to learn more about what your service is providing and how you are delivering rheumatology follow-up in the community. It is my impression that most rheumatologists do not seem to appreciate that profesionals other than doctors and specialist nurses are required to meet the care needs of these client group except on an "ad hoc" basis for RA patients in particular - which seems to go against the published evidence.

Today we are piloting one of our inter-disciplinary review clinics for RA patients with podiatrists, OTs and physios there. It should prove interesting.