Rheumatology

The Rheumatology Service at Hereford County Hospital focuses on inflammatory arthritis and connective tissue disease. Our service provides:

• Early diagnosis and long-term management to preserve joint function and prevent major organ damage.
• Expertise in diagnosis and management of patients with complex systemic inflammatory disease.
• Special interest in early inflammatory arthritis and vasculitis.
• Ultrasound service and intra-articular and soft tissue injections.
• Education and specialist knowledge to patients, their families and carers about their disease, drugs, and monitoring.
• Rheumatology patient telephone and email advice service.
• Physiotherapy led clinics for Inflammatory Back Pain, Axial Spondyloarthropathies, Hypermobility Syndromes and Fibromyalgia
• Peripheral clinic in Llandrindod Wells.
• Osteoporosis advice.

We provide a holistic approach; our dedicated multi-disciplinary team includes:

• Consultants, Clinical Nurse Specialists, Pharmacist, Physiotherapists, Occupational therapists, and Administrative and Management team.

The service has close links with other specialties and departments:

• We also work closely with colleagues in other specialities relevant to rheumatic diseases including Radiology, Orthopaedics, Gastroenterology, Dermatology, Respiratory, Immunopathology and the Pain service.
• Paediatric Rheumatology in conjunction with Birmingham Children’s Hospital.
• Intravenous therapies on Fred Bulmer Medical Day Case or Macmillan Renton Unit.
• Podiatry service in Belmont.

About our Rheumatology Specialist Advice Service:

• Our Rheumatology telephone advice service 01432 36 4020 runs between 9am-1pm, Monday-Friday (closed Bank Holidays and weekends).
• It provides non-emergency specialist advice for patients, carers, and other health professionals (not GPs). 
• An answerphone is available to leave a message and the right clinician will return your call within five working days.
• If you prefer, you can email us instead on rheumatology.patient@nhs.net
• GPs – for Advice & Guidance contact us via ERS service (except Powys GPs).
• GPs – to send investigations or general enquiries email rheumatology.admin@nhs.net

Rheumatology Educational Videos

Herefordshire and Worcestershire - Rheumatology (icb.nhs.uk)

Frequent Asked Questions (FAQ)

1. Your rheumatology condition
2. Rheumatology medication
3. Infections and vaccination
4. COVID-19
5. Patient Initiated Follow-Up (PIFU)
6. Administrative queries

1. Your Rheumatology condition

Managing a flare-up

Steroids

Pain

Conception and pregnancy

Employment

Exercise

Diet

Websites about Rheumatology conditions and useful resources

2. Rheumatology medication

Rheumatology medication is chosen on an individual basis and may vary depending on the severity of your symptoms, how long you had them, your medical history, and bloods tests.

Rheumatology medications

How long will the Rheumatology medication take to start working?

How long do I have to continue taking my Rheumatology medication? Can it ever be stopped?

What if the medication I am on does not work?

I am experiencing SIDE-EFFECTS with my Rheumatology medication, what should I do?

Injection site reactions

INTERACTIONS with other medications

Can I take over-the-counter pain medications as well as my prescribed drugs?

Can I use complementary or herbal remedies?

ALCOHOL and my Rheumatology medication

SMOKING and my Rheumatology condition

I am having a SURGERY do I need to stop my Rheumatology medication? When can I re-start?

Dental Advice

What should I do if I miss a dose of my Biologic drug (biosimilar)?

BLOOD TESTS and my Rheumatology medication

TRAVELLING/ GOING ON HOLIDAY and my Rheumatology medication

Blood tests whilst I am away on holiday or travelling?

Issues with the DELIVERY COMPANY OF MY BIOLOGIC MEDICATION

What do I do with the used sharps bins?

Who do I contact if I have a query regarding my Methotrexate prescriptions?

3. Infection and vaccination

Some of the Rheumatology medication we use can make you more vulnerable to pick up infections and you might not be able to fight the infections so well. This means some infections could become severe or very severe. It could also take you longer to recover from the infection.

It is probably best not to meet with people if you know they have a serious ‘catching’ infection. For example a ‘diarrhoea and vomiting bug’.

Rheumatology medications that need to be stopped if you have an infection, as they suppress your immune system

I have an INFECTION, what should I do about my Rheumatology medication?

Do I need to avoid any foods whilst I am on Biologic drug (or biosimilar)? Tips to avoid food poisoning.

I have been in contact with someone with shingles or chickenpox, what should I do?

I have shingles or chickenpox, what should I do?

Can I have vaccinations whilst I am on rheumatology medication?

Useful links

4. COVID-19

Should I stop my Rheumatology medications just because COVID-19 is around?

What should I do if I test positive for COVID-19?

Useful links

5. Patient Initiated Follow-up (PIFU)

What is Patient Initiated Follow-up?

When NOT to use PIFU

How does PIFU work?

When should I call for a PIFU?

How do I book an appointment when I need one?

What if I change my mind and would prefer to go back to booking regular follow-up appointments?

Useful links

6. Administrative queries

What number do I contact if I have a question about my appointment or want to cancel/change my appointment?

I have been referred to Rheumatology by my GP or specialist – when should I expect to receive an appointment?

I have been referred for a scan – how do I contact Radiology to find out when my appointment is or if I need to change my appointment?

I have had a diagnostic test – How do I find out of the result of this?

I have a query regarding my biologic medication – who do I contact?

I have a query regarding my subcutaneous Methotrexate - who do I contact? 

I have been discharged from Rheumatology – how do I get seen again?

I have a query regarding my Osteoporosis treatment - who do I contact?