05 August 2020


On 31 July, NHS England Chief Executive Sir Simon Stevens and Chief Operating Officer Amanda Pritchard wrote to all NHS trusts in England calling for a move to the third phase of the NHS response to COVID-19 from 1 August. The priority of the NHS is to return to near-normal levels of non-COVID health services, making full use of the capacity available in this window between now and winter.


Among the priorities for the NHS from August is the following:


  • Trusts are asked to re-establish (or if necessary, redesign) services to deliver 100% of last year’s activity for new and follow-up outpatient attendances, whether face to face or virtual, from September through the balance of the year. Aiming to achieve 90%.

  • To facilitate social distancing and reduce risk of infection, clinicians should consider avoiding asking patients to attend physical outpatient appointments if a clinically-appropriate and accessible alternative exists.

  • In collaboration with GP practices, trusts should ensure every patient whose planned care has been disrupted by COVID-19 receives clear communication about how their care will proceed and who to contact in the event their clinical circumstances change.


The letter also highlights the need to prepare for winter alongside a possible COVID-19 resurgence, while considering the lessons learned during the first COVID-19 peak.


Among these lessons, is a need to prioritise the health and safety of the NHS workforce. It also highlights the need to prevent the health inequalities reflected in the disproportionate impact of COVID-19 on some sections of the population, including minority ethnic communities, older people, men, those who are obese or who have long-term health conditions and those in certain occupations.


BSR welcomes the move to restore normal rheumatology services, as we know this is a priority for our members and patients, although feel the timetable is overly ambitious. There are of course many challenges including changing prevalence of COVID-19 and ongoing impact of consequences taken at the start of the pandemic to manage in-patients with COVID-19. We have been alerted by members from all four nations that they have been struggling to reclaim rheumatology clinic and office space and restart rheumatology services that have been disrupted.


As a result, BSR (including our National Chairpersons in the devolved nations) have written to all four nations' health ministers to discuss the urgent need to support the restarting and recovery of rheumatology services across the UK.


We have worked hard to support our members through COVID-19 and understand that further support may be needed to restore service capacity. We have released regularly updated guidance on COVID-19, new advice on remote consultations and triage, and drafted a letter of support for members with struggling with high-cost drugs (HCD) reviews and Blueteq.


Our new ePROMs (patient-reported outcome measures) platform goes live this month, supporting the collection of PROMs across all rheumatological conditions in adult and paediatric and adolescent rheumatology for the very first time. We also have upcoming documents on promoting Advice and Guidance (A&G) and patient-initiated follow-up (PIFU) in rheumatology.


Please email policy@rheumatology.org.uk if you have any concerns about restoring your local services so that we can help to support you.