Devolved nations | British Society for Rheumatology

Overview

Our members in the devolved nations represent the entire profession – from those at the beginning of their career to the most senior.

We recognise that health and social care provision in Scotland, Northern Ireland and Wales operates within their own uniquely devolved structures.

Rheumatology services, based on local needs, vary tremendously across the geography of our home nations; from the Integration Authorities in Scotland, to the Welsh Local Health Boards or the Northern Irish Integrated Care Partnerships.

Those Scotland, Wales and Northern Ireland are supported by a network of peers including by the National Chairperson in their home nation, a Trainees Committee representative, and nurse, allied health professional/pharmacist or psychologist and paediatric and adolescent representatives.

We work closely with the entire multidisciplinary (MDT) team ensuring best practice is recognised and raised at council meetings to support delivery of our strategic plan.

Northern Ireland

Representatives:

National Chairperson: Michelle McHenry
Nurse representative: Anne Quinn
Paediatric representative: vacant
Trainee representative: Sara Stewart

Six Health and Social Care (HSC) Trusts manage and administer health and social care facilities including hospitals, health centres, residential homes and day centres.

Where rheumatology services are delivered

Belfast has the largest team in the country and the four remaining trusts have seen rapid and continued expansions of staff and services in rheumatology.

Specialist training locations

Belfast HSC Trust services are based in Musgrave Park Hospital, Belfast City Hospital and Royal Victoria Hospital
Trust-wide rheumatology service for the Northern HSC Trust based at Antrim Area Hospital with rheumatology day unit on this site at Fern House. Clinics held in Ballymena, Coleraine, Magherafelt, Larne and Newtonabbey
Western HSC Trust rheumatology services delivered at Altnagelvin Hospital in Londonderry and at South West Acute Hospital in Enniskillen
Rheumatology occupational therapy services and podiatry rheumatology services provided across each of the five Health and Social Care Trusts
Rheumatology Specialist Nurses based in a number of hospitals, including Belfast City Hospital, Royal Victoria Hospital, Antrim Area Hospital, Ulster Hospital, Craigavon Area Hospital and Altnagelvin Hospital
Northern Ireland combines rheumatology with General Internal Medicine (GIM) and rotates through locations in Northern Ireland’s five Health and Social Care Trusts
Trainees typically undertake GIM training alongside rheumatology over 5-year period which includes a combination of posts with either rheumatology alone within the Belfast Trust and combined posts (all other sites) which are 50:50 rheumatology:GIM
Northern Ireland is a leading centre for MSK ultrasound (MSKUS) in rheumatology practice with the majority of rheumatologists EFSUMB certified (levels 1-3). All trainees are supported to train in MSKUS with the opportunity to gain formal certification of competence in MSKUS

Scotland

Representatives:

National Chairperson: Dr Robin Munro
Nurse representative: Ellen Forde
Paediatric representatives: Imogen Kelly/Neil Martin
Trainee representative: vacant

Healthcare is a devolved matter, and is the responsibility of the Scottish Government. There are 31 Integration Authorities, each with a Joint Integration Board managing local services in Scotland's diverse communities.

Where rheumatology services are delivered

Rheumatology services in Dingwall, Dumfries & Galloway, Glasgow, Inverclyde, East Kilbride, Wishaw and Airdrie supplement the specialist training locations
In Fife, the Rheumatic Diseases Unit (FRDU) service is based at Whytemans Brae Hospital in Kirkcaldy with clinics and hospital sites also located in Dunfermline, Markinch and Cupar
NHS Scotland regional bases are defined as North, East, South East and West
North: training provided in Aberdeen Royal Infirmary on Foresterhill site. Training in General Internal Medicine (GIM) provided at Raigmore Hospital, Inverness
East: based at Ninewells Hospital in Dundee; specialist services also delivered at Perth Royal Infirmary and Western General Hospital (WGH) in Edinburgh
South East: Rheumatic Diseases Unit at WGH (the major referral centre for patients with rheumatic disease in the region), Livingston’s St John’s Hospital and Borders General Hospital in Melrose. Outpatient clinics also provided at St John’s Hospital, Roodlands Hospital in Haddington or the Royal Hospital for Sick Children in Edinburgh
West: Glasgow is a Centre of Excellence in rheumatology. Specialist training and placements take place in Gartnavel General, Glasgow Royal Infirmary, Queen Elizabeth University Hospital, Stobhill Hospital, Western Infirmary, Victoria Infirmary, Southern General Hospital
Across the wider West region, training takes place in Inverclyde Royal Hospital, Greenock, Royal Alexandra Hospital, Paisley, University Hospital Wishaw, Ayr Hospital, Forth Valley Royal Hospital, Larbert, Monklands Hospital, Airdrie and Crosshouse Hospital, Kilmarnock
BSR is a member of the Scottish Parliament’s Cross Party Group for Arthritis and Musculoskeletal Conditions

Wales

Representatives:

National Chairperson: Dr Ceril Rhys-Dillon
Nurse representative: Mr Brian Rhys-Dillon
Paediatric representative: vacant
Trainee representative: Amna Younas

Wales is served by seven Local Health Boards (LHBs) and services are delivered at a number of community hospitals and clinics throughout Wales.

Where rheumatology services are delivered

Abertawe Bro Morgannwg University Health Board diagnoses and manages adult rheumatology disorders at Singleton, Morriston, Neath Port Talbot and Princess of Wales. A Rheumatology Day Unit operates out of the Princess of Wales hospital. The MDT is predominately nurse-led
There are approximately seven consultant rheumatologists and six specialist nurses working out of the Aneurin Bevan University Health Board. Rheumatology in-patient and day-case care is provided in Nevill Hall Hospital and outpatient services are provided throughout the region at Royal Gwent, Nevill Hall, Ysbyty Ystrad Fawr, St. Woolos, Chepstow, County, Brecon War Memorial and Ysbyty Aneurin Bevan
The Betsi Cadwaladr University Health Board combines the North Wales NHS Trust (previously North East Wales NHS Trust and Conwy & Denbighshire NHS Trust), the North West Wales NHS Trust, and the six LHBs of Anglesey, Conwy, Denbighshire, Flintshire, Gwynedd and Wrexham. At Wrexham Maelor Hospital, the Medical Day Care Unit is used by the rheumatology service for intravenous drug therapy with community rheumatology services at Deeside Hospital. Rheumatology services are also delivered at Glan Clwyd and the Peter Maddison Rheumatology Centre (Llandudno/Bangor), Dolgellau Hospital, Ysbyty Bryn Beryl, Ysbyty Alltwen, Ysbyty Eryri, Ysbyti Penrhos Stanley and Blaenau Ffestiniog Health
The Cardiff and Vale University Health Board offers both outpatient and inpatient services. The rheumatology department is based at University Hospital of Wales and University Hospital Llandough
The Royal Glamorgan, Dewi Sant and Prince Charles hospitals are all part of the Cwm Taf University Health Board. Rheumatology teams operate out of the Royal Glamorgan and Dewi Sant. Specialty clinics include biologic therapy, Lupus and Ankylosing Spondylitis. There is a large emphasis on developing research with the Rheumatology Department at Cwn Taf University Health Board
Rheumatology services are health board-wide in the Hywel Dda University Health Board with bases at the Prince Philip Hospital, West Wales General Hospital and the Prince Philip Hospital Day Unit. The LHB’s Clinical Musculoskeletal Assessment and Treatment Service (CMATS) is a specialist team of advanced physiotherapy and podiatry practitioners running clinics in a range of sites across Carmathenshire, Ceredigion and Pembrokshire. The LHB is also served by Bronglais and Withybush hospitals
Paediatric and adolescent rheumatology provision in Wales is a part-time and limited practice. Services at Alder Hey Childrens’ Hospital in Liverpool or Bristol Royal Hospital for Children are utilised. BSR jointly campaigned with Arthritis Care Wales, Versus Arthritis and the NRAS for a full MDT paediatric and adolescent rheumatology service for South Wales, with expansion of the current service in North Wales

Specialist training locations

The Welsh Rheumatology Specialist Training Committee (STC) comprises rheumatology consultants from each of the Welsh LHBs and a trainee representative. A chair and training programme director (TPD) oversee the STC
STC meetings take place during the Annual All Wales meeting with calendar dates in April and October. These meetings are held in Central Wales and discuss issues relating to teaching, training, research and service delivery. An all-Wales audit is presented and reports given by the chair of BSR and RCP meetings
Hospitals participating in rheumatology training: Ysbyty Gwynedd, Bangor, Peter Maddison Rheumatology Unit, Llandudno, Wrexham Maelor Hospital, Wrexham, Prince Charles Hospital, Llantrisant, Royal Gwent Hospital, Newport, Nevill Hall Hospital, Abergavenny, Ysbyty Ystrad Fawr, Morriston Hospital Swansea, Neath Port Talbot Hospital, Princess of Wales, Bridgend, University Hospital of Wales, Cardiff and Llandough Hospital, Penarth
North and South Wales have a regular teaching programme with teleconference links and have external speakers contributing to their teaching programmes
Active research programme in Wales. Professor Ernest Choy, Head of Rheumatology and Translational Research and Director of the Cardiff Regional Experimental Arthritis Treatment and Evaluation Centre (CREATE) at Cardiff University School of Medicine has a major research interest in experimental medicine and clinical trial design in rheumatic diseases
Clinical trials at all major centres in Wales
The All-Wales Ultrasound Group aims to deliver standardised rheumatology ultrasound training across Wales and works in close collaboration with BSR's Ultrasound Special Interest Group and the Scottish Rheumatology Ultrasound Group (SRUG)
Currently five sites (three in South and two in North) recognised for ultrasound training
Wales Deanery coordinates postgraduate training for the nine StRs and one academic StR in Wales, as well as a number of core medical training and foundation posts in rheumatology
StR training includes monthly supra-regional training days co-hosted with Severn deanery, regular regional updates and access to a variety of sub-speciality training opportunities
Excellent links between North Wales rheumatology units and Manchester & Merseyside

Cymru

Cadeirydd Cenedlaethol - Cymru: Dr Ceril Rhys-Dillon
Cymru, Cynrychiolydd Nyrsio: Mr Brian Rhys Dillon

Mae saith Bwrdd Iechyd yng Nghymru. Cynigir gwasanaethau mewn sawl clinig ac ysbyty cymunedol ledled Cymru.

Ble darperir gwasanaethau rhewmatoleg. Bwrdd Iechyd Prifysgol Abertawe Bro Morgannwg.

Gwasanaeth sy’n gweld ac yn trin oedolion â chyflyrrau rhewmatolegol mewn pedwar ysbyty: Ysbyty Singleton, Ysbyty Treforys, Ysbyty Castell Nedd Port Talbot ac Ysbyty Tywysoges Cymru. Cynhelir yr Uned Ddydd Rhewmatoleg yn Ysbyty Tywysoges Cymru, Penybont. Nyrsys sydd yn arwain y tim aml-ddisgyblaeth yno.

Ar ôl mis Mawrth 2019, bydd Ysbyty Tywysoges Cymru yn ymuno a Bwrdd Iechyd Prifysgol Cwm Taf.

Mae tua 7 ymgynghorydd a 6 nyrs arbenigol yn gweithio i Fwrdd Iechyd Prifysgol Aneurin Bevan. Darperir gwasanaeth cleifion mewnol ac yn ystod y dydd yn Ysbyty Neuadd Nevill. Mae gwasanaeth cleifion allanol ar gael ledled Gwent, gan gynnwys Ysbyty Brenhinol Gwent, Ysbyty Neuadd Nevill, Ysbyty Ystrad Fawr, Sant Woolos, Casgwent, Pontypwl, Ysbyty Aneurin Bevan, ac Aberhonddu.

Mae Bwrdd Iechyd Prifysgol Betsi Cadwaladr yn gwasanaethu Gogledd Cymru yn gyfan. Yn Ysbyty Maelor Wrecsam mae’r Uned Dydd Meddygol yn darparu trwythau mewnwythiennol ar ran yr adran rhewmatoleg. Mae gwasanaethau rhewmatoleg cymunedol ar gael yn Ysbyty Glannau Dyfrdwy. Cynigir gwasanaethau rhewmatoleg hefyd yn Ysbyty Glan Clwyd, Canolfan Rhewmatoleg Peter Maddison yn Llandudno a Bangor, Ysbyty Dolgellau, Ysbyty Bryn Beryl, Ysbyty Alltwen, Ysbyty Eryri, Ysbyty Penrhos Stanley a Blaenau Ffestiniog.

Mae Bwrdd Iechyd Prifysgol Caerdydd a’r Fro yn cynnig gwasanaethau i gleifion mewnol ac allanol yn Ysbyty Athrofaol Cymru Caerdydd ac Ysbyty Prifysgol Llandochau.

Mae Ysbyty Brenhinol Morgannwg, Ysbyty Dewi Sant, Ysbyty Cwm Cynon ac Ysbyty Tywysog Siarl yn rhan o Fwrdd Iechyd Prifysgol Cwm Taf. Cynhelir clinigau arbenigol gan gynnwys triniaethau biolegol, Lupus, Sbondylitis Ymasiol. Mae clinigau Gwynegon Cynnar a gwasanaeth Uwchsain hefyd ar gael. Mae pwyslais ar ddatblygu ymchwil yn yr Adran Rhewmatoleg yng Nghwm Taf.

Yng Ngorllewin Cymru mae gwasanaethau Rhewmatoleg ar gael ar draws Bwrdd Iechyd Prifysgol Hywel Dda gyda chanolfannau yn Ysbyty Tywysog Philip, gan gynnwys Uned Dydd, ac Ysbyty Cyffredinol Gorllewin Cymru, Caerfyrddin. Mae gwasanaethau hefyd ar gael yn Ysbyty Bronglais ac Ysbyty Llwynhelyg. Mae gwasanaeth Asesu Clinigol gan Ffisiotherapyddion a Phodiatryddion arbenigol hefyd ar gael mewn clinigau yn Sir Gaer, Ceredigion a Sir Benfro.

Mae gwasanaeth Rhewmatoleg Paediatrig yng Nghymru yn gyfyngedig ac yn rhan amser. Cynhelir Clinigau yn Ysbyty Athrofaol Cymru ac Ysbyty Brenhinol Morgannwg. Defnyddir gwasanaethau yn Ysbyty Plant Alder Hay Lerpwl ac Ysbyty Brenhinol i Blant ym Mryste. Mae Cymdeithas Rhewmatoleg Prydain (BSR) wedi bod yn ymgyrchu gyda Gofal Gwynegon Cymru, Versus Arthritis a Chymdeithas Cenedlaethol Gwynegon Gwynegol (NRAS) er mwyn sefydlu gwasanaeth amlddisgyblaeth Rhewmatoleg Paediatrig ar gyfer De Cymru, ac ehangu’r gwasanaeth bresennol yng Ngogledd Cymru.

Canolfannau Hyfforddiant Arbenigol
Mae’r Pwyllgor Hyfforddi Arbenigol Rhewmatoleg (STC) yng Nghymru yn cynnwys ymgynghorwyr o bob Bwrdd Iechyd, ac hefyd cynrychiolydd o blith y meddygon iau sy’n hyfforddi. Mae Cadeirydd y Pwyllgor a Chyfarwyddwr y Rhaglen Hyfforddi (TPD) yn goruwchwylio’r Pwyllgor Hyfforddi. Cynhelir Cyfarfod y Pwyllgor Hyfforddi yn ystod y Cyfarfod Cenedlaethol Blynyddol pob mis Mawrth, yng Nghanolbarth Cymru. Dyma fforwm i drafod materion yn ymwneud ag addysg, hyfforddi, ymchwil a darparu gwasanethau. Caiff Awdit Cenedlaethol ei gyflwyno ac adroddiadau gan y Cadeirydd am gyfarfodydd Cymdeithas Rhewmatoleg Prydain (BSR) a Choleg Brenhinol y Meddygon (RCP).

Ysbytai sy’n ymgymryd â Hyfforddiant Rhewmatoleg: Ysbyty Gwynedd Bangor, Uned Rhewmatoleg Peter Maddison, Llandudno, Ysbyty Maelor Wrecsam, Ysbyty Brenhinol Morgannwg, Llantrisant, Ysbyty Tywysog Siarl, Merthyr Tudful, Ysbyty Brenhinol Gwent, Casnewydd, Ysbyty Neuadd Nevill, Y Fenni, Ysbyty Ystrad Fawr, Ystrad Mynach, Ysbyty Treforys, Abertawe, Ysbyty Castell Nedd Port Talbot, Ysbyty Tywysoges Cymru, Penybont, Ysbyty Athrofaol Cymru, Caerdydd, Ysbyty Athrofaol Llandochau, Penarth.

Addysg Parhaol: Mae gan Gogledd a De Cymru raglenni addysgiadol cyson ac mae siaradwyr gwadd yn ymweld yn aml. Mae cyswllt fideo ar gael er mwyn ymuno a’r sesiynau o bell.

Ymchwil: Mae ymchwil yn bwysig yng Nghymru, ac mae’r Athro Ernest Choy, Pennaeth Rhewmatoleg ac Ymchwil Drosiadol, a Chyfarwyddwr Canolfan Gwerthuso Triniaethau Arbrofol i Wynegon (CREATE) yn Ysgol Feddygol Prifysgol Caerdydd. Mae gan yr Athro Choy ddiddordeb mewn meddygaeth arbrofol yn ogystal â dylunio Treialon Clinigol mewn cyflyrrau Gwynegol. Cynhelir treialon clinigol mewn canolfannau ar draws Cymru.

UwchsainBwriad Grŵp Uwchsain Gwynegol Cymru yw darparu hyfforddiant safonol mewn Uwchsain ar draws y wlad. Mae’r grŵp yn cydweithio gyda’u cyfoedion yng Nghymdeithas Rhewmatoleg Prydain (BSR Ultrasound Special Interest Group) ac hefyd yn yr Alban (SRUG). Bellach mae 5 canolfan yn darparu hyfforddiant uwchsain ar draws Cymru (3 yn y De a 2 yn y Gogledd).

Addysg a Gwella Iechyd Cymru
Mae Addysg a Gwella Iechyd Cymru (AaGIC/HEIW) yn cydlynnu hyfforddiant ôlraddedig ar gyfer naw cofrestrydd arbenigol ac un cofrestrydd academaidd yng Nghymru.

Darperir hefyd nifer o swyddi gradd Hyfforddiant Sylfaenol a Meddygaeth Mewnol ym maes Rhewmatoleg. Mae addysg I'r cofrestryddion yn cynnwys dyddiau hyfforddi ar y cyd gyda Deoniaeth Hafren, yn ogystal ag amrywiaeth o weithgareddau is-arbenigol. Mae gan yr adrannau yn y Gogledd gysylltiadau a’u cyfoedion ar Lannau Merswy a Manceinion.