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Rheumatology 

The Children and Young People’s Rheumatology Service at Nottingham Children’s Hospital is based in the Queens Medical Centre Campus of the Nottingham University Hospital NHS Trust. It provides a comprehensive Paediatric and Adolescent Rheumatology Tertiary Service for the East Midlands.

The service looks after children and young people with:

Juvenile Idiopathic Arthritis

Juvenile Dermatomyositis

Vasculitis

Juvenile Systemic Lupus Erythematosus

Juvenile Scleroderma

Other inflammatory musculoskeletal conditions

Uveitis in conjunction with ophthalmology department

Some genetic and infective conditions with musculoskeletal manifestations

Some mechanical conditions

 

 

The service works closely and in conjunction with other specialist services such as; Dermatology, Respiratory, Endocrine, Ophthalmology (with whom we run combined clinics), Gastroenterology, Renal, and Paediatric surgery

Network

The team based in Nottingham support and work with services in other hospitals within the East Midlands by using a network approach:

·       Derby

·       Leicester

·       Lincoln

·       Mansfield

·       Peterborough

A description of these services can be found at the end of this page.

Nottingham Service

The Paediatric & Adolescent Rheumatology Service is staffed by professionals whose work is exclusively in this specialist area. The consultants are fully trained in the Specialty and are on the Specialist Register and accredited for running a specialist service. The therapy and nursing teams similarly solely work with young people within rheumatological conditions.

In Nottingham we run combined specialty clinics for young people with rheumatological illnesses. Consultants from at least 2 specialties run these clinics together. These clinics are for patients who are either under our service and additional advice is needed or who are under shared care. For instance a patient may have delayed growth and an endocrine opinion is sought. Alternatively the patient may have a rare disease such as Scleroderma that benefits from the shared expertise of both a skin specialist (Dermatologist) and us.

We aim for children to have the best care as close to home as possible. However this does not mean that it can always be in the local hospital. For specialist advice and procedures these are currently based in Nottingham. Here the expertise is concentrated both in Rheumatology and other specialties such as taking X-rays and scans (Radiology) kidney (Renal) and coping with inflammatory diseases (Immunology).

Children and young people will often have to come to Nottingham at the start of their illness. The first stage is to ensure that all the necessary tests are done promptly. Then it is important that the correct diagnosis is made so that the best treatment can be started. This allows the team to explain the condition to the family and give a prediction of how the disease may progress. Together, the staff and family can then make a management plan. A complex plan will often be centred in Nottingham. However simpler or more routine care can be offered in the local hospital depending upon the expertise of the local staff.

East Midlands rheumatology services

Derby

The team consists of a Consultant Paediatrician who has an interest in paediatric rheumatology, a Consultant Rheumatologist who also undertook training in Paediatric and Adolescent Rheumatology at Wexham Park Hospital (when it was the regional unit for Oxford) before her consultant post, Nurse Specialist, Occupational Therapist and Physiotherapist; the Derby service that has run for many years.

There is a clinic that runs once a month in Derby Childrens Hospital. They are joined on alternate months by paediatric rheumatologist and nurse specialist or therapist to provide specialist medical and nursing expertise from Nottingham. This means that children and young people can have more of their specialist care locally.

Leicester

The team consists of a Consultant Paediatrician who has an interest in paediatric rheumatology, a Consultant Rheumatologist and Therapists. There is a Rheumatology Clinic that runs once weekly, with most of the care provided locally. The Consultant Rheumatologist cares for the young people when they move on to her adult service. Improvement work is taking place between Nottingham and Leicester at this time to seek an improved network approach.

Lincoln

A Consultant Rheumatologist with an interest in Paediatric and Adolescent Rheumatology cares for the young people when they move on to her adult service

There is currently no Paediatric lead for the service to see patients from throughout the county whether originally referred from Boston, Grantham or Lincoln.

We hope to commence outreach clinics in Lincoln in the near future, to see children locally when their management plan is stable.

Mansfield

The team consists of a Consultant Paediatrician who has an interest in paediatric rheumatology, a Consultant Rheumatologist who has developed an interest in Adolescent Rheumatology over many years since being in his consultant post. He cares for the young people when they move on to his adult service.

The specialist nurse input is provided by the Nottingham specialist nurses.

A Paediatric Rheumatology clinic takes place once a month in the Children's Department at Kings Mill Hospital with the team joined by the Nottingham Rheumatology Team members to enable specialist care to be delivered locally to those patients in Mansfield who have stable management plans. 

Peterborough

The team consists of a Consultant Paediatrician who has an interest in paediatric rheumatology who undertook some training in Paediatric and Adolescent Rheumatology. She is the paediatric lead for the well-established Paediatric Rheumatology Service. A senior nurse and therapist have been coordinating the Peterborough service that has run for many years.

A Paediatric Rheumatology Clinic takes place once a month in the Peterborough District Hospital. A specialist clinic is held four times a year when the consultant and nurse specialist/ therapist from Nottingham attend.  This clinic sees patients with stable management plans and adult care is transferred locally as needed.