Other conditions that we manage include osteoarthritis, gout, bone disorders such as osteoporosis, osteomalacia and Paget’s disease. 

Treatments are mainly based in the outpatients department and on the medical day unit. We work closely with physiotherapists and occupational therapists within the hospital and the Primary Care Trust.

Acute and chronic inflammatory conditions

These include rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, polymyalgia rheumatica, and systemic autoimmune disorders such as systemic lupus erythematosus (SLE), antiphospholipid syndrome, Sjogren’s syndrome, scleroderma, inflammatory myopathies and vasculitides.

Most conditions are assessed in the rheumatology outpatient clinics.  In clinic, patients have the opportunity to discuss other coping strategies to improve their health including exercise and alternative therapies such as the use of TENS machine, acupuncture, hydrotherapy and osteopathy, occupational therapy and podiatry.

The need for social service intervention is also discussed and if necessary an immediate referral to the appropriate health professional is made. There are specialist clinics in the following areas:

• General Rheumatology clinic: These clinics are for patients who have inflammatory or degenerative arthritis and other musculoskeletal conditions, including neck/back pain, and soft tissue problems
• Early Arthritis clinic: This clinic is for patients with less than one year’s history of symptoms of inflammatory arthritis. This is a rapid access clinic and we aim to see patients within two weeks of referral. This is available via Choose and Book or your GP can refer directly to Dr Claire Gorman
• Rheumatoid Arthritis clinic: This clinic is for management of patients with longstanding rheumatoid arthritis
• Connective tissue diseases clinic: This clinic manages patients who have SLE or other systemic autoimmune disorders such as antiphospholipid syndrome, Sjogren’s syndrome, mixed connective tissue disease, scleroderma, polymyositis, dermatomyositis, overlap syndromes and vasculitides
• Biologics clinic: This is for patients who may benefit from or are receiving therapy with anti-TNF drugs or other biologic agents when treatment with traditional disease modifying drugs is ineffective or insufficient to achieve adequate disease control
• Combined hand and foot clinic: These clinics take place with the orthopaedic upper limb surgeon and podiatric surgeon and take place every three months
• Emergency Rheumatology Clinic: This is an urgent follow-up clinic for patients with flares of their rheumatic disease
• Patient education and drug monitoring clinic: This involves physical assessment and ongoing education by the Rheumatology Specialist Nurse to ensure patients understand their disease, medication and reasons for blood tests
• Biologics therapy clinic: These clinics are for patients who have Infliximab intravenous infusion or subcutaneous injections such as Enbrel and Humira as part of their treatment for rheumatoid arthritis, ankylosing spondylitis or psoriatic arthritis

Infliximab infusions are administered intravenously on the medical day unit. Each patient must allow up to four hours stay in hospital for the treatment, close observation of their vital signs, joint assessment and have a blood test before being discharged.

Patients on Enbrel and Humira subcutaneous injections are taught how to self-administer them. Initially, a verbal discussion about the injection is followed up by a video on self-administration and a drug information leaflet is given to ensure the patient is fully informed.

A nurse from ‘Healthcare at Home’ will visit the patient at home to demonstrate safe administration of the injection. Delivery is normally made to the patient’s home. All patients on biologic therapy must carry an alert card at all times which specifies the name of the drug and possible side effects. It also has contact numbers of the rheumatologist and specialist nurse.

• Methotrexate injection clinic: This is held in the outpatients department twice a week for the administration of subcutaneous methotrexate.

Making an appointment

We hold clinics on Mondays, Tuesdays, Wednesdays, Thursdays and Fridays. Appointments can be made via a refferal from your GP.

How to contact us

To change or cancel an appointment please contact the outpatients department on 020 8510 5544.

Rheumatology patient helpline:
Mondays to Fridays 9am to 5pm
tel: 020 8510 7200

Rheumatology Secretaries
Monday to Friday 9am - 5pm
tel: 020 8510 7612
fax: 020 8510 7574

Key staff

Dr Claire Gorman
Consultant Rheumatologist with a special interest in early inflammatory arthritis and rheumatoid arthritis

Dr Beena Hameed
Consultant Rheumatologist and General Physician (Special interests in inflammatory arthritis, connective tissue diseases, soft tissue rheumatism and osteoporosis)

Dr Piero Reynolds 
Consultant in rheumatology with a special interest in inflammatory arthritis with ultrasound disease activity monitoring, SLE and other connective tissue diseases, vasculitis and the anti-phospholipid syndrome

Diane Paul
Rheumatology nurse specialist

Rheumatology Secretaries
Debra Walters
Roslyn Kates

Useful websites

• National osteoporosis society (NOS)
• Arthritis research campaign (ARC)  
• Lupus Uk  
• National rheumatoid arthritis society (NRAS)  
• National Ankylosing Spondylitis Society (NASS)
• British Society for Rheumatology (BSR)
• European League Against Rheumatism (EULAR)