For Rheumatology patients taking immunosuppressant/biologic drugs please visit the British Society of Rheumatology website for the latest update and further guidance: https://
Our service has two branches; General rheumatology service and a tertiary hypermobility and rehabilitation service.
Our General rheumatology service only accepts referrals from our immediate catchment area.
Our tertiary hypermobility and rehabilitation service, accepts referrals nationally from secondary care providers.
- We aim to assist people with hypermobility, Complex Regional pain Syndrome and chronic pain by reducing the impact of persistent pain by optimising pain management principles, improving function and promoting selfmanagement.
What we offer:
- Initial assessment by a member our multidisciplinary team. This could be a rheumatology consultant, Registrar, physiotherapist and a clinical nurse specialists.
- In patient Multidisciplinary Pain Management programmes for suitable candidates
- Expert input from physiotherapists and occupational therapist
- Clinical psychology
We do not offer:
- Long term follow up
- Genetic testing
- Further investigations
It is the responsibility of the referring clinician to provide a comprehensive and honest assessment of the patient prior to referral to maintain patient satisfaction and prevent rejection. Please provide full clinical detail, including history and examination, drug history, psychiatric history and any previous treatment (including input from pain services locally). Please complete and return the proforma (It is found in the related documents section).
We do not offer long term follow up, genetic testing and any further investigations.
Information that must be included in the referral:
Reason for referral
- Duration of symptoms
- Pain history: onset, location, nature of pain and duration
- Comprehensive past medical history
- Current and complete medication history (including nonprescription medicines, herbs and supplements)
- Relevant pathology and imaging reports
- Psychological status and cognitive function
- Details of previous pain management including the course of treatment(s) and outcome of treatment(s)
- History of alcohol, recreational or injectable drugs, or prescription medicine misuse
- Details of any current behaviours that may impact on the person’s ability to participate in a chronic pain management program (e.g. behaviours of concern, level of alcohol intake, cognition issues, reliance on a carer, mental health issues)
Provide the following information if available:
- Details of functional impairment
- Psychiatric history
- If the person has symptoms of, or have been diagnosed with, posttraumatic stress disorder (PTSD)
- Results of previous investigations
- If the person has previously completed a chronic pain management program and if so the provider of the program
- If the person is part of a vulnerable group
Referrals that do not have adequate information will be returned with a request for more information
Exclusion criteria
Referral are not appropriate for:
- Children under 18
- Patients who are currently not willing to explore living well with pain and not willing to learn to self-manage ongoing pain
- Patients who are unable to commit to 3 weeks of inpatients admission ( excluding weekends)
- Patients already referred to another pain service for the assessment, or treatment of the identifiable cause of pain and awaiting further procedures.
- Patient waiting for further investigations for undiagnosed and untreated symptoms ( such as frequent fainting)
- Patients waiting for surgery.
- Patient with untreated and uncontrolled psychiatric conditions
- Patients who are unable to work effectively in a group and ward environment
- Patients with severe fatigue (bedbound for more than 2 days of the week)
- Patients with uncontrolled eating disorders and / or self-harm
- Patients with extremely restrictive diet, tube feed, or TPN with unstable weight who cannot self-manage their regime
- We do not offer genetic testing
- Please refer your patient to local genetic services if you are concerned regarding the rarer typed of EDS such as vascular EDS.
RNOH Sport, Exercise and Musculoskeletal Medicine service uses EpicCare Link for all Consultant-led referrals from secondary and tertiary care organisations.
General Practitioners should continue to refer to RNOH using the UK Electronic Referral System (ERS)- please see below.
To make a tertiary referral to RNOH you will need to register for an account on EpicCare Link. Please follow the instructions here.
Referrals are accepted from GPs and consultants. If you are a GP referring to the RNOH please use the NHS e-Referral Service system, e-RS.
Rheumatology & Sports Medicine Department
Dr Cohen /Dr Mittal / Dr Kia /Dr Seah (SEMM): Administrative Questions and Appointments
Phone: 020 3947 0044* Email: rnoh.
Please follow the voice guide who will direct your call to a respondent
Clinical Nurse Specialist
Helpline: 020 3947 0184 Email: rnoh.metabolic-rheumatologycns@nhs.net
This is for clinical queries such as advice about medication, side effects, advice and support
Rheumatology
As well as general rheumatology, our consultants provide specialist opinion in the following areas:
Dr Helen Cohen - Hypermobility, Complex Regional Pain Syndrome, chronic pain and Fibromyalgia
Dr Gayatri Mittal - Ankylosing Spondylitis, early inflammatory arthritis, gout, hypermobility
Dr Rick Seah - Sports injuries; Musculoskeletal injuries; Exercise-induced leg pain; Paediatric & Adolescent SEM; Dance medicine; Bone stress injuries; Muscle, tendon & ligament soft tissue injuries; Injection therapies; Musculoskeletal rehabilitation; Physical activity and exercise prescription.
Dr Sanam Kia - Hypermobility, Complex Regional Pain Syndrome, chronic pain and Fibromyalgia,