Covid-19 Coronavirus

Rheumatology Department

The Rheumatology Department at Noble's Hospital provides an outpatient service every week day. This is to facilitate patient’s access as well as respond to emergent needs of rheumatology patients. 

COVID-19 Advice to Rheumatology Patients

Update from the Rheumatology Department - 4 June 2020

You may have been keeping in touch with the updates provided by the DHSC, Public Health and the Isle of Man Government.  This mirrors steps being taken in the UK where shielded (extremely vulnerable) patients are being allowed to go out and exercise in the fresh air and, within limits, are allowed to meet relatives by maintaining social distancing norms. 

This is of importance to rheumatology patients on the Isle of Man who received risk stratification letters (as per the British Society for Rheumatology Risk Stratification Guidance) from the Rheumatology Department to either shield, self-isolate, and/or social distance for a period of 12 weeks. For most patients, this period of 12 weeks will be coming to an end around 15 June 2020. It is for this reason, and taking into account recent guidance from Public Health / DHSC, Isle of Man (Covid-19 and Seasonal Flu Advice 2020/2021) that we are providing this update for our patients. 

As you are all aware, the rheumatology service is run from DATU (Day Assessment & Treatment Unit).  At present, at least 3 clinics a week are running as face-to-face clinics with PPE (personal protective equipment) protocols in place. The infusion and injection services are running as normal.  Starting from 1 July 2020, the rheumatology clinics will run as regular face-to-face clinics across all clinic streams. Please be assured that our clinics will be run as per agreed Standard Operating Protocols/Procedures (SOP) with PPE in place and with full cleaning measures between each patient appointment.   We have good evidence of this process working well due to our current experience with the service template in place at present. Some of you will have attended DATU to avail of these services over the pandemic period. These have been deemed safe and effective, and we are heartened by the outcomes. As such, we are now in a position to effectively roll out the complete rheumatology OPD service, starting on 1 July 2020. 

  • For patients who have received a risk stratification letter asking them to shield - our recommendation is to follow the Government’s advice for the same. This is a high risk / extremely vulnerable category of patients and further direction/advice from the Public Health Department / DHSC will follow shortly (Covid-19 and Seasonal Flu Advice 2020/2021).  We advise you to be vigilant and stay safe at present and follow social distancing protocols at all times. 
  • For patients advised to self-isolate - we recommend that you send a copy of your risk stratification letter to your employer’s Occupational Health Department. Your employer needs to undergo a process of risk assessments to ensure a safe working environment for your return to work. If your employer does allow you to work from home and you can, that may be an option you may choose. 
  • For patients advised to social-distance - most of you are probably already working at your place of work with social distancing norms/rules in place. 

We ask you to remain vigilant, maintain social distancing norms and follow the Government’s advisory guidance at all times. Please do take time to read the Covid-19 and Seasonal Flu Advice 2020/21 once it becomes available – at which time we will include it in this update. Patients who take DMARD medications should refer to the Black Box instruction at the end of their clinic letters and follow this advice.  This is for your health, safety and well-being.

COVID-19 Advice to Rheumatology Patients PDF version

COVID19 - Update advice - blood tests and appointments

Letter to Rheumatology Patients - COVID-19 25.3.2020

An update from the Rheumatology Department 16 April 2020

Update from the Rheumatology Department - 4 June 2020 PDF

  1. Avoid contact with people with respiratory/other infections, flu-like illnesses or children/adults with contagious illnesses. 
  2. Avoid any trips abroad which are not necessary. 
  3. Avoid events/places with large numbers of people. 
  4. Do not visit people in hospital or elderly persons in care homes. 
  5. Follow good hand hygiene and avoid touching face. 
  6. Continue rheumatological DMARD therapy unless advised not to take it – this should not be discontinued if patients do not have any symptoms of infection. 
  7. If you have any flu-like symptoms, cough, temperature, self-isolate and stop medication PLEASE ADVISE THE RHEUMATOLOGY TEAM IF YOU STOP YOUR MEDICATION OR HAVE BEEN ADVISED TO STOP YOUR MEDICATION BY THE GP OR THE EMERGENCY DEPARTMENT. 
  8. Please ensure that your vaccinations as per the black box on your clinic letters are up-to-date.

Contact Details

Clinical Nurse Specialist Tel: +44 1624 650159
Secretary Tel: +44 1624 650138
Outpatient Appointments Tel: +44 1624 650103
Email: hospital.nobles@gov.im

The service is led by Dr. R Peshin (Specialist in Rheumatology/General Internal Medicine (GIM), and Sports Medicine), who has led a process of restructuring, and started services for which patients in the past needed to go to areas in the UK.

The service is supported by a Clinical Nurse Specialist, Staff Grade Doctor in Rheumatology/GIM, along with Physiotherapists, Occupational Therapists. These along with other dedicated staff have developed patient focussed education sessions (ACTION Classes).

Rheumatology Services are largely run on an outpatient basis, but inpatient care beds are available in the Medical Division for patients who require acute interventions or in the event of a rheumatological emergency. The service provides an Early Arthritis Clinic, Biologic Clinic for patients on biological therapies, disease specific clinics, injection and infusion services.

In addition, we also provide an Osteoporosis Service both clinical as well as for dual energy X-ray absorptiometry (DEXA) scans, along with a fracture liaison service. We provide an Inpatient Rheumatology Referral service and work in a multidisciplinary manner with other medical and surgical specialities in Noble's Hospital. We also provide an educational, counselling and monitoring service for all rheumatology patients on the Isle of Man.

The Rheumatology Department is located in the Day Assessment Treatment Unit (DATU). All our services are located at 'one point of care', which is an effective and efficient use of resources. It also allows for availability of senior rheumatological input at all times, and on site.

We maintain strong links with the Mersey Deanery - the visiting Professor who attends quarterly, allows us to maintain a vital link with the UK, management of difficult cases, as well as providing Continuing Medical Education/Continuing Professional Development (CME/CPD,) and continual development of the department, so that we can provide a best practice rheumatology service for all patients on the Isle of Man.

We endeavour to provide an effective, dynamic and best practice service, and continue to improve services as the need arises with the latest investigations, therapies and management protocols. Our friendly and dedicated team in DATU are always willing to listen to patients and adopt changes that best serve their needs.

Local Societies

Arthritis Care Ellan Vannin

Tel: +44 1624 852664 (Office) 
Email: arthritiscareev@hotmail.com

Isle of Man Group

Tel: +44 1624 676694

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