Background: With an ageing population, Rheumatic Diseases continue to provide a significant burden of adult inpatient admissions in the National Health Service (NHS), United Kingdom. Recent reports from the NHS and British Society of Rheumatology (BSR) suggest significant pressures on the workforce, and a need to recruit additional Rheumatologists. The BSR workforce report in 2023 advocated for the need to employ an additional 159 consultants and 264 specialist nurses in adult rheumatology [1]. They recommend for every 60,000 - 80,000 population, one additional adult rheumatologist is required [2]. To further understand the pressures on the NHS from Rheumatic Disease, we reviewed national data for adult inpatient admissions - for which the primary diagnosis was a disease commonly referred to Rheumatology/requiring Rheumatology input.

Objectives: We compared this with the number of Rheumatology Outpatient appointments provided in the NHS to map the current pressures on the workforce.

Methods: Using NHS digital, Hospital Episode Statistics (HES) were reviewed in which the Primary Admission Diagnosis was coded as either: Seropositive Rheumatoid arthritis; Other Rheumatoid Arthritis; Systemic Lupus Erythematosus; Systemic Sclerosis; Sarcoidosis; Ankylosing Spondylitis; Polymyalgia Rheumatica; CREST; Giant Cell Arteritis with Polymyalgia Rheumatica; Other Giant Cell Arteritis; Gout; Behçet’s Disease; Osteoporosis with pathological fracture; Osteoporosis without fractures; Polyarteritis Nodosa (PAN) and related conditions; and Myositis. Admission statistics were reviewed for the years 2018 – 2024. Only data on the number of admissions was collected; we did not have access to any other patient demographics. Data on the number of outpatient appointments provided in rheumatology was also collected for the years 2018 – 2024.

Results: 2020/2021 saw a decline in hospital admission and outpatient hospital appointments - throughout the time of the global covid-19 pandemic. These results are in keeping with expected events because of the pandemic. Results from the 2023/2024 HES show a return to figures similar to pre-pandemic. Following this in 2021/2022, a rise in both hospital admissions and hospital outpatient appointments was observed with similar values to the year 2019/2020. A slight peak was observed in outpatient hospital appointments being offered in the year 2021/2022 following the Covid-19 pandemic with an increase of 13,998 appointments. This figure remains under the 2019 value with a decrease in 44,304 outpatient appointments.

Conclusion: Following the Covid-19 pandemic, the trend in hospital admissions shows an overall increase in the number of admissions related to Rheumatic Disease. Additionally, the total number of Rheumatology outpatient appointments are decreasing. A possible interpretation of this is a decreasing workforce is unable to keep up with increasing additional demands on the services. This would support the BSR’s workforce agenda to recruit additional Consultant Rheumatologists to reduce the burden of inpatient admissions within the NHS. We aim to highlight the need for expanding the British rheumatology workforce.

REFERENCES: [1] British Society for Rheumatology. (2023) The People We Need. Available at: Manifesto final c.pdf [Accessed 20 Dec 2024].

[2] British Society for Rheumatology. (2021) Rheumatology workforce: a crisis in numbers Available at: https://www.macpweb.org/_userfiles/pages/files/resources/rheumatology/bsr-workforce-report-crisis-numbers_june2021.pdf [Accessed 20 Dec 2024].

Acknowledgements: NIL.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.