12 60 seconds with… Dr Rapti Mediwake consultant rheumatologist and general physician Tell us about yourself and your team I have been at BH since 2007 across both rheumatology and general medicine. In that time, our team has grown significantly – we now have seven rheumatology consultants across BH and CFH, with four of us also contributing to general medicine. Our team includes four specialist nurses, administrators and an internal medicine trainee. It’s very much a team effort, and that’s what allows us to run the service effectively. What has driven the expansion of the rheumatology service? The main driver has been increasing demand, alongside major advances in treatment. Over the past 20 years, therapies – particularly biologics – have expanded significantly, allowing us to treat more complex conditions. However, these advancements also require more patient monitoring and ongoing support, which has increased workload and contributed to the growth of the service. What are some of the challenges the team faces? One of the key challenges is managing capacity, particularly reducing our waiting lists and the need for ongoing follow-up. Outpatient clinics are often busy, as appointments bring together clinical care, education and counselling in one setting. That said, there are positives. Digital systems have improved communications, coordination and recordkeeping, and the team has adapted well to support patients. Also patients today are far more informed and engaged in their care, often coming to appointments with a good understanding of their condition, and for many this is something you can live well with, rather than something that significantly limits your life. Are there any innovations in the team that stand out? One key development was helping to establish the medical day treatment unit. It allows treatments that once required hospital admission to be delivered on an outpatient basis, which is much better for patients and reduces pressure on beds. We also run a rheumatology advice line for GPs and junior doctors, helping to provide early guidance and prevent unnecessary admissions. Alongside that, our admin and nursing teams play a crucial role in keeping communication flowing and supporting patients proactively. What are your ambitions for the future? We’d like to continue expanding – particularly increasing nursing capacity, which is essential to how we deliver care. Beyond that, it’s about strengthening the patient experience and bringing some more in-person patient groups together. That helps build a supportive, informed community around care. How do you like to unwind outside of work? I’m very sporty and enjoy running and being active outdoors. Recently, I completed a 120km Santiago de Compostela hike with friends over five days, which was a fantastic experience. For me, exercise and spending time outdoors are the best ways to relax and recharge after work. Taking care of your wellbeing Every day, our staff go above and beyond to care for our patients. Please take the time to also look after your own wellbeing: • 24/7 helpline (out of hours) contact Care First on 0800 174319 (24/7) service) for emotional and psychological support or access online via carefirst-lifestyle.co.uk; login details can be found on Freenet • Contact the Samaritans (on 116 123), NHS Helpline (111) or your GP • Cost of living worries can have a huge impact on our mental health – visit our financial wellbeing page on Freenet • Visit Freenet for a range of resources, information and other wellbeing tips
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