Rheumatology telephone helplines: an activity analysis

Background. Anecdotal evidence suggests that the services offered by rheuma tology telephone helplines in the UK vary widely between NHS Trusts because of the lack of national or European guidelines. Objective. To conduct an activity analysis of six NHS Trust rheumatology te lephone helplines in the south and west of England. Methods. Serial data were collected on the first 100 calls received on or a fter 1 January 1999 by six rheumatology helplines in the south and west of England. Background information was gathered on the management, availabilit y, setting and purpose of each helpline. Data on the time taken to manage t hese calls and patient satisfaction were not collected. Results. Patients with rheumatoid arthritis were the major users and no sig nificant differences were found in the outcome of their calls between centr es, but wide variations were revealed in the management of the helplines, t he populations they serve and the services they offer. Conclusion. The rheumatology helpline services in six NHS Trusts in the sou th and west of England were shown to be the same in name only. They lacked uniformity in the delivery of care and accessibility to relevant patient gr oups. The geographical variation in service delivery may result in patient dissatisfaction and confusion if a number of hospitals are attended over th e course of a patient's chronic disease. Further research is required to id entify the helpline needs of the broader rheumatology population, patient s atisfaction, outcomes and system costs, and to progress towards the develop ment of national and European guidelines.