Patients whose condition is clinically stable with low disease activity scores, who are making good progress and doing well on disease modifying drugs (DMARDs) or biologics

Patients who already have a wide appointment interval, eg 12 months, and in whom not much new has happened between appointments

Patients requiring discussion of test results and proposed treatments/drugs after initial appointment

Osteoporosis referrals where patients require interpretation of DEXA and advice about treatment

Alternate clinics for patients requiring monthly escalation for early inflammatory arthritis

Patients requesting to be seen earlier than their set appointment – this allows accurate assessment of the degree of urgency required

Patients on remote monitoring who are completing their outcome scores online and with low disease activity

Patients not suitable for patient-initiated follow up, where a teleclinic will enable assessment of their condition

Patients who decline to have teleconsultation

Patients not in a location where they can speak confidentially

New patients being referred with a new problem; they should have face-to-face (FTF) appointments unless there is a good reason for a teleclinic (eg symptoms suggest that accurate advice can be given in a teleclinic)

Patients with new symptoms that need clinical examination for accurate evaluation

Patients with existing conditions that need clinical examination for meaningful assessment, eg swollen joint counts in rheumatoid arthritis

Situations where patient confidence requires FTF consultation even if appropriate decisions could be made in a teleclinic. Often such patients require the reassurance of a clinical examination

Children under the age of 18, unless a parent or guardian is available, and vulnerable adults

Patients who are unable to use or access IT or phone

Patients with communication difficulties, eg speech/hearing impairments, poor English if independent interpreter service not accessible

Patients with impaired cognition, unless a relative or friend is available to speak on patient's behalf with patient's adequate consent