What are the potential problems to be faced in the years to come? Change is often difficult to
accept. Working to targets, for example, could have an adverse impact on clinical practice …

Service developments to improve rheumatologic care will be specific to local circumstances,
but will rest on the introduction of patterns of work that are structured and address the issue …

We read about the effects of globalisation everyday in the pages of our newspapers; now
read about them here in the pages of your rheumatology journal—the European League …

As outlined in the Hill's article, much of the focus on the value of all specialist services rests
almost entirely on cost savings rather than quality indicators. The challenge for us all, but …

Introduction According to the World Health Organisation (WHO)“an integrated, people-
centred approach is crucial to the development of health systems that can respond to …

Musculoskeletal conditions are very common across Europe, affecting all ages, and the
associated physical disability is an enormous burden on individuals and society. 1 They can …

We were invited to consider here the development of rheumatology in the UK, as reflected in
Rheumatology from its inception in 1952. Those interested in the detailed history of the …

How can our system of providing rheumatological services be made more effective and
more efficient? The answer to this question entails careful consideration of five issues:(a) the …

The rheumatological clinics at the General Infirmary at Leeds are moving towards a divided
system of patient care. This change was initiated to fulfil a particular local need andmay not …

Many rheumatologists are concerned at the number of return visits being made to their out-
patient clinics. This study investigates the outcome of 179 general practitioner referrals to …