Dudley Group NHS Foundation Trust, UK

The Department of Rheumatology of DGH FT is one of the largest in the UK. It offers specialist and super-specialist services both to a local population of over 650.00 and acts as a tertiary referral centre for rare conditions, on an outpatient, day-case and inpatient basis. There are specialist early inflammatory arthritis, rheumatoid arthritis, lupus, vasculitis, spondyloarthopathies, osteoporosis clinics, as well as combined clinics with other specialties, including cardiology, renal, chest medicine, and orthopaedics. The clinical service is provided by a multidisciplinary care team consisting of 8 Consultant Rheumatologists and several affiliated medical and surgical specialists together with professionals allied to medicine, including 5 specialist nurses, 2 biologics and 3 research nurses, 2 physiotherapists, 1 occupational therapist, 1 podiatrist, 1 surgical fitter, 2 exercise physiologists and 1 health psychologist and 8 secretaries. The Department sees in excess of 12000 outpatients, 4500 day cases and 500 inpatients per year and has received several awards for the quality of service provision, as well as the quality of education and training it provides to medical students, general medicine and rheumatology trainees and allied professionals.

The Rheumatology Clinical Research Unitprovides integrated in-house diagnostic and research capability (light and polarised light microscopy, nail-fold capillaroscopy, musculoskeletal untrasound, spirometry, night oxymetry, consultation rooms for clinical trials, day case infusion facilities, IT infrastructure etc). It incorporates a vascular research laboratory fully equipped with plethysmography, laser Doppler, flowmetry, and vascular ultrasound equipment to allow non-invasive assessment of most vascular beds; an exercise physiology research laboratory equipped with multiple top of the range ergometers and gas analysers; a body composition research laboratory including top of the range TANITA body composition analysers and DXA; and accredited basic research and molecular genetics laboratories extensive capabilities for ELISA, HPLC with capillary electrophoresis, automated PCR, RANDOX proteomics microarray system, GC-MS, multicolour flow-cytometer, spectrophotometer, western blotting, standard and refrigerated centrifuges, ultracentrifuge, and long-term –700C and liquid nitrogen storage facilities, amongst other pieces of equipment. Action Heart is the largest cardiac rehabilitation facility in the UK and has enjoys Department of Health Beacon Status: it is the base for multiple studies of physical activity and cardiovascular health for rheumatology patients.

The Rheumatoid Arthritis Co-morbidity Research Group (RA-CRG) was set-up and is led by Professor George Kitas since 1998. Its aim is to identify important co-morbidities, their causes, impact and ways to control them in patients with Rheumatoid Arthritis, with particular focus on cardiovascular and psychosocial morbidity. The group has received funding from multiple research councils, charities, the NIHR and industry and has performed a number of original studies, from observational to basic scientific studies, as well as single or multicentre controlled trials of pharmacological, educational and exercise interventions on CVD in RA. These have produced a number of PhD degrees and over 170 PubMed-listed publications in the field of CVD in RA over the last few years. Dudley, together with the University of Manchester is also the sponsors of the Arthritis Research UK and British Heart Foundation-funded trial of atorvastatin in the primary prevention of cardiovascular events in patients with rheumatoid arthritis (TRACE RA). TRACE RA is the largest ever academically-led RCT in RA in the world, with over 3000 patients recruited and is due to report in 2014/15.

Website http://www.dgh.nhs.uk/tracera