Private rheumatologist recommendations in London for possible psoriatic arthritis

[DonkeyKon]

A relative of mine is looking for a private rheumatologist in london.

worried about psoriatic arthritis.

they are willing to travel & have money so affording private care is not an issue. Any recommendations?

Your friend shouldn't go private. If they have grounds to believe they have psoriatic arthritis their GP should take what they say seriously and refer to a rheumatologist.
Any consultant R would be fine. This is not a difficult disease to diagnose

Not London but Will Tillet and Ellie Korendowych in Bath are excellent, the latter diagnosed me after I couldn’t get referred on NHS and first private one was rubbish. Some rheumatologists aren’t great with diagnosing it.

I’m with Taryn Youngstein for this exact condition. Had never heard of it before I met with her, she’s brilliant very thorough and caring.

Money not an issue and very frequent travel in and out of the country so just want consistency of 1 consultant with convenient appointment times, video consults etc.

I had two NHS GPs tell me that my swollen toe definitely wasn’t psoriatic arthritis. Private rheumatologist then told me it was classic presentation of psoriatic arthritis.
So don’t hold your breath for NHS referral by clueless NHS GP in my experience

I know you say money is not an issue but how much of not-an-issue is it? The gold standard treatment for PsA is biologics which are very expensive still. With appointments etc, you can easily spend over 10k a year (probably more) and ongoing treatment/meds aren’t generally covered by insurance. There’s no harm going private initially but for ongoing treatment and meds, it is definitely worth getting onto an NHS consultant’s list.

Prof Christopher Edward’s is great. Clear, friendly and obviously v knowledgeable

Dr Gerard Hall

Not all NHS GP's are clueless. A percentage may be but this is typical of any profession.
If most of us believed that our GP's were clueless how would you account for their popularity?
If all of us formed our attitudes with reference to our personal experience, do you think we should live in a better society?

Are GPs popular? They are the gatekeepers to NHS treatment so unavoidable.
The two I saw were clueless about psoriatic arthritis

When you say money no object, how much money is no object? As treatment with biologics would be prob £10-20K at least per year forever.

My NHS GP correctly diagnosed me with psoriatic arthritis within seconds of me telling him my symptoms.

I've heard good things about Dr Kaul at the London Lupus Centre.

Any suspected inflammatory arthritis is supposed to be a priority referral, with a target to get us on treatment within 6 weeks. Unfortunately, many areas don't even come close to meeting this goal. I went private initially as neither my GP nor NHS rheum team were taking my concerns seriously, thankfully saw a well respected private consultant who advocated for me so I was able to start treatment on the NHS.

The first line meds used for PsA are not expensive at all, though the regular blood work costs will add up if it's all done privately.

What are the first line meds for PsA? Are they the same ones used for psoriasis?

But you can get diagnosed privately and treated on the NHS.

Dr Sangita Agarwal is absolutely hands down the best doctor (of any speciality) I have ever been to. Extremely thorough, kind, emotionally intelligent and knowledgeable. Cannot recommend her enough!

I don’t think the NHS would fund biologics unless systemic meds had been tried.

NICE guidelines are failing 2 DMARDs before biologics with one exception which I can’t remember where you only need to fail one.

The most common first line meds are things like Methotrexate and Sulphasalasine. Methotrexate injections give fewer side effects than tablets (taken with folic acid) and these are often continued when starting biologics as help prevent body from rejecting the biologic. Injections incredibly easy to do, lid off pen and push onto skin, wait for 2nd click, count to 5 and job done.

There has been work done to get GPs to be more aware of PsA which is improving the situation . There are a couple of FB groups and sadly some people are struggling with some rheumatologists. Have read of people being diagnosed then changing area and being told they don’t have it so it is very sensible to get a decent one.

Unfortunately my PsA wasn’t diagnosed for some time and I am not responding well to meds as the disease got quite a grip and that is what research is now showing I believe, hit it quickly with drugs. I really struggled to get diagnosed and was refused NHS referral to rheumatology and this was despite having worked in a couple of rheumatology departments back in the day. As said above the first person I saw privately was useless. Am now on 2nd injection of 2nd biologic later today and hoping this may work.

Hi Crisps,

That was unfortunate experience but not typical. Worrisome (above) bears that out. I think it's worth persisting with the NHS because you shouldn't have to pay twice i.e. tax to fund the NHS and then fees etc. to go private.
In the end people have to do what's best for them and that might sometimes mean they have to go private to kickstart the process but to get the best out of the NHS you sometimes have to be assertive and persistent.

There's an example from my life that may be useful to people here: My husband was suddenly taken ill one night. He was seen immediately by an A & E consultant who treated him appropriately and panic over but I was unhappy because I thought he had missed something important which proved correct.

Hubby had a very swollen tongue which threatened to choke him but what was odd was that the swelling, though enormous, was one sided. Antihistamines and steroids quickly reduced it so I was able to take him home.

But I was puzzled and spent some time online doing homework. Long story short I found that the problem was probably a rare reaction to a blood pressure medication which can happen without warning even if you've been taking the stuff for years.

I printed off a learned paper on the subject and sent husband off to GP with it. GP said "I've never heard of this but I think your husband might be right" and referred him to a consultant, as an emergency, who saw him within hours. The guy confirmed my suspicion and took him off the offending medication, substituting another. Problem solved.

At no point in the process did I think it would be best to go private. That's a lot because the NHS has expertise and facilities which are just not available privately unless you are loaded. Again the NHS can react very quickly if the need is seen - you just have to make them see it.

There's a broader point here. The NHS won't necessarily improve and be more responsive unless we demand it.
We also have to make life difficult for politicians who don't want to fund it properly.
Is there really anything more important than our health?

Professor Tahir
Dr Colin Tench

Full private will add up- think £1,000 for a scan. My biologic is £1,100 a month privately.

Tahir has a fake professorship from a dodgy university in Central America. 🤣

Doesn’t mean he’s not a qualified doctor? You asked for recommendations and I tried to help you.

True, but the original question is about diagnosing possible psoriatic arthritis.

I think it would be absolutely bizarre to go straight to biologics without trying other remedies first. I’ve been through biologics and I’m now on a JAK inhibitor. If I could go back to methotrexate I absolutely would.

There is a reason for the pathway and it is not about saving money.

As an aside here’s a link to some Podcasts that may be of interest:
https://birdbath.org.uk/podcasts?fbclid=IwY2xjawRyaEdleHRuA2FlbQIxMABicmlkETExTUtsVkswVklMVjhlSElpc3J0YwZhcHBfaWQQMjIyMDM5MTc4ODIwMDg5MgABHoBEPvGplV91zTzLBVTWw7TNRwQ1SkkWnI_wMKU_JUA1Uy9X7zunZgmu7l0H_aem_YWdncwDBF8QWiED1fstj5jtKPdZD&brid=YWdncwFCM5KzpNsD-RaRtWero3nX