Barriers | Non-Professional | Professional | ||
---|---|---|---|---|
 | Patients | Carers | Secondary Care Specialists | General Practitioners |
Specialist Referral |    • Delay in referral from primary care |    • Delay in referral from primary care | • Delay in referral from primary care • Quality of referral influences prioritisation | • Role as gatekeepers to specialist care • Need for positive blood tests • Referral linked to personal confidence and role perception |
Routine follow up and DMARD monitoring | • Lack of time with rheumatologist • Cancellation and postponement of appointments • Perceived lack of knowledge of GPs • Poor primary/secondary care interaction | • Waiting times in clinic • Transport difficulties • Perceived lack of knowledge of GPs • Poor primary/secondary care interaction | • Time pressures • Paucity of follow up appointments • Lack of monitoring by GPs | • Lack of regular review • Lack of clarity of role in monitoring |
Access to care in times of need |    • Difficulty of access during a flare |    • No specific comments | • Seeing patients urgently impeded by time pressures and paucity of appointments. • GPs not providing emergency care | • Lack of knowledge of RA treatment • Preference for personal knowledge of rheumatologist to access secondary care urgently |