Rheumatoid Arthritis

Part 2 – Pollyanna Penguin’s RA Blog

This is that rare thing, Pollyanna Penguin trying to stay calm, measured and reasonable, and not ‘fly off the handle’ at the GP, since I don’t particularly want to get thrown off the practice register. (Although if the practice up the road with the much better reputation would take me, that would be a blessing indeed!)

So, for the delectation and delight of anyone that can be bothered to read this, here is my reply from the surgery this morning regarding my unnecessary shielding letter, and my response to that reply. (The response is the calm, measured and reasonable bit, or so I believe. What I actually wanted to say is not printable.)

Response from the doc


Thank you for the email.  We have been advised by public health england to ensure letters are sent out to all patients who are on immunosuppressive therapy.  I understand that this differs from the guidance as you have states from the Rheumatology website.  However being on methotrexate still suppresses your immune system making you more vulnerable to covid 19.  This is why we have been advised to ensure shielded letters are sent to all patients on methotrexate.  I hope this clarifies your concerns.

Kind Regards

Doctor X

My reply to the doc

Dear Doctor X,

Thank you for your response. I presume you refer to the 13-page letter sent out by Public Health England on 21 March. However, point 5 on page 4 of the letter actually states “People on immunosuppression therapies sufficient to SIGNIFICANTLY [my capitals] increase risk of infection’. I would suggest that the reason the hospital didn’t send me a shielding letter two months ago is because I clearly do not fit into this category.

I appreciate the pressure that everyone in the NHS is under at the moment, and that you don’t necessarily have time to go through all individual patient records and work out who fits into this category and who does not. However, as previously stated, the Risk Stratification Guide from British Society for Rheumatology, produced to help medics to decide who falls into this category and who does not, makes it quite clear that I do not.

While I realise the extra strain put on to practices, with this extra job of having to go through records and work out who needs shielding, is not fair, I also don’t think it’s fair to put people on effective ‘house arrest’ for a minimum of just over a month, because there isn’t time to do a thorough job on this.

Please don’t feel the need to respond to this as I know how busy you all are, but I wanted to put my point across nonetheless.

For anyone with time on their hands or who is interested in this because they’ve also been asked to shield and don’t believe their eyes

Here is the link to the Public Health England letter sent out to GPs on the 21st March (also in the link above in my reply) – and yes, I do genuinely feel for GPs, getting this landed on them on top of everything else – but not quite as much as I feel for the folk being asked to ‘shield’ unnecessarily. (Note: the link will require you to download a PDF file to view.)


This does, of course, make it very obvious who I am (outside of Pollyanna Penguin) should my GP read this blog but a) that’s incredibly unlikely – they have better things to do and b) I’m beyond caring!


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