19 November 2025
In healthcare, we feel the pressures that the colder months bring on, more so than most. In the rheumatology community, our patients can be much more susceptible to infections due to immunosuppressant treatments. This blog explores the unique challenges which face our specialty, and different ways we can tackle them.
Causes
With winter, the prevalence of seasonal infections drastically increases. Hospital admissions go up, as do sickness related staff absences, a combination that can feel impossible to navigate. Vaccination programs are one of our strongest lines of defence against these illnesses, keeping our most vulnerable patients as healthy as possible. However, vaccine hesitancy continues to create challenges to this strategy, leading to additional patient queries and anxiety. This NRAS blog regarding last year’s vaccination program could be a useful resource for easing concerns as well as this informative pdf, while these tips for keeping warm during the winter on a budget could be helpful for patients with Rheumatoid Arthritis.
Impact
Immunosuppressive treatments prescribed for rheumatic conditions can leave our patients more susceptible to infections, creating worse outcomes if they do become unwell. This, alongside the pressure on our teams to provide urgent appointments (to prevent hospital admissions) can play a role in increased pressure on rheumatology teams.
Hospital staff aren’t immune to the flus and viruses which go round, so it’s common for winter to mean more gaps in rotas and staff shortages – in all departments, meaning that if rheumatology is organisationally aligned with medicine , there is risk of rheumatology staff being redeployed to acute medical cover. Nursing staff also often face additional strain covering clinics and increased enquiries through advice lines.
Mental health
It makes sense, therefore, that we see an increase in mental health concerns during wintertime, for both patients and in staff. In patients we see heightened anxiety around becoming ill, or due to vaccine misinformation. The resulting queries often arrive through helplines, leading to an increased workload for the nurses in charge. If this is a concern for you, we have designed a free online course, supporting nurses as well as the wider team by providing telephone advice, addressing a key service pressure.
Unfortunately, it’s uncommon for psychologists to form part of a rheumatology MDT, and this lack of embedded support can mean that patients aren’t receiving the mental health support they need within the care network, leading to longer wait times and worse outcomes – as was recently highlighted in the findings of our NEIAA report. We are strong advocates in this area, recognising the crucial role that mental health plays within holistic approach.
Winter pressures often lead to mental health concerns in medical staff. We are keenly aware of the need to address these early before they spiral into the worst-case scenario - burnout. Maintaining strong boundaries to ensure a good work life balance, connecting with other members of the community, or continuing to engage with passions that are separate from work are all effective ways to mitigate this risk. As healthcare professionals, it’s vital for members of BSR to find community with each other through the commonality of their struggles, shared advice and peer to peer support.
Our Mental Health SIG is a great way to contribute to a better working environment for the medical community, giving members the opportunity to share practical advice for frontline staff. We also have a wealth of wellbeing resources ready for you to benefit from on our eLearning platform, which encourage and support staff to prioritise self-care.
Workforce challenges
The recruitment and retention challenges facing the rheumatology specialty – as well as the wider medical community – are significant. As a result, we are actively contributing to national workforce planning, including input to the NHS 10-year plan, advocating for sustainable staffing and support.
Nationally, we know that rheumatology teams are embracing community and shared challenges – made possible through networks within membership bodies like ours which nurture those connections as well as working tirelessly to support you with valuable resources.
BSR support
Our Service Guidance area is full of useful resources to support you with triage and referral requests as well as specific nurse job planning support. This Talking Rheumatology Spotlight pod on burnout and mental health was recorded live at the BSR Annual Conference 2025. Gain insights into how to recognise warning signs of burnout and mental health issues, when and how you might act to support yourself and colleagues, and learnings from a rapid access staff mental health service.
Our newly launched csDMARDs guideline presents a more pragmatic approach to blood monitoring of the drugs which could mean a reduced burden on practioners during the stressful winter months.
At BSR, we are deeply invested in fostering a strong community for rheumatology professionals to support and uplift each other through these challenging months. It’s more important than ever to remember that you are not alone in enduring these pressures – we are working hard to support you along with your team members.