Dr Mhairi Brandon is a consultant allied health professional (AHP) duel-trained as a musculoskeletal (MSK) sonographer. Based at NHS Greater Glasgow and Clyde, Dr Brandon has a 30-year career working in physiotherapy and ultrasound. Having led AHP acute medicine in Glasgow during the pandemic, Dr Brandon tells us how a ‘one stop’ clinic has helped waiting times, how valuable being a BSR member has been and why all AHPs should get involved with the society.
How has rheumatology changed over your career?
Going back 31 years, rheumatology was rehabilitation-orientated. There were limited medications, no biologics and we saw lots of deformities. We spent our time making splints, casting, and resting patients. Care has since transformed. Our patients have busy, working lives and the physio we do is exercise therapy in sport centres or walking groups. I used to have two huge walking aid storage cupboards; now I rarely use walking aids at all.
As an MSK sonographer, what do you love about ultrasound?
We’ve been fortunate in our scientific community to have biologics, but ultrasound has been a mainstay in supporting us. We can deliver ultrasound anywhere, in the patient's home, in clinic or on the wards. It’s helped to evaluate disease activity and manage the patient and has been a major success in rheumatology care.
How did your work change during the pandemic?
In the first wave, I found myself chief AHP for acute medicine in Glasgow. At the same time, I was co-opted into a Nightingale hospital, the Louisa Jordan, located in the Scottish Exhibition and Conference Centre. I worked on mobilising the AHP workforce into acute critical care.
That meant bringing in AHPs from different backgrounds, including rheumatology, to come and work in critical care and high dependency units. In parallel, I was responsible for being part of the senior executive team at the Nightingale, leading on workforce deployment training and operational aspects.
How has this affected rheumatology?
During the pandemic we’ve been able to set up a ‘one stop’ clinic for rheumatology in the Nightingale. We’ve been able to give 50 patients a day hands-on care. We do an assessment, a plan, ultrasound, injections, physio, occupational therapy and an exercise programme, all in a COVID-19-free environment.
This has meant we’ve kept on top of our waiting times. Our nurses have been manning our advice line. We had two rheumatologists who gave us input, but essentially the rheumatology care has been managed by our nurses and AHP team. We did well to manage our patients both remotely and hands-on.
You've been instrumental in Glasgow's vaccine programme: tell us more?
We’ve used our Nightingale hospital as our largest vaccination centre. We had people who had never picked up a needle before, so it’s been a case of upskilling everyone through the training modules.
We have four acute hospitals in Glasgow, so we’ve also been doing in-patient vaccinations as well. So far, we’ve vaccinated over 5,000 in-patients – this includes people who are in hospital with long-term injuries who would’ve otherwise been missed. There have been blips during the pandemic, but we’ve supported each other through it. We have an amazing group of staff who’ve worked incredibly hard and made me so proud.
What have you gained from being a member of BSR?
I’ve been a member since the early '90s. The society has incredible UK and global networks. We’re smaller than some of the other specialties, so getting to know people and be in touch with other AHP colleagues has been phenomenal for me. You can access such a wealth of training, information and research. It’s such a valuable way to learn and share with each other.
What work have you been involved with as a member?
I’m part of the Clinical Affairs Committee, an active and dynamic group that produces guidelines and initiatives. We’ve led on the guidance for COVID-19 and vaccinations, GIRFT and ePROMs. It’s incredibly important that the nursing and AHP community is involved with this kind of work from the outset.
I’m also part of the Physiotherapy Working Group, a newly established group developing a capability framework for physiotherapists. There’s a lot of scope for specialist advanced level AHPs and I want to see an expansion of AHP consultant roles.
What would you say to someone thinking about becoming a BSR member?
Go for it! There's so much useful education, training and networking for allied health professionals. The AHP workforce is expanding: for instance, look at the first contact practitioner roles appearing in GP surgeries. These people will be seeing almost 30% of MSK conditions, so we’re going to see a growing number of AHPs in rheumatology. It’s vital they're part of BSR.
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