Jonathan, we need need advice regarding services in Suffolk ( Rheumatology perhaps?) We have encountered a blip in Suffolk. Having some creative thoughts about service provision and a specialist service head. In order to maintain a two tier service- for adults primarily; 1. mild/ moderate, diagnosis and management- 2. on going review and moderate to severe patient needs. Putting together some evidence based and other documents in prep for conversation with commissioners and contract staff. Suffolk have the money via 'unmet need'- Independent funding request (IFR) so I bet they might jump at the chance for a resolution albeit another "suck it and see". With several experts in background as expert adviser and NICE CCG members and Jo Edward in the wings?....... I am looking at rheumatology departments locally, as long as they are not BSP inclined ...who see fibro cases regularly. Thoughts and comments welcome!