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In conversation with consultant rheumatologist Dr Benjamin Ellis

Broadening his professional scope to make the biggest impact on patient care is what consultant rheumatologist Dr Benjamin Ellis has been striving to do since joining the profession. With roles at NHS England and the World Health Organization, as well as charity positions under his belt, he speaks to Saša Janković about what his diverse career has taught him, his passion for supporting patients with chronic pain and his hopes for the future of rheumatology.

Are you a hiker or a mountain climber? This is the question junior doctors and medical students are often left wondering after they speak to consultant rheumatologist Dr Benjamin Ellis about the path their career might take.

‘I say there are two sorts of careers you can have: one like a hiker who has a map and a route plotted, and one like a mountain climber, where all you can see on the cliff face is the next handhold,’ he says.

‘My career has always been more like the latter – I never know what’s coming but I look for the most interesting thing and I grab it and go for it.’

This approach has seen his patient-facing clinical work complemented by a whole host of additional roles within the NHS, UK charities and even the World Health Organization.

Why a career in medicine appealed in the first place is simple: ‘It was the coming together of two things I enjoyed, which was sciences and working with people, and it is infinitely exciting to work with people who are unwell or in pain to become partners in their healthcare.’

And it was this desire to build strong partnerships that led him to specialise in rheumatology, too. ‘I’d reached the conclusion that I wanted to do an outpatient-focused specialty and have patients that I would see for many years, and relationships felt very important, which left me with a small number of specialties,’ he explains.

A serendipitous phone call from a hospital he’d previously worked at saying there was an opening in rheumatology in two weeks’ time was the deciding factor. Was he free? Absolutely.

Rheumatology and beyond

Since then, supporting patients living with chronic pain has become his passion and Dr Ellis works tirelessly to offer person-centred care and help to improve their quality of life.

‘The medicine is complex and fascinating. But supporting people who have previously been well and now have an illness and helping them to unpack it and reach a level of understanding where they can be in control of navigating the treatment choices over the long term is so important to me,’ he says.

‘There is something about the invisibility of chronic pain and the connection you can make with another person when you say, “I see you and I know that other people can’t see your pain and it’s invisible”, and then being able to support them to live more of the life they want to.’

With a strong desire to continue making a difference to as many people as possible, it wasn’t long before Dr Ellis was keen to expand his remit.

‘After two years as a rheumatology trainee I felt there was something more I wanted to do’, he says. ‘As an undergraduate I had loved courses in public health, and I heard that the then chief medical officer [for England], Liam Donaldson, was looking to recruit clinical advisors to work half the time at the Department of Health and the other half supporting the World Health Organization Patient Safety programme, which he chaired.’

Dr Ellis applied and got the role, taking a break from his clinical training to work on data analysis and develop presentations, which fostered a particularly useful and transferable skillset.

‘I learned a lot from Liam Donaldson. He taught me how to chair a meeting – a very useful skill – as well as how to bring together a working group, and management around policymaking’, he says. ‘I also wrote chapters for his annual reports, including one on chronic pain, which was actually the burgeoning of my interest in that topic and led me to do a master’s in public health, which I did in my own time at Johns Hopkins University.’

After two years in this dual role, a conversation with the medical director of the charity Arthritis Research UK – which would later become Versus Arthritis – revealed his next opportunity.

Putting his metaphorical crampons back on once again, Dr Ellis started a similar position as senior clinical policy advisor for the charity in 2010. Fitting in around the remainder of his medical training, this role opened up another avenue for him to follow his core passion of supporting people to live the life they want.

He was able to champion a public health approach to musculoskeletal health and improve the extent and quality of musculoskeletal health data. ‘I’m doing something where I am using the best of my energy and enthusiasm and making a little bit of difference’, Dr Ellis says of the role in which he remains to this day.

Cross-pollination of ideas

Broadcasting his community spirit ever wider, in 2010 Dr Ellis was a founding trustee of KeshetUK – an organisation aiming to ensure that Jewish LGBT+ people in the UK and their families are included in every aspect of Jewish life.

Now an education and training charity, which Dr Ellis chaired until 2022, KeshetUK works with schools, youth and young adult organisations, synagogues and others to champion ‘a vision of the world where no one is forced to choose between their Jewish and LGBT+ identity’.

Following on from this, at the start of 2024, Dr Ellis was named Member of the Order of the British Empire (MBE) in the New Year Honours list for services to healthcare, equality and the Jewish community.

‘It made me feel that the issues I really care about are being recognised,’ he says of the honour, ‘and that is a wonderful thing, because if the MBE opens doors and helps get more good work done, that’s great for everyone.’

Acknowledging his diverse career, Dr Ellis says he thinks it ‘absolutely makes such a difference’ for consultants to broaden their professional scope in order to extend their practice.

‘In England, very many of us have only worked in the NHS and you imagine the whole world runs like that,’ he says, ‘but I see friends in other industries and in the charity sector who think completely differently from people in the NHS, and I’ve learned a great deal from that cross-pollination.’

He adds: ‘The more experiences you have, you realise you can almost always solve things by bringing together good people and having a think, and that’s made me much more creative within the NHS.’

Maximising value

Back in the hospital, Dr Ellis spends two-and-a-half-days a week in clinic at Imperial College Healthcare NHS Trust ‘seeing a mixture of new and follow-up patients in rheumatology’. In 2022, handed over his role as head of speciality for rheumatology to take up the position of clinical director for outpatient transformation alongside his diverse set of responsibilities.

To this end, one day a week is spent working on strategies about ‘how we maximise the value of every outpatient encounter between the clinician and the outpatient’ – a particularly important task considering the immense pressure the NHS is currently under.

‘We’re looking at all our processes and procedures so that when clinicians come together with patients and carers it’s through the most seamless pathway for everyone,’ explains Dr Ellis.

Part of this includes the strengthening of the primary-secondary care interface, and it’s here, once again, that Dr Ellis looks to others for inspiration.

‘Patients we see for the first time almost always come through a referral from a primary care physician first before they see a specialist, but we know from systems in other countries that it doesn’t have to be that way,’ he says.

‘We want to support GPs to hold people in primary care without ever coming to see a specialist in the first place. We are making it easier for primary care physicians to approach us through electronic systems if they have questions about a patient’s test results, what else they should consider before referring or maybe not even referring at all.

‘We are also implementing online multidisciplinary meetings where primary care teams can discuss patients with specialists, which can improve holistic care while reducing unnecessary referrals.’

The road ahead for rheumatology

Dr Ellis says there are ‘big, big challenges’ in rheumatology despite good progress having been made in the field.

‘Although the range and effectiveness of treatments for autoimmune diseases have got much better compared even to 30 years ago, I still cannot tailor the treatment to the person, so it remains a sequential treatment path of trying one thing, then another, then the next until something – hopefully – works, and we need that to shift,’ he says.

The next hurdle he sees is the lack of treatments that can change the course of osteoarthritis. ‘While joint replacement can be very effective for those that need it, there’s a massive gap in medicines that can treat the pain of osteoarthritis and help people to enjoy a high-level quality of life,’ he says.

‘We need technologies now to be able to identify what is going on early in the course of the disease and then invent treatments that can change the outcome. Up to 50% of osteoarthritis may be preventable – so, as prevalence rises, we need a public health arthritis manifesto to tackle risk factors and prevent people getting the condition in the first place.’

And then there’s addressing the wider landscape of chronic pain. ‘There is huge prevalence of chronic pain, including back pain and conditions like fibromyalgia where the chronic pain is the condition itself,’ Dr Ellis explains. ‘We’re just beginning to unpick what some of this is, but there is still incredibly poor understanding of these conditions among the general public and clinicians. Recent research linking chronic pain to joint hypermobility and neurodiversity is fascinating, and we have so much more to learn, and, importantly, to communicate to the general public and those affected.’

How can this be achieved? ‘A frame shift within clinical provision as to how health services de-medicalise and support people with many of these chronic pain conditions, and a change in society about how we think about these conditions. Only when those two come together can we really make something happen,’ he says.

As for what the future holds for himself, Dr Ellis admits he doesn’t know what will come next – a classic answer from a clinician who has taken the uncharted mountain climbing route to their career. ‘I find that through making connections and being constantly curious about where I can contribute, something always comes up. Perhaps there’ll be somebody who reads this and says, “please come and talk”.’

Having already made an impressive contribution to rheumatology and beyond, and with a huge amount of potential in the field, not to mention his unrivalled drive to make a difference, it undoubtedly won’t be long until Dr Ellis’s next handhold comes into view and his climb will continue.