relevant information.There is also functionality for the rheumatology team to reply to the referral with advice, which creates a new permanent document in the patient's EPR.The Orthopaedic team, who are the first point of call for hot joints in our Trust, were consulted to ensure that there were not any unintended consequences as a result of this change.The form included the following sentence to avoid delays in patient care for septic arthritis: 'patients with suspected septic arthritis should be referred to Orthopaedics by ringing the on-call registrar'. Conclusion:The current method of paper rheumatology referrals was inefficient and referrals often lacked vital information.The new electronic system will ensure relevant items are included in the referral and that there is a clear audit trail of the referral process.Referrals will be reevaluated again in three months to assess the impact of this change on outcomes including time to rheumatology review and inpatient bed stay.In the second round of this project we plan to include an education component onto the rheumatology referral form.For example, if gout is suspected, the referrer will be linked to guidelines and patient information sheets to assist best management whilst awaiting review.We would encourage others to consider their referral systems-could you improve yours?