Kitty I am shocked and sorry at the lack of support your BIL is receiving. I too have RA but have a wonderful consultant, who has been so supportive.
Also, I have access to a rheumatology support nurse (in fact she phoned me yesterday to ask how I was faring) a physio, an OT, I attend a fatigue support group run by OTs (which has far surpassed my expectations) and when my pain became unbearable, I was referred to a pain clinic.
I too was stoical and refused to give up my job,(despite being advised to) until I became so ill, I had to retire early. Being bloody minded nearly finished me off.
Although my RA is not stable at the moment, it is not for the want of everyone pulling together to try and help. Is your BIL being too stoical and both GP and consultant are actually unaware of how very ill he is feeling? Just a thought.
It is an awful condition. I have had little sleep at all the last few nights, due to my pain levels and the chronic fatigue drags you down so much.
A Blue Badge enabled me to keep working for many more years than would have been expected and a PIP has allowed me to buy gadgets which make my life easier. I was very proud and embarrassed initially, as I had paid my way all my life, but what a difference they have been in helping me retain some measure of independence.
I am so sad at how your BIL is suffering, please urge him to re-think and consider asking for more support. Nothing ventured, nothing gained.
I found that, before seeing my GP and Consultant, if I wrote everything down in bullet points, it allowed me to focus without becoming too upset. It seemed to help get my case across. Every best wish to your BIL.