Early inflammatory arthritis patients waiting too long for specialist support

Published: 11 Oct 2019

A new report reveals that patients with suspected early inflammatory arthritis are waiting too long to see a specialist.

The National Early Inflammatory Arthritis Audit, conducted by the British Society for Rheumatology (BSR), is the largest and most comprehensive study into the condition. It aims to improve patient care and treatment and has recorded the data of over 20,600 patients with 98% of trusts and health boards in England and Wales participating.

Data is measured against NICE’s quality standards. These highlight key areas to help services improve, such as prompt referral from a GP, seeing a specialist within three weeks and getting treatment.

The report reveals that only 41% of patients met the 3-day standard for referral from their GP and only 38% referred to a rheumatology unit were seen within the 3-week guidelines. The average wait for the first appointment was 28 days.

Ali Rivett, Chief Executive of the British Society for Rheumatology, said: “A prompt diagnosis of early inflammatory arthritis can make the difference between developing life-long disabilities or actually going into remission.

“As the leading organisation representing rheumatology professionals throughout the UK, we know how hard they are working to meet the needs of the growing number of people who need their help. However, we recognise that more needs to be done so that all units reach the standards.” 

BSR said many reasons are causing these issues, but that a shortage of staff was a factor.

Ali adds: “There’s no doubt that staff shortages are part of the problem and contributing to longer waiting times. The NHS simply doesn’t have enough rheumatology staff and some units are stretched.”

On a positive note, BSR says the audit helps to show the true impact of early inflammatory arthritis on people’s lives and the importance of prompt treatment; patients who accessed appropriate treatment within three months were much more likely to get back to work and less likely to be depressed and anxious.

The audit data also shows considerable variation across England and Wales and identifies 51 trusts or health boards performing less well than the rest. These ‘outliers’ are being encouraged to use their data to lobby for additional resources as well as to look at how processes can be improved.

Ali explains: “Our audit plays a vital role in identifying where the problems are. It’s not just about resources but also units making better use of the resources they have. Reconfiguring services and sharing learning amongst units can make a real difference.”

The report shows that there many good examples across England and Wales where units are performing well, and regional champions have been set up to help others learn from their good practice.

Ali says: “Although things won’t change overnight there are improvements being made so that all units can reach the standards. Doing this audit really raises awareness of the condition, gets it on people’s radars and encourages trusts to strive for more. We’ll be working hard with the rheumatology community in the coming months and have developed a Quality Improvement Plan to drive real change across the UK.”

For more information, visit www.rheumatology.org.uk/neia-audit