Shaping the Rheumatology Service in Scotland Scottish Quality Registry (ScotQR) for Rheumatoid Arthritis

Published: 11 Oct 2019

People with RA will be interested to know about a new initiative very soon to be trialled in two areas of Scotland, NHS Greater Glasgow and Clyde and NHS Lanarkshire.

We announced its launch earlier in the year but, due to some technical problems, things have been delayed by a few months. Happily, all is now ready to go ahead! The project is being organised by Healthcare Improvement Scotland with the help of a grant from the Health Foundation. Throughout planning and implementation people with RA have been involved.

The system, inspired by arrangements used successfully in Sweden for some time, is designed to offer and strengthen patient-centred care, to make a reality of the doctor-patient partnership and shared decision-making, to support informed self-management and to promote continuity of care through symptom-tracking and measurement of outcomes.

The focus of the consultation in clinic will be an online tool or ‘dashboard’ which will combine patient-reported wellbeing outcomes with validated clinical information. Patient and clinician will use this as the basis and framework for their conversation, matters raised and shared decisions will be logged, as well as printed out for the patient to retain.  In a fully operational system this resource would be available to patients between routine appointments as a means of recording information and two-way communication; the pilot, being time-limited will not yet include this.

The pilot programme will run for four months from October 2019. Participants at the two pilot sites – both members of the clinical team and patients – will be asked for feedback. The testing of the ScotQR is designed to inform the construction and evaluation of a business case for the further roll out of the registry approach across Scotland within rheumatology as well as possible extension to other specialties.

The benefits to be gained from a quality registry approach – better communication, smoother continuity of care, more timely interventions when required, stronger patient voice both in individual care and in pathway redesign, availability of useful data and, above all, better outcomes (in Sweden a 50% reduction in the effects of disease has been claimed among people with RA) make this an exciting initiative. If you live in one of the pilot sites you will probably have received information already – or will be given all you need ahead of participation. Elsewhere, we will keep you in the picture in the hope that this scheme will be available to us all in Scotland in the near – or at least the foreseeable - future.