The below Parliamentary question was asked by David Amess on 2016-03-14.
To ask the Secretary of State for Health, with reference to the findings of the First Annual Report of the National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis, published on 22 January 2016, on the proportion of patients in England and Wales referred within three working days of their GP appointment, what steps he is taking to improve the referral rate from GPs when inflammatory arthritis is suspected.
Jane Ellison
National Clinical Audits are commissioned and managed on behalf of NHS England by the Healthcare Quality Improvement Partnership (HQIP). Audits help drive improvement by providing local trusts with individual benchmarked reports on their performance against a range of measures, feeding back comparative findings to help participants identify necessary improvements for patients
The first annual report of the national clinical audit of rheumatoid and early inflammatory arthritis was published on 22 January 2016. The report identifies that although most services offer prompt educational support and agree targets for treatment with their patients, performance against criteria for referral and assessment could be improved. Since the audit, HQIP has reported that a number of trusts have successfully reconfigured their services in order to improve patient care. More information can be found at the following link:
www.hqip.org.uk/national-programmes/a-z-of-nca/arthritis-rheumatoid-and-early-inflammatory
To help clinicians to identify the symptoms of rheumatoid arthritis (RA) and make prompt referrals to specialists, the National Institute for Health and Care Excellence (NICE) published Rheumatoid arthritis: The management of rheumatoid arthritis in adults, in 2009. This best practice guideline sets out the signs and symptoms of the disease and emphasises the need for early diagnosis with urgent referral to a specialist rheumatologist on suspicion of RA. For those diagnosed with the condition, the guidance also recommends they should be offered the opportunity to take part in educational activities, including self-management programmes.
The NICE RA quality standard (QS), published in 2013, is based on the NICE guideline, and one of the seven quality statements recommends that people with suspected RA are assessed in a rheumatology service within three weeks of referral. However, whilst providers and commissioners must have regard to these standards in planning and delivering services, they do not provide a comprehensive service specification and are not mandatory.
Regarding the establishment of early arthritis clinics, the configuration of services, including decisions to such arthritis clinics, is a matter for the local National Health Service.
The latest monthly workforce statistics published by the Health and Social Care Information Centre showed that, as of November 2015, there were 563 full time equivalent rheumatology consultants employed in the NHS. This is an increase of 119 (26.8%) since May 2010. The recruitment and retention of staff is matter for local NHS services.
