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We love hearing about what Trusts and Boards have done to improve their services. In the current NEIA Audit, Southport and Ormskirk has consistently been amongst the top ten performers for NICE Quality Statement 2, a huge difference from its performance just three years ago.

We spoke to Dr Ashar E Ahmed, the Clinical Director of Medicine at Southport and Ormskirk Hospital NHS Trust, to find out how its service has improved since being identified as an outlier in the 2015-2016 National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis.

Dr Ashar E Ahmed, Southport & Ormskirk Hospital

During the 2015-16 audit, we were identified as an outlier Trust with ‘alarm’ status. This led to a review of our service.

What did we do?

We designed an early arthritis referral proforma for GPs based on models similar to other neighbouring Trusts who did well in the audit. This was disseminated to all primary care providers in our catchment.

Referral pathways

We also set up a dedicated weekly clinic for patients referred via the ‘suspected early arthritis’ pathway. We were really helped by the electronic referral system, which the Trust introduced as part of a national initiative. Within this system we introduced a dedicated Referral Assessment Service where triage is done by rheumatology consultants with direct access to book appointments in the early arthritis clinic.

Faxing took too long!

The previous system of triaging faxed referrals and then waiting for patient access to arrange appointments wasted valuable days. Now, rheumatology consultants actively monitor the referrals on the e-system. If any patients are identified as being likely to breach the 21 days referral-to-appointment window, this is rapidly escalated to operational service managers who are mandated to arrange appointments even if this means setting up an extra clinic (such as a waiting list initiative).

Audit results are improved

This system has worked well. Our patients’ care as well as audit results have greatly improved as a direct result of the NEIAA. We are now consistently amongst the top ten performers for Quality Statement 2 (2nd quarter running) for the current audit and this has boosted staff morale immensely. We shall not rest on our laurels and will continue to try our best to achieve excellent results for our patients.

Looking to improve your own service? Find supporting materials such as driver diagrams and clinic prompts to help support units on the audit webpage.