20 January 2021
Latest figures released from the National Early Inflammatory Arthritis Audit reveal significant improvements in referral and treatment times.
The audit, with Year 2 data published last week, is the largest and most comprehensive arthritis study. It aims to improve patient care and treatment and has collected data from over 13,500 patients, with 96% of trusts in England and Wales participating.
View report
A word from the audit's Clinical Director, Dr Jo Ledingham
She says: “The fact that we were able to recruit over 13,500 patients in Year 2 confirms the high level of engagement from the rheumatology community right up until the first wave of the COVID-19 pandemic took hold.
“The audit shows significant improvements in all of the first three NICE quality standards assessing timelines to treatment. We’ve fully achieved our targets in the audit’s quality improvement plan. The audit shows that getting treatment within NICE-recommended timelines associates with good clinical response after 12 months of care, so it’s encouraging to see substantial improvements in these timelines. In many circumstances, it’s due to the implementation of successful new care pathways.
“In a real-life setting, it’s worth noting the significant and progressive improvements over time in all the patient-reported outcomes collected through the audit, including reduction in levels of anxiety and depression, and in work impacts. Disease remission is achieved for 52% of patients by 12 months.
“While there is certainly still room for improvement, the audit is showing important and significant improvements in care quality and the positive impact of rheumatology services on disease activity and on outcomes of importance to patients."
Dr Ledingham continues: “We have to acknowledge that the COVID-19 pandemic will have set services back, but we hope the improvements evidenced in Year 2 of the audit can help lift and inspire rheumatology service providers once care starts getting back to the new normal.
“It’s not mandatory to input into the audit at the moment, but we’re keen to measure the impact of COVID on rheumatology services and the audit is a major mechanism for doing this. Wherever possible, we're keen to encourage colleagues to enter data. We’ve made changes to the website to allow data capture from remote consultations, given these are likely to remain in place into the longer-term.”
Key takeaways
- 47% of patients met the three-day NICE quality standard for referral from their GP, up from 41% in the first year of the audit
- 10% increase in the number of patients being seen by a rheumatology service within the 15-working day/three-week guideline (48% compared to 38% in year 1).
- Average time from referral to being seen was 16 working days, a reduction from 28 working days
- Significant improvements in patients starting treatment promptly (64% beginning treatment within six weeks of referral, compared to 54% in the previous year of the audit)
Other key findings from the data include:
- Early arthritis clinics are available in 77% of departments; an expansion compared to the previous year
- The vast majority of patients received disease education and self-management support, but there is ongoing variability in clinician and patient-reported experience
- Access to allied health professionals remains incomplete, especially for mental health services (only available in 38% of Trusts and Health Boards)
- Newly-diagnosed patients receive on average six appointments in the first 12 months from diagnosis, revealing Trusts and Health Boards are widely engaging with treat-to-target strategies
- Delays in specialist review were much greater for patients with a diagnosis of axial spondyloarthritis.
We're very proud of the contribution of patients to this audit. This was recognised by HQIP with the audit receiving the Richard O’Driscoll Memorial Award for outstanding patient and public involvement in 2020, having been commended in 2019.
The data collection period, which began on 8 May 2019, was curtailed by approximately six weeks from the planned 12 months due to the COVID-19 pandemic.