• Joanna M Ledingham, Neil Snowden, Ali Rivett, James Galloway, Zoe Ide, Jill Firth, Elizabeth MacPhie, Ngianga Kandala, Elaine M Dennison, and Ian Rowe.
• Rheumatology Department, Portsmouth Hospitals NHS Trust, Portsmouth Jo.ledingham@porthosp.mhs.uk.
• Rheumatology (Oxford). 2017 Feb 1; 56 (2): 223-230.

ObjectivesA national audit was performed assessing the early management of suspected inflammatory arthritis by English and Welsh rheumatology units. The aim of this audit was to measure the performance of rheumatology services against National Institute for Health and Care Excellence (NICE) quality standards (QSs) for the management of early inflammatory arthritis benchmarked to regional and national comparators for the first time in the UK.MethodsAll individuals >16 years of age presenting to rheumatology services in England and Wales with suspected new-onset inflammatory arthritis were included in the audit. Information was collected against six NICE QSs that pertain to early inflammatory arthritis management.ResultsWe present national data for the 6354 patients recruited from 1 February 2014 to 31 January 2015; 97% of trusts and health boards in England and Wales participated in this audit. Only 17% of patients were referred by their general practitioner within 3 days of first presentation. Specialist rheumatology assessment occurred within 3 weeks of referral in 38% of patients. The target of DMARD initiation within 6 weeks of referral was achieved in 53% of RA patients; 36% were treated with combination DMARDs and 82% with steroids within the first 3 months of specialist care. Fifty-nine per cent of patients received structured education on their arthritis within 1 month of diagnosis. In total, 91% of patients had a treatment target set; the agreed target was achieved within 3 months of specialist review in only 27% of patients. Access to urgent advice via a telephone helpline was reported to be available in 96% of trusts.ConclusionThe audit has highlighted gaps between NICE standards and delivery of care, as well as substantial geographic variability.© The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

47 keywords...

hide…