26.07.16
Referrals of arthritis patients should be treated ‘as urgently as cancer’
Just 20% of arthritis patients were referred to a rheumatology specialist within the time recommended by NICE clinical guidelines, a new report has said.
The second national audit from the British Society for Rheumatology (BSR) found that of 5,002 patients with rheumatoid and early inflammatory arthritis, just 20% were referred to a rheumatology service within three days of showing symptoms to their GP, as recommended by NICE.
Similarly, just 37% were seen by the specialist within three weeks – despite this standard being introduced in 2013 to improve arthritis treatment – and the median waiting time to see a specialist was 29 days.
Dr Jo Ledingham, clinical audit director of the report, said: “Inflammatory arthritis is a widespread medical condition with higher linked mortality rates than some cancers. But, with appropriate and quick treatment the disease and its consequences can be controlled. GPs understand the need for speed when it comes to diagnosing and referring cancer patients, yet many still don’t understand that they need to treat inflammatory arthritis with the same urgency.
“Remission is a realistic aim with modern management, allowing patients to live a longer and more fulfilling life, benefitting themselves, their families, their employers and ultimately costing the government less in benefit payments and more costly drug treatment. Rapid access to specialist services is needed, however, to facilitate this.
“I hope this report serves as a wake-up call to everybody involved in referring, diagnosing, treating and commissioning services for inflammatory arthritis – from GPs to specialists. In particular, far quicker, and more consistent referral and treatment times need to be achieved across England and Wales.”
Around 10m people in the UK have a form of arthritis. It can leave patients too severely disabled to dress themselves, and if untreated can damage vital organs such as the lungs, heart and nervous system.
It also has economic consequences, with one-third of sufferers stopping working within two years of onset at an estimated cost of almost £2bn a year.
The audit also found that less than 70% of patients received medication to help manage their condition within the recommended six weeks, and 67% were offered education on managing the condition within a month. However, despite the shortcomings, 95% of patients said that they had had a good experience of care overall.
The report also found considerable variations by region in how well care was provided. For example, in Wales, 46% of patients received a referral within three days, but this number fell to just 23% in the north of England, 19% in London and the south, and 14% in the Midlands and east.
The report recommended that providers review the adequacy of their provision of specialist nursing, after finding that patients were significantly more likely to meet the targeted time for being prescribed medication in trusts with higher ratios of nurses to patients.
Nursing shortages is an area of increasing concern, with the NHS facing clinical staffing shortages of 50,000 people and professional bodies warning that the government’s decision to abolish nursing bursaries could make the problem worse.
Dr Liam O'Toole, chief executive officer at the charity Arthritis Research UK, added: “We urge that immediate action is taken to improve access to these services, so that people with inflammatory arthritis get the treatment they need and the quality of life they deserve.”
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