Over 1 million people in the U.K live with Inflammatory Arthritis of which almost 700, 000 adults and 12,000 children have Rheumatoid Arthritis (RA), in which the body’s immune system starts to attack healthy bones and joints; like “friendly fire”. It can lead to irreversible joint damage and disability, and have severe personal and financial impact on people’s lives, their ability to work, to be a parent and growing up as child.

In the last 15 years, we’ve seen a revolution in treatment. Greater scientific knowledge has led to new “biologic” therapies, now used when older, conventional treatment hasn’t worked. These drugs, which cost the NHS up to £10,000 per person each year, target the immune system to halt the disease. As a result of these advances, much of the pain and disability should now be potentially preventable along with the complications such as diabetes, cardiac disease and osteoporosis.  

Much of the pain and disability should now be potentially preventable

However, the key factor in the long-term outcome is how quickly people access a specialist rheumatologist. NICE has therefore developed Quality Standards for the care that the NHS should provide. One of these is that people with suspected RA are assessed in a multidisciplinary rheumatology service within 3 weeks of their GP referral.

The British Society for Rheumatology is committed to support its members to deliver best possible care. We therefore initiated and led the first ever national audit of RA, in partnership with HQIP. This has been an outstanding success. Over the last 2 years, information has been obtained about the care of over 5000 patients with suspected RA, across nearly all rheumatology units in England and Wales.

The audit has shown major variation in this care, partly explained by differences in manpower between hospitals. On average, only 37 per cent, of people with suspected RA were assessed within 3 weeks of referral. This varied from 47 per cent in London to 22 per cent in Wales. As a result of the audit, important lessons are being learnt about how to eliminate these variations in care and enable faster diagnosis and treatment. BSR is actively facilitating this dialogue between primary and secondary care clinicians, and those who commission healthcare. There is much to be done, but a tremendous potential for the audit to drive improvements in care and outcomes for people living with RA.