GPs back bid to speed up rheumatoid arthritis diagnoses

Plans to pay hospitals to accelerate the diagnosis of rheumatoid arthritis following a GP referral have been welcomed by the profession as a key step forward.

Dr Louise Warburton: disappointed with delays in arthritis treatment (Photo: NTI)
Dr Louise Warburton: disappointed with delays in arthritis treatment (Photo: NTI)

From April, three new best practice tariffs for early inflammatory arthritis will pay hospitals more if they promptly diagnose and treat patients with new-onset disease.

At present, delays in hospital care mean just 10% of patients begin treatment within three months of GP referral, the target recommended by NICE.

A senior rheumatology GP welcomed the news, while an arthritis charity called on CCGs to make sure hospitals meet the new targets.

NICE guidance advises that patients should begin treatment within three months of initial onset of inflammatory arthritis symptoms. A National Audit Office report published in 2009 found wide variation in treatment times and outcomes across the UK.

From April, adult patients with new-onset inflammatory arthritis should be seen by a rheumatologist within three weeks of GP referral. Patients should then receive a diagnosis and begin treatment within six weeks of referral, and have regular reviews with a specialist until the disease is controlled.

The tariffs were developed in line with NICE guidance by the DH, the British Society for Rheumatology and charity Arthritis UK.

The DH also called on GPs to continue referring patients with suspected early inflammatory arthritis within a maximum of six weeks of onset.

'Important development'
Shropshire GPSI Dr Louise Warburton, former president of the Primary Care Rheumatology Society, said she had been 'very disappointed' with past delays in treatment.


But she said the tariffs were an 'important development'. She added: 'Uncontrolled rheumatoid arthritis is a destructive disease producing life-long impairment, pain and suffering for patients. It is imperative that DMARDs are started as early as possible to minimise joint damage.'

Dr Chris Deighton, president of the British Society for Rheumatology, said: 'This is an exciting opportunity to further embed the principles of improving clinical outcomes within the recommended time frames for treatments including DMARD therapy and biologics.'

Dr Benjamin Ellis, senior clinical policy advisor at Arthritis Research UK, called on every CCG to implement the tariffs 'to ensure hospitals provide the early, intense treatment needed to prevent permanent pain and disability for thousands of people'.

Rheumatoid arthritis affects around 400,000 people in the UK.

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