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Patients with early inflammatory arthritis must be referred more quickly, says report

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Delays in NHS treatment mean that up to a million people with rheumatoid and early inflammatory arthritis are at risk of preventable, long-term disability and reduced life expectancy.

That´s according to a clinical audit by the British Society for Rheumatology which revealed that across England and Wales just one in five patients (20%) who see a GP with suspected rheumatoid and early inflammatory arthritis are referred to specialist services within three days, as recommended by the National Institute for Health and Care Excellence (NICE).

Fewer than half of patients who are referred are seen by a specialist within the three-week time limit recommended by NICE. For some health providers, a quarter of their patients have to wait more than 20 weeks.

Early referral, assessment by rheumatology specialists and targeted treatment are essential to rapidly control the disease and minimise long-term joint damage.

A shortage of rheumatology specialists needed to diagnose and treat the disease is one of the reasons for the delays in accessing services.

The report also highlights a lack of awareness of the symptoms of inflammatory arthritis and of the need for quick referral amongst GPs.

Commenting on the findings, clinical audit director Dr Jo Ledingham 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, benefiting 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.”