Question to the Department of Health and Social Care:

To ask Her Majesty’s Government what action they are taking to promote early identification and referral of patients with suspected inflammatory arthritis in primary care.

The latest monthly workforce statistics published by the Health and Social Care Information Centre showed that, as of November 2015, there were 563 full time equivalent rheumatology consultants employed in NHS. This is an increase of 119 (26.8%) since May 2010. The recruitment and retention of staff is matter for local NHS services.

To help clinicians to identify the symptoms of rheumatoid arthritis (RA) and make prompt referrals to specialists, the National Institute for Health and Care Excellence (NICE) published Rheumatoid arthritis: The management of rheumatoid arthritis in adults in 2009. This best practice guideline sets out the signs and symptoms of the disease and emphasises the need for early diagnosis, with urgent referral to a specialist rheumatologist on suspicion of RA. How the guidance is adhered to is a matter for the local National Health Service. The NICE guidance is attached.

NICE quality standards (QS) are important in setting out to patients, the public, commissioners and providers what a high quality service should look like in a particular area of care. The RA QS, published in 2013, is based on the NICE clinical guideline, and one of the seven quality statements recommends that people with suspected RA are assessed in a rheumatology service within three weeks of referral. However, whilst providers and commissioners must have regard to these standards in planning and delivering services, they do not provide a comprehensive service specification and are not mandatory.

In February 2015, Public Health England, in partnership with the Department, ran a local pilot campaign to raise public awareness of the signs and symptoms of RA symptoms in Nottingham City and Hardwick Clinical Commissioning Group. The aim of the campaign was to support earlier diagnosis and thereby enable treatment to begin earlier to improve the quality of life for people with the condition. The results of the campaign are currently being evaluated.

Finally, the provision of health services in the United Kingdom is a devolved matter, and therefore RA services in Wales are a matter for the Welsh Government.