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People with inflammatory arthritis let down by health service, new report shows

Published on 22 January 2016

A man sat in a waiting roomPeople with rheumatoid and early inflammatory arthritis are being let down by the health service, a new clinical audit has shown.

The audit, led by the British Society of Rheumatology, found that many patients in England and Wales are experiencing long waiting times and delays.

A high proportion of services weren't meeting the quality standards set by the National Institute for Health and Care Excellence (NICE), including referral from a GP within 3 days, and assessment in a rheumatology service within 3 weeks of referral.

Average wait times

According to the audit:

  • only one in six patients were referred by their GP to rheumatology services within 3 days
  • a quarter of patients waited more than 3 months to be referred
  • just over a third (38%) of patients were seen in rheumatology within 3 weeks of referral, with the average waiting time being 4 weeks.

An estimated 20,000 new cases of rheumatoid arthritis are diagnosed each year. Around three quarters of these patients are of working age.

Early referral, assessment by rheumatology services and targeted treatment is vital to rapidly control disease and minimise long-term joint damage.Early referral, assessment by rheumatology services and targeted treatment is vital to control disease and minimise joint damage.

Dr Liam O’Toole, our chief executive officer, said: "The audit findings are deeply concerning. We know that early diagnosis and treatment of disease means joint damage and disability caused by inflammatory arthritis can be avoided.

"The vital evidence highlights the urgent need to improve services for patients and the need to act now so that all patients will have a better chance of getting their disease under control and enjoying pain-free lives."


The audit recommends:

  • greater training and support for healthcare professionals in primary care to raise awareness of early symptoms and signs of inflammatory arthritis and the importance of early referral and diagnosis
  • assessments by rheumatology services and providers on how to increase clinical capacity, ensuring quicker access to rheumatologists. 

The audit, the first of its kind, used data from 6,354 patients collected from 143 trusts and health boards, representing almost all NHS rheumatology providers in England and Wales. It highlights variability in quality of care across the country and between different hospital trusts.

The insight provided by the audit is already being used by some trusts that took part to reconfigure their services and to improve patient care. 

The full report and a patient and public guide to the audit are available at

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