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Specialist nurses helping ‘transform’ rheumatology care

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Higher numbers of specialist nurses mean rheumatology patients are more likely to receive care in line with standards set by the National Institute for Health and Care Excellence, says a senior nurse.

Specialist nursing staff are significantly associated with patients receiving better pain control by starting combination disease modifying drugs within six weeks, as recommended by NICE.

“Investment in additional specialist staff delivers improved outcomes for patients”

Jill Firth

Dr Jill Firth, consultant nurse in rheumatalogy and president of the British Health Professionals in Rheumatology, noted that better access to multi-disciplinary teams, including nurses, had improved outcomes for patients with musculoskeletal conditions over the past 20 years.

She said data emerging from the second year of the National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis provided “further evidence” of the importance of the team approach.

The audit, which is in its second year, measures progress on achieving the 2013 NICE quality standards for the management of rheumatoid arthritis and other musculoskeletal conditions.

In year one of the audit, it was revealed that higher numbers of consultants were associated with shorter waiting times to first appointment, facilitating early diagnosis and rapid access to care.

Dr Firth said: “This year we have undertaken additional analyses which demonstrate that higher numbers of specialist nurses are significantly associated with patients starting combination disease modifying drugs within six weeks – NICE Quality standard 3.

“Early access to combination treatment is crucial to improve pain, maintain function, aid work retention, and protect joints from irreversible damage in early disease,” she noted in a blog published by NHS England.

She said the second year of the audit also found higher specialist nursing numbers were associated with the prescription of short-term glucocorticoids, which are used to “bridge the gap” while slow acting disease modifying drugs have “chance to work”.

“Nurse-led clinics facilitate treating to target and this data builds on existing evidence from randomised controlled trials demonstrating that specialist nurses provide high quality, cost-effective care for patients with inflammatory arthritis,” said Dr Firth.

She noted that it was “encouraging that we are starting to see successful business cases for additional consultant and specialist nurse staffing” as a result of the audit findings.

NHS England

Specialist nurses helping ‘transform’ rheumatology care

Jill Firth

“Investment in additional specialist staff delivers improved outcomes for patients and has the potential to reduce the long term costs to the NHS and wider health economy,” said Dr Firth.

However, she highlighted that the audit also revealed “many gaps in in access” to multi-disciplinary teams, especially for specialist physiotherapy, specialist occupational therapy and specialist podiatry.

“The added value of specialist nurses and allied health professionals working in rheumatology has long been recognised by our medical colleagues, primary care teams, patients and carers, but we need to ensure that service managers and commissioners fully appreciate our worth to drive improvements in care,” she stated.

Dr Firth highlighted that the British Society for Rheumatology was promoting a webinar – titled Coordinating a person-centred pathway to high quality care for people with rare autoimmune disorders – as part of the MSK Network Series of webinars on 30 September, 12.00-13.00pm.

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