Throughout this report we have highlighted examples showing how uptake of our guidance has contributed to improvements in arthritis care. Improvements include the reduction in referral, assessment and treatment initiation wait times for people with inflammatory arthritis and the provision of education and support for people with all forms of arthritis.
We have also highlighted the transition to biosimilars and expanded access to high-cost biologic medicines, and the reduction in unnecessary knee arthroscopies for people with osteoarthritis. While developing this report, we have engaged with the following stakeholders to identify further implementation challenges and available support across the healthcare system:
- NHS England and NHS Improvement
- Getting It Right First Time (GIRFT) programme
- All-Party Parliamentary Group (APPG) for Axial Spondyloarthritis
- Versus Arthritis
- British Society for Rheumatology
- National Axial Spondyloarthritis Society
- Chartered Society of Physiotherapy.
Stakeholders have identified the following key priority areas:
Reducing diagnostic delays for inflammatory arthritis, particularly for axial spondyloarthritis
Improving access to psychological therapies for people with long-term physical health conditions
Improving access to physiotherapy both pre and post-surgery for people having joint replacements
Improving data collection on the diagnosis and management of osteoarthritis in primary care
We will continue to encourage implementation of our guidance and help the wider system address priority areas. To do this, we will:
- Continue to support the National Axial Spondyloarthritis Society, who work to transform the diagnosis and care of people living with axial SpA. We will support their initiatives by contributing to the development and promotion of the Aspiring to Excellence and Clinical Champions programmes.
- Continue discussions with the BestMSK Health programme, who are developing primary and community MSK Transformation toolkits. We will agree options for supporting the embedding of NICE guidance within these toolkits and to support their promotion once published.
- Continue to contribute to meetings of the APPG for Axial Spondyloarthritis. We will support them in raising awareness of, and focusing discussion on, reducing delays to diagnosis and improving services for people with axial SpA.
- Work with RightCare to support the development of MSK-related scenarios, showing optimal patient pathways, by contributing to working groups and embedding NICE guidance where available.
Our partners are also doing work in these priority areas, which is underpinned by NICE guidance. For example:
- The Adult Improving Access to Psychological Therapies (IAPT) programme has been developed to increase access to evidence-based psychological therapies within the NHS. This programme includes a focus on people with long-term conditions, and should improve access for people with arthritis.
- The First Contact Practitioners (FCP) programme involves placing physiotherapists directly into GP practices to diagnose and treat patients who come into the clinic with musculoskeletal problems.