Appendix 1: Summary Table of Recommendations Recommendation Rationale & report reference NHSScotland Suggested Quality Strategy level for Quality Ambition implementation addressed 1. Public awareness of rheumatoid arthritis Early treatment of RA improves outcomes. Quality Ambition: National should be raised in order to limit the delay However, Scottish audit data shows that Effective care in patients presenting to their General considerable delays occur in the diagnosis of RA. Practitioner (GP). The greatest delay in diagnosis occurs during the time between symptom onset and the patient’s first presentation to their GP. , Section 4.2.2 & 4.2.3 2. Referral guidelines with referral treatment of RA improves outcomes but audit Quality Ambition: National / NHS routes should be agreed with GPs, data shows that considerable delay occurs in the Effective care Board encouraging urgent referral of patients with referral of patients from primary care to secondary possible RA to a rheumatology specialist, care for specialist rheumatology assessment. ideally within 2 weeks of the patient The initial presentation of early RA can be presenting to primary care, in order to variable, making diagnosis difficult and GP facilitate treatment commencing within 12 awareness of referral guidelines may be poor. weeks of onset of symptoms. Clear signposting is required. , Section 4.2.4 3. Protocols should be developed for Concern was expressed during the corporate Quality Ambition: National / NHS assessment that the recent development of new Safe, Effective care Board physiotherapy triage services and other
Appendix 1: Summary Table of Recommendations Recommendation Rationale & report reference NHSScotland Quality Strategy Quality Ambition addressed Suggested level for implementation 1. Public awareness of rheumatoid arthritis should be raised in order to limit the delay in patients presenting to their General Practitioner (GP). Early treatment of RA improves outcomes. However, Scottish audit data shows that considerable delays occur in the diagnosis of RA. The greatest delay in diagnosis occurs during the time between symptom onset and the patient’s first presentation to their GP. , Section 4.2.2 & 4.2.3 Quality Ambition: Effective care National 2. Referral guidelines with referral routes should be agreed with GPs, encouraging urgent referral of patients with possible RA to a rheumatology specialist, ideally within 2 weeks of the patient presenting to primary care, in order to facilitate treatment commencing within 12 weeks of onset of symptoms. treatment of RA improves outcomes but audit data shows that considerable delay occurs in the referral of patients from primary care to secondary care for specialist rheumatology assessment. The initial presentation of early RA can be variable, making diagnosis difficult and GP awareness of referral guidelines may be poor. Clear signposting is required. , Section 4.2.4 Quality Ambition: Effective care National / NHS Board 3. Protocols should be developed for physiotherapy triage services and other Concern was expressed during the corporate assessment that the recent development of new Quality Ambition: Safe, Effective care National / NHS Board
2012_09_12-PART-A_RA-HCNA_EXECUTIVE-SUMMARY-es1.docx