new models of care for musculoskeletal triage pathways (using telephone based systems) (MSK) conditions to facilitate the for musculoskeletal presentations may potentially of patients with potential inadvertently lead to delays in the assessment of inflammatory joint disease. Regular auditing those with early RA. of time to specialist assessment should be undertaken to ensure no retrograde steps , Section 4.2.4 occur in time to treatment. 4. Rheumatology departments should intensive management of those with newly Quality Ambition: National / NHS provide rapid access or urgent diagnosed RA results in superior outcomes and is Effective care Board appointments for people with possible RA cost neutral in the short term. within 4 weeks of referral. , Section 4.2.2 5. Patients referred to rheumatology with a Rheumatoid arthritis is a multi-system disease Quality Ambition: NHS Board possible diagnosis of inflammatory arthritis that requires experience and expertise to Effective care should be seen by a rheumatology diagnose. There are no absolute diagnostic tests consultant on the specialist register, or a for RA - RA is a clinical diagnosis made on the doctor with experience and expertise in the basis of a number of findings. This requires assessment and management of RA but considerable clinical expertise. under the overall supervision and responsibility of a consultant , Section 4.3 rheumatologist. 6. Assessment tools should be applied from A number of scoring systems exist to quantify the Quality Ambition: NHS Board the outset to enable monitoring of progress degree of active RA disease at time of diagnosis. Effective care and treatment to target. Examples of The most commonly used is the DAS-28. It is not
new models of care for musculoskeletal (MSK) conditions to facilitate the of patients with potential inflammatory joint disease. Regular auditing of time to specialist assessment should be undertaken to ensure no retrograde steps occur in time to treatment. triage pathways (using telephone based systems) for musculoskeletal presentations may potentially inadvertently lead to delays in the assessment of those with early RA. , Section 4.2.4 4. Rheumatology departments should provide rapid access or urgent appointments for people with possible RA within 4 weeks of referral. intensive management of those with newly diagnosed RA results in superior outcomes and is cost neutral in the short term. , Section 4.2.2 Quality Ambition: Effective care National / NHS Board 5. Patients referred to rheumatology with a possible diagnosis of inflammatory arthritis should be seen by a rheumatology consultant on the specialist register, or a doctor with experience and expertise in the assessment and management of RA but under the overall supervision and responsibility of a consultant rheumatologist. Rheumatoid arthritis is a multi-system disease that requires experience and expertise to diagnose. There are no absolute diagnostic tests for RA - RA is a clinical diagnosis made on the basis of a number of findings. This requires considerable clinical expertise. , Section 4.3 Quality Ambition: Effective care NHS Board 6. Assessment tools should be applied from the outset to enable monitoring of progress and treatment to target. Examples of A number of scoring systems exist to quantify the degree of active RA disease at time of diagnosis. The most commonly used is the DAS-28. It is not Quality Ambition: Effective care NHS Board
2012_09_12-PART-A_RA-HCNA_EXECUTIVE-SUMMARY-es1.docx