NRAS Service Reform Recommendations Endorsed by Audit Office

The National Rheumatoid Arthritis Society (NRAS) is delighted that the Public Accounts Committee (PAC) has endorsed the recommendations of the National Audit Office and their own recommendations for improvements to rheumatology services that will improve patient outcomes and make better use of public resources.

The PAC has called for Government led initiatives to improve training for GPs on rheumatoid arthritis (RA), launch a public awareness campaign about the symptoms of RA to improve chances of earlier diagnosis and direct programmes to get people with RA back into work.

The PAC report ‘Services for people with Rheumatoid Arthritis’, is the Committee’s response to the National Audit Office report of the same name, published in July 2009.

The PAC has made vital recommendations on how services for RA patients can be made more equal, supporting the conclusions of the Kings Fund report into RA services, published in January 2009 in conjunction with the Rheumatology Futures Group of which NRAS CEO Ailsa Bosworth is Joint Chair.

Evidence provided to the PAC by NRAS showed a threefold difference between the highest and lowest levels of spending by PCTs on RA services in England. The Committee has recommended that the Department of Health set national benchmarks for PCT spending and that SHAs should hold them to account for local variations. NRAS believe that this is a necessary step in providing fairer access to the best RA care for all patients.

NRAS works tirelessly to help educate and empower people with RA to help them manage their condition more effectively. They have recently partnered with the EPPCIC (Expert Patients Programme) to develop a self management programme which was successfully piloted in 3 locations in England at the end of 2008. Three further pilots will run over the next 2-3 months. NRAS were therefore delighted that the PAC has recommended that the Department of Health produce an action plan by March 2010 on improving access to flare up and pain management services for RA patients.

Responding to the PAC report today, NRAS founder and Chief Executive Ailsa Bosworth said:

“NRAS wholly support the Public Accounts Committee’s recommendations. It is vital that resources are targeted on education and awareness for patients and clinicians to ensure that patients seek help at an earlier stage when they experience symptoms and are referred rapidly to specialist care for diagnosis and commencement of treatment. Early intervention is vital to prevent the progression of RA and disability later in life so that people are able to remain in work. NRAS and the Rheumatology Futures Group look forward to working with the Department of Health to help implement the Committee’s recommendations.”

‘Services for people with Rheumatoid Arthritis’: KEY STATS

Lack of GP awareness

• NAO reports that people with RA visit a GP on average four times before being referred to a specialist.
• 18% of patients visit more than eight times before being referred.
• This costs the NHS £6 million a year in unnecessary, repeated visits.

Lack of public awareness

• The NAO identified that between half and three quarters of people with RA delay seeking medical help from their GP for three months or more following the onset of symptoms.
• A fifth of patients delay seeking help for a year.
• The NAO has identified that this could be addressed by increasing the number of people diagnosed with RA in the first three months from the current 10% to 20%.
• This increase in earlier treatment could result in productivity gains of £31 million for the economy due to reduced sick leave and lost employment.

Inefficient use of resources in musculoskeletal care

• In 2008/9 NHS expenditure on musculoskeletal conditions increased from £3.5 billion to almost £4.1 billion – an increase of over 15%. (Department of Health, Programme budgeting data 2007-08, 16 July 2009) but this did not result in improvements in outcomes.

Local variations in RA spending

• NRAS has undertaken an analysis of the level of spending on rheumatoid arthritis services in each PCT area. Spending varies from £5.68 per head in Bexley PCT to £17.58 per head in Gateshead PCT with an England average level of £10.97 per head.
• The NAO report revealed that 71% of PCTs had not carried out a local needs assessment for rheumatology services overall and 73% had not undertaken any assessment to establish the number of people with RA living in the locality.

Employment Support

• The NAO estimated that for the cost to the economy of sick leave and work-related disability for people with RA is £1.8 billion a year.
• Only 20% of those surveyed by the NAO stated that they had received sufficient information about employment issues.
• Only 12% of GPs surveyed offered people diagnosed with RA information on staying in work.
• NRAS research has shown that once on Incapacity Benefit (Employment and Support Allowance) 80% of people with musculoskeletal conditions never return to work.

For more information about NRAS and details on how to contact the NRAS volunteer network please go to www.rheumatoid.org.uk

 

Press Release Supplied With the Kind Permission of Louise Abbott, at Insight PA