Rheumatology

Aim

To adopt a chronic disease model of care, to facilitate “the right person, right place, first time” approach to the patient with rheumatic disease

Quality

  • To reduce mortality associated with rheumatic diseases
  • To improve both short-term and long-term outcome measures (e.g. Disease activity scores) in patients with rheumatic diseases
  • To reduce physical/mental/vocational disability related to rheumatic diseases

Access

Primary care team:

  • Full national roll out of primary care teams and appropriate clinical infrastructure.
  • To reduce overall the numbers of patients referred to rheumatology OPDs by encouraging management in primary care as appropriate

Secondary Care

  • To reduce waiting lists for all rheumatology referrals to < 6 months within 1 year
  • To reduce waiting lists for all rheumatology referrals to < 3 months within 2 years
  • Allow fast tracking of early inflammatory arthritis and systemic disease  in order to reduce waiting times for such urgent referrals to < 2 weeks within 1 year.

Interface between Primary care and Secondary Care

  • Develop interface clinics/consultations between primary and secondary care services.
  • To develop/agree/implement national referral guidelines for all patients with MSK disease within 1 year

Cost

  • To identify potential efficiencies and savings within the system
  • To reduce MSK-related work disability
  • By ensuring timely access to services, to reduce the impact of rheumatic disease-related joint damage (e.g. reduced requirement for joint replacement surgery)
  • By identifying and treating patients at risk for osteoporosis, to significantly reduce low-trauma fracture occurrence and consequent morbidity and mortality

Objectives/Key Solution areas

  • To reduce overall the numbers of patients referred to rheumatology OPDs by encouraging management in primary care as appropriate
  • To standardise referral  practices and guidelines
  • To reduce the waiting periods for patients referred to rheumatology OPD
  • To fast track early inflammatory arthritis and systemic disease
  • To provide access to biologic therapies to patients as indicated but in a cost-effective manner
  • To identify potential efficiencies and savings within the system