National Early Inflammatory Arthritis Audit Second Annual Report 2021
Source: data.gov.uk (2024-10-11)

National Early Inflammatory Arthritis Audit (NEIAA). The purpose of the NEIAA is to improve the quality of care for people living with inflammatory arthritis by measuring care provided to patients against the seven quality statements set out in NICE quality standard 33 (2013 version). 

The audit assesses seven key metrics of care provided for people with new symptoms of arthritis attending rheumatology services for the first time:

1. How quickly do primary care health professionals refer people suspected to have inflammatory arthritis?
2. How soon after referral are people seen in secondary care? 
3. How long does it take to start treatment?
4. Do patients receive timely education about their condition? 
5. Are treatment targets set and agreed?
6. Do patients have access to emergency advice? 
7. Are annual reviews taking place?

More information can be found on the audit website (www.arthritisaudit.org.uk)

National Early
Inflammatory
Arthritis Audit
January 2021
© 2021 Healthcare Quality Improvement Partnership (HQIP)
Patient and Public Second Annual Report
(Data collection: 8 May 2019 – 7 May 2020)

2
National Early Inflammatory Arthritis Audit (NEIAA)
Key findings
3
Background
4
Who is taking part?
4
Purpose of the audit
5
Results
6
Patient demographics
6
Access to care
7
Quality of care
9
Support for self-care
9
Changes made to treatment when required
10
Access to specialist support
11
Annual reviews
11
Impact of early inflammatory arthritis
12

Patient-reported outcome (PRO) measures
12

Work status and impact
14
Additional information
15

Unplanned admissions
15

Joint replacements and mortality
15
Axial spondyloarthritis
16
What has the audit shown us so far?
16
Where does the audit go from here?
16
Further information
17
Q&A
17
Where to go for more information and help
17
Glossary
18
Acknowledgements
19
References
19
Contents

3
Patient and Public Second Annual Report
Recruitment
patients were recruited to
the audit in year two
13,578
Time to first appointment
of patients were referred
within three working days
47%
of patients referred with suspected
early inflammatory arthritis were
seen within three weeks
48%
average wait for the
first appointment
16 days
Treatment
Key findings
of all NHS rheumatology
services in England and Wales
participated
96%
16d
64%
of patients with a diagnosis of
early inflammatory arthritis
were prescribed a conventional
disease-modifying anti-rheumatic
drug (cDMARD) within six weeks
of referral
3d
of patients were given access to a
rheumatology specialist advice line
92%
of patients received disease-specific
education as reported by clinicians
94%
of patients had a treatment
target set and agreed
89%
Reported improvements
by 12 months
of people were in disease remission
12 months after diagnosis
52%
49% to 25%
of patients who were depressed or anxious at first
appointment and at 12 months
19% to 5%
reports of absenteeism at baseline and at 12 months
45% to 25%
reports of presenteeism at baseline and at 12 months

4
National Early Inflammatory Arthritis Audit (NEIAA)
Who is taking part?
The National Early Inflammatory Arthritis Audit (NEIAA) is looking in detail at what happens
to patients over 16 years of age in England and Wales with suspected early inflammatory
arthritis (EIA) when they are referred to a rheumatology service. Timelines to referral and
being seen in a specialist service are collected for all patients with suspected inflammatory
arthritis; more detailed information is collected over a 12-month period for all patients with a
confirmed rheumatoid arthritis (RA) pattern of inflammatory arthritis.
All organisations which provide NHS rheumatology services in England and Wales are required
to take part in the audit. This report includes information collected from 8 May 2019 to
7 May 2020. Data collection was non-mandatory from 27 March 2020 due to the COVID-19
pandemic, therefore, data analysed predominantly reflects activity prior to the major impact
of COVID-19.
Background
patients were recruited
to the audit in year two
13,578
of all NHS rheumatology services in
England and Wales participated
96%

5
Patient and Public Second Annual Report
Statement 1
People with suspected persistent synovitis affecting the small joints of the
hands or feet, or more than one joint, are referred to a rheumatology
service within three working days of presentation.
Statement 2
People with suspected persistent synovitis are assessed in a rheumatology
service within three weeks of referral.
Statement 3
People with newly diagnosed rheumatoid arthritis are offered conventional
disease-modifying anti-rheumatic drug (cDMARD) monotherapy within
three months of onset of persistent symptoms.
Statement 4
People with rheumatoid arthritis are offered educational and self-
management activities within one month of diagnosis.
Statement 5
People who have active rheumatoid arthritis have their C-reactive protein
(CRP) and disease activity measured monthly in specialist care until they
are in remission or have low disease activity.
Statement 6
People with rheumatoid arthritis and disease flares or possible drug-related
side effects receive advice within one working day of contacting the
rheumatology service.
Statement 7
People with rheumatoid arthritis have a comprehensive annual review that
is coordinated by the rheumatology service.
The first annual report focused on the first six quality statements. None of the patients
had been enrolled in the audit for 12 months. Findings on QS7 were not included in the first
report because data cut-off for analysis was exactly 12 months after the start of data
collection. In this report, the performance of rheumatology services is assessed against all
seven statements as information on annual reviews is now available.
The audit also assesses how inflammatory arthritis affects people’s day-to-day function,
mobility, sleep, mental health, wellbeing and ability to work.
Purpose of the audit
People who are suspected to have RA or EIA need to be referred to a rheumatology service
and treated as quickly as possible to suppress inflammation and minimise potential damage
to joints.
The audit uses the seven National Institute for Health and Care Excellence (NICE) quality
statements to assess the care provided for people with new symptoms of arthritis attending
rheumatology services for the first time (Table 1). These quality statements were updated
during the second year of the data collection and are now reduced to five statements.
This audit still focuses on the previous statements to allow direct comparison with the
first-year data.
Table 1. Standards of care

6
National Early Inflammatory Arthritis Audit (NEIAA)
Patient demographics
The audit collected information on diagnosis and patient characteristics, including gender
and smoking status, for all patients referred with suspected inflammatory arthritis.
Results
Rheumatoid arthritis was the most common diagnosis (30%) and osteoarthritis was the
second most common diagnosis (18%).
83% Non-smoker
17% Current smoker
Smoking status
65% Female
35% Male
Gender
30% Rheumatoid arthritis
18% Osteoarthritis
9%
Undifferentiated arthritis
8%
Psoriatic arthritis
4% Fibromyalgia
4% Crystal arthritis (gout)
3%
Reactive arthritis
2% Axial spondyloarthritis
1%
Connective tissue disease
1%
Mechanical back pain
19% Other
Diagnosis
84% White
7% Asian/Asian British
3% Black British/African/
Caribbean
3% Other ethnic group
2% Not known
1%
Mixed/Multiple
ethnic groups
Ethnicity

7
Patient and Public Second Annual Report
Access to care
NICE quality statement 1 states:
“People with suspected persistent synovitis (inflammation of the joint) affecting the
small joints of the hands or feet, or more than one joint, need to be referred to a
rheumatology service within three working days of presentation.”
When inflammatory arthritis is suspected, early referral is important so that a diagnosis can
be made, and treatment offered. The audit found that 47% of patients were referred within
three working days of presentation with early inflammatory arthritis symptoms, a 6%
improvement on last year’s performance. A target of 5% improvement was set in the audit’s
quality improvement plan and, therefore, was achieved.
47%
of patients were referred
within three working days
Science Photo Library

8
National Early Inflammatory Arthritis Audit (NEIAA)
NICE quality statement 2 states:
“People with suspected persistent synovitis should be assessed in a rheumatology
service within three weeks of referral.”
Access to specialist care means that treatment can be started early in anyone confirmed to
have inflammatory arthritis. This improves pain, function and quality of life, and protects
the joints from damage in the early stages of disease. The audit found that 48% of patients
referred with suspected early inflammatory arthritis were seen within three weeks, a 10%
improvement on last year’s performance, therefore meeting the 5% improvement target
set out in the audit’s quality improvement plan. The average time to first specialist
assessment was reduced dramatically over 12 months, from 28 days to 16 days. An
assessment needs to take place within 15 working days to meet this quality statement. Only
57 (1%) patients waited over six months for assessment, compared to 264 (3%) in year one.
For quality statements 3 to 7 and for clinician- and patient-reported outcomes, data are
presented just for those patients who had a confirmed diagnosis of RA pattern early
inflammatory arthritis.
48%
of patients referred
with suspected early
inflammatory
arthritis were seen
within three weeks
average wait for the first
appointment, (target is 15 days)
16d 16 days
Patients waiting over six
month for an appointment
reduced by
66%

9
Patient and Public Second Annual Report
Support for self-care
NICE quality statement 4 states:
“People with rheumatoid arthritis should be offered educational and self-management
activities within one month of diagnosis.”
For this statement, the audit asked both clinicians (members of the rheumatology specialist
team) and patients whether disease-specific education had been offered to the patient. This
service was offered by telephone, email or an app. The audit found that clinicians reported
offering this education to 94% of patients, while 81% of patients reported receiving
education by three months. The difference here suggests that sometimes clinicians may not
be signposting and/or delivering the education in a clear or detailed way. These findings are
in line with the previous year.
Quality of care
NICE quality statement 3 states:
“People with newly diagnosed rheumatoid arthritis should be offered conventional
disease-modifying anti-rheumatic drug (cDMARD) monotherapy within three months
of onset of persistent symptoms.”
There is good evidence that the early use of cDMARDs makes the greatest difference to
how well patients do in the longer term1.
Nationally, 64% of patients with a diagnosis of EIA were prescribed a cDMARD within six
weeks of referral, a 10% improvement on last year’s performance, therefore meeting the 10%
improvement target set out in the audit’s quality improvement plan.
of patients were offered disease-specific
education (clinician-reported)
94%
81%
of patients received disease-specific
education (patient-reported)
64%
of patients with a diagnosis
of early inflammatory arthritis
were prescribed a cDMARD
within six weeks of referral

10
National Early Inflammatory Arthritis Audit (NEIAA)
Changes made to treatment when required
NICE quality statement 5 states:
“People who have active rheumatoid arthritis have their C-reactive protein (CRP)
(a blood test to measure inflammation) and disease activity measured monthly in
specialist care until they are in remission or have low disease activity.”
The statement was measured by asking “Was a treatment target of low disease activity or
remission agreed with the patient?”
‘Treat-to-target’ is an approach to care that involves a goal for disease control being agreed
between patients and clinicians, disease activity being measured monthly and treatment
changed if required to improve control of their inflammatory arthritis. Agreement of
treatment targets is a good indication to demonstrate how clinicians and patients share
decision-making. ‘Treat-to-target’ in inflammatory arthritis has been shown to result in
less joint damage and improved quality of life2. The audit found that, nationally, clinicians
reported 89% of patients with confirmed EIA had a treatment target agreed, a 5%
improvement on the previous year.
89%
of patients had a treatment
target set and agreed
(clinician-reported)
Science Photo Library

11
Patient and Public Second Annual Report
Access to specialist support
NICE quality statement 6 states:
“People with rheumatoid arthritis and disease flares or possible drug-related
side effects receive advice within one working day of contacting the
rheumatology service.”
When people experience disease flares or drug-related complications, access to prompt
advice from a specialist team helps reduce the problems caused by uncontrolled
inflammatory disease and allows rapid change in treatment if needed.
Access to urgent advice via a dedicated advice line is available to a majority of newly
diagnosed EIA patients but is not available everywhere. It is possible that Trusts/Health
Boards may have developed other methods to provide advice, such as a dedicated email
address or app. Clinicians reported that 92% of patients were provided with access to
rheumatology specialist advice (e.g. a telephone advice line).
92%
of patients were given
access to rheumatology
specialist advice
Annual reviews
NICE quality statement 7 states:
“People with rheumatoid arthritis have a comprehensive annual review that is
coordinated by the rheumatology service.”
Having inflammatory arthritis increases cardiovascular risk, fracture risk and the risk of
disability. An annual review provides the opportunity to review and highlight specific risks to
the individual.
Clinicians were asked whether they conducted an annual review and whether this included
an assessment of bone health, a cardiovascular risk assessment and an assessment of
disability. The actual scores for any of these assessments were not recorded. Of those who
had returned data on annual review status, 48% had received an annual review, a 5%
improvement from year one.
48%
of patients had received
an annual review as reported
by clinicians

12
National Early Inflammatory Arthritis Audit (NEIAA)
Impact of early inflammatory arthritis
The audit has used some rheumatology ‘tools’ to show what impact early disease has
on patients’ lives and how patients respond to treatment during the first 12 months of
specialist care.
The audit used the Disease Activity Score (DAS28) to measure disease activity in RA. A score
is calculated using information on the number of tender and swollen joints, a score from the
patient about their ‘global health’ and the result of the most recent blood tests measuring
inflammation (ESR/CRP). A DAS28 score higher than 5.1 implies severe active disease activity,
lower than 3.2 implies low disease activity and lower than 2.6 implies remission.
Table 2. Disease activity measured using DAS28
Patient-reported outcome (PRO) measures
The audit asked people taking part to complete a questionnaire at the time of their first
appointment, at three months and 12 months. The questionnaire asks patients about how
their condition is affecting them physically and mentally. The findings below cover data from
years one and two combined. Although supply of data from patients has been good, the
absolute numbers are relatively low, and this is why data on patient outcomes from both
years are included.
PROs were available for 4,996 at baseline, 2,482 at three months and 858 at 12 months.
At the first appointment, patients reported a high impact of the disease, with significant
levels of functional and work impairment, depression and anxiety. Over the first 12 months
of treatment, the audit saw improvement across all the areas assessed on the questionnaires.
of patients with early
inflammatory arthritis
were in remission
52%
At 12 months,
DAS28 score
Disease activity
< 2.6
Remission
2.6 – 3.2
Low disease activity
3.2 – 5.1
Moderate disease activity
> 5.1
Severe active disease activity

13
Patient and Public Second Annual Report
PRO data collected:
Musculoskeletal Health Questionnaire (MSK-HQ)
This is a 15-item questionnaire that measures overall health. Scores range from 0 to 56, with
higher scores meaning better musculoskeletal health. A clinically meaningful improvement is
when the patient’s score improves by six points or more.
Health Assessment Questionnaire (HAQ)
10 questions have been developed to measure how well people can function and perform
day-to-day tasks. Scores range from 0 to 3, with lower scores indicating better ability to
perform tasks. A clinically meaningful improvement is when the patient’s score reduces by
at least 0.22.
Mental Health (PHQ4ADS)
These are the two questionnaires recommended for use in the NHS to identify people who are
likely to have significant low mood or anxiety3,4. Each measure contains two items, with a
score from 0 to 6. The score is combined, and a lower score indicates a lower likelihood that
the person completing them has low mood or anxiety. A clinically meaningful improvement is
when the patient’s score reduces by four points.
of patients with confirmed early
inflammatory arthritis met the
criteria for a probable low mood
or anxiety at diagnosis
49%
Musculoskeletal health scores improved from
25.5
37.2
34.8
at the first
appointment
at three
months
at 12
months
The ability to perform tasks improved from
1.1
0.7
0.8
at the first
appointment
at three
months
at 12
months
This reduced to
30%
25%
of patients at
three month
follow-up
at the 12-month
follow-up

14
National Early Inflammatory Arthritis Audit (NEIAA)
Work status and impact
EIA often affects people of working age. The audit collected information about the effect
the disease has on people’s working lives using the Work Productivity and Activity Index
(WPAI). This measures reduced work attendance (absenteeism), and impact on work
performance (presenteeism).
People with higher levels of absenteeism are more likely to lose their job or have to give up
work5. Not being able to work can have several negative effects including reduced financial
security, worsening of physical health, and loss of self-esteem6. Information on a patient’s
ability to work is a crucial measure of the impact of inflammatory arthritis.
Measurement of the impact and offering emotional support as soon as possible is essential
to help people remain in the workforce.
In this audit, patients initially reported high levels of absenteeism (19%) and presenteeism
(44%). Absenteeism had reduced to 9% at three months and 4% at 12 months and
presenteeism had also decreased, to 33% at three months and 27% at 12 months. Overall
impairment had reduced from 32.3% to 26.3% at three months and 24.1% at 12 months.
Absenteeism
went from
19%
5%
9%
at baseline
at three months
at 12 months
32%
26%
at baseline
at three months
Presenteeism
went from
45%
25%
32%
at baseline
at three months
at 12 months
Overall impairment
had reduced from
24%
at 12 months

15
Patient and Public Second Annual Report
Additional information
Information was available on some additional outcomes using linkages to the national
information partners NHS Digital and NHS Wales Informatics Service (NWIS). This was
applied for all patients with a confirmed diagnosis of EIA recruited to the audit since May
2018 with a valid NHS number.
Unplanned admissions
Unplanned admissions refer to when a patient is admitted to hospital for any reason other
than elective or planned-for care and includes people being admitted via the emergency
department. Unplanned admissions are an increasing problem for the NHS and can also be
distressing for patients and their families. The audit found that the annual unplanned
admission rate was approximately 1 in 8 patients, which is in line with the previous findings of
1 in 7 unplanned hospital admissions within two years of diagnosis. The audit is not able to
separate out any admissions directly linked to EIA and its treatment.
Joint replacements and mortality
It is known from previous research that patients with inflammatory arthritis are more likely
to require joint replacement surgery and have a reduced life expectancy than the general
population7. The audit measured how many patients require joint replacement surgery and
mortality rates after a diagnosis of EIA. The audit found that 85 out of 12,185 people recruited
to the audit since it started in May 2018 had a joint replacement and 108 deaths occurred.
Again, the audit is not able to separate out any joint surgery and deaths directly linked to
early inflammatory arthritis and its treatment. The number of joint replacements directly due
to early inflammatory arthritis would be expected to be very low in the first few years of a
diagnosis, as joint damage usually takes time to accumulate.
1 in 8
unplanned hospital
admissions
Approximately

16
National Early Inflammatory Arthritis Audit (NEIAA)
What has the audit shown us so far?
The second year of the audit has been successful, with excellent recruitment despite the
impact of COVID-19 on data collection. Patients continue to complete more questionnaires
than comparable national audits.
The audit has reinforced that inflammatory arthritis has major, diverse effects on patients’
mental and physical health. Some of this impact has been shown to reduce over the first 12
months of care. Mortality, joint replacements and unplanned admissions after receiving a
diagnosis of inflammatory arthritis have also been reported for the first time. Over time
these data will help us understand the factors that can influence these outcomes.
Although the data from year 2 show improvements in the quality of care provided to many
patients when compared to year 1, performance against the NICE standards is still below the
target of 100%. There continues to be significant variation in performance across England
and Wales, with some rheumatology services performing better than others. There needs to
be further work to help the team to understand the reasons for these differences.
Where does the audit go from here?
The audit will continue to collect information on early arthritis care across the NHS in England
and Wales. The next report will consider the impact of the COVID-19 pandemic on the quality
of care provided.
The information collected will help units to improve the quality of care that they deliver to
patients with early RA.
To read the full annual report, and to see how your local Trust/Health Board has performed,
go to www.rheumatology.org.uk/neiaa. You will be able to download the annual report
spreadsheet and will find instructions on how to use the spreadsheet on the first page of
the document.
Axial spondyloarthritis
Axial spondyloarthritis is a type of inflammatory arthritis mainly affecting the spine.
Patients often have other signs such as bowel, eye or skin inflammation and are thus likely
to be referred from other specialists as well as from primary care. The audit found that
2% of all patients recruited to the audit were diagnosed with this condition and most of
the referrals came from primary care. Compared to patients with RA, patients with axial
spondyloarthritis had symptoms for much longer before they were seen in a rheumatology
clinic. Over 65% of patients with confirmed axial spondyloarthritis had symptoms for over
12 months. Timely referral and diagnosis are important to reduce the impact of the condition.
65%
of patients with confirmed
axial spondyloarthritis had
symptoms for over 12 months
before having an assessment
Over

17
Patient and Public Second Annual Report
Further information
Q&A
My Trust/Health Board has been identified as an outlier – what is this and should
I be concerned?
Outlier analysis aims to identify Trusts/Health Boards that have not performed as well as
others. An outlier in this audit is a provider (Trust/Health Board) that had long waiting times
for patients to be seen after referral. These departments will investigate the reasons for
their performance. Outlier status does not necessarily mean that a Trust/Health Board does
not provide good quality of care once a patient has been seen for their first appointment.
Please note that the data reported were collected from 8 May 2019 to 7 May 2020 with
data collection becoming non-mandatory on 27 March due to the COVID-19 pandemic.
Several units have informed us of the actions that they will be implementing to improve
their performance.
Who else will you share my information with if I have taken part in the audit,
and for what purpose?
Researchers can apply to British Society for Rheumatology (www.arthritisaudit.org.uk/
pages/research) for access to anonymised information gathered through the audit for
research purposes. No identifiable information will be shared.
I have looked at the main report but cannot see all the audit results for my local
provider. What is the reason for this?
You can access information for an individual Trust/Health Board via the following link
www.rheumatology.org.uk/neiaa. If your Trust/Health Board data are not on this
spreadsheet this is because your Trust/Health Board recruited very low numbers of patients
for the audit. This information is not shown for two reasons:
• the analysis is unreliable as a result of the low numbers;
• it may not be possible to keep information on each patient confidential.
You can find more information about the audit on our patient website:
www.myarthritisaudit.org.uk
Where to go for more information and help
National Rheumatoid Arthritis Society (NRAS)
Freephone xx-xxxx-xxxx to receive information and support if you have rheumatoid
arthritis. Support available includes speaking with a trained telephone support volunteer with
rheumatoid arthritis at a mutually convenient time about whatever aspect of your
rheumatoid arthritis concerns you most. Free information resources are also available. If you
have any queries you can email xxx@xxx.xx. Please check the website for more
details: www.nras.org.uk
Versus Arthritis
You can read or download information about living with arthritis from this organisation’s
website, www.versusarthritis.org, and read about the latest research.
National Axial Spondyloarthritis Society (NASS)
NASS provides support, advice and information for people with axial spondyloarthritis (axial
SpA). Further details can be found at www.nass.co.uk
Patient Advice and Liaison Service (PALS)
PALS provides help in many ways, by offering confidential advice, support and information on
health-related matters.

18
National Early Inflammatory Arthritis Audit (NEIAA)
Glossary
absenteeism
absence from work
axial
spondyloarthritis
an inflammatory disorder which affects the spine and can, in some
people, also affect other joints
BSR
British Society for Rheumatology
cDMARD
conventional disease-modifying anti-rheumatic drug
clinician
any healthcare professional seeing you for your arthritis
connective tissue
disease
a group of disorders that can impact on many parts of the body as
well as causing joint and muscle pain
crystal arthritis
a condition characterised by accumulation of tiny crystals in one or
more joints
DAS
Disease Activity Score
fibromyalgia
A condition that is classically characterised by pain, tenderness and
fatigue, often affecting the whole body
global health
A patient’s self-assessment of how their disease is impacting on them
HQIP
Healthcare Quality Improvement Partnership
NEIAA
National Early Inflammatory Arthritis Audit
NHS
National Health Service
NICE
National Institute for Health and Care Excellence
NWIS
NHS Wales Informatics Service
osteoarthritis
a condition characterised by the breakdown and eventual loss of
the cartilage within joints
outlier
a Trust/Health Board that has performed significantly below the
rest of the country at quality statement 2
presenteeism
reduced productivity at work
PRO
patient-reported outcome
providers
Trusts or Health Boards that provide specialist rheumatology services
psoriatic
arthritis
a specific form of inflammatory arthritis that is often linked to the
skin condition psoriasis
quality
improvement
actions that lead to measurable improvement in healthcare services
and the health of patients
reactive arthritis
a specific form of inflammatory arthritis that is classically triggered
by an infection; the inflammation also affects the joints, eyes, skin
and urinary tract
remission
a period in the course of a disease when the inflammation is controlled
rheumatoid
arthritis
a specific inflammatory disorder that causes pain, swelling and
stiffness in the joints, particularly the hands, feet and wrists
synovitis
inflammation of the lining of a joint
undifferentiated
arthritis
an inflammatory arthritis for which no definite diagnosis can yet be
made, usually because the disease is in an early stage and/or results
of tests are not yet available

19
Patient and Public Second Annual Report
Acknowledgements
This report was prepared by members of the National Early Inflammatory Arthritis Audit
(NEIAA) operations team and the Patient Panel, with data provided by patients and staff
within the NHS or private hospitals. The continued success of this national clinical audit is
due to the hard work and commitment of the rheumatology clinical community. British
Society for Rheumatology (BSR) is very grateful to all the clinical and administrative staff
and patients who support and contribute to the NEIAA.
HQIP
The NEIAA is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as
part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). HQIP aims
to promote improvement in patient outcomes, and to increase the impact that clinical audit,
outcome programmes and registries have on healthcare quality in England and Wales. HQIP
currently oversees over 40 projects covering the care provided to people with a wide range of
medical, surgical and mental health conditions. Funding for the NEIAA and for most work
that The HQIP does is by NHS England and the Welsh Government.
British Society for Rheumatology (BSR)
BSR exists to promote excellence in the treatment of people with arthritis and
musculoskeletal conditions, and to support those delivering health services. BSR is responsible
for engaging with Trusts and Health Boards, sharing best practice, managing communication
and holds the contract to run this audit.
Net Solving
Net Solving created the online data collection platform. It has 15 years of experience working
with clinical data collection web tools in the UK and worldwide. It is committed to its work
with BSR on the NEIAA project.
King’s College London
The Centre for Rheumatic Diseases at King’s College London has analysed all the information
provided for the audit and produced the results shown in this report.
Appendix 1
Patient Panel
Amlani-Hatcher Paul (Chair)
Stevens Roger (Deputy
Chair)
Esterine Thomas
Lempp Heidi
Lowe Christine
Maltby Hannah
Simpson Carol
Spencer Yvonne
Wilkins Kate
Williams Ruth
Operations team
Fairfax Rosie (Chair)
Oyebanjo Sarah (Deputy
Chair)
Galloway James (Dr)
Ledingham Jo (Dr)
Yates Mark (Dr)
References
1. Verstappen SMM, van Albada-Kuipers GA, Bijlsma JWJ, Blaauw AAM, Schenk Y, Haanen HCM, et al. A good response
to early DMARD treatment of patients with rheumatoid arthritis in the first year predicts remission during follow up.
Ann Rheum Dis 2005;64(1):38–43.
2. Grigor C, Capell H, Stirling A, McMahon AD, Lock P, Vallance R, et al. Effect of a treatment strategy of tight control
for rheumatoid arthritis (the TICORA study): a single-blind randomised controlled trial. Lancet 2004;364(9430):263–9.
3 Mitchell AJ, Yadegarfar M, Gill J, Stubbs B. Case finding and screening clinical utility of the Patient Health Questionnaire
(PHQ-9 and PHQ-2) for depression in primary care: a diagnostic meta-analysis of 40 studies. BJPsych Open
2016;2(2):127–38.
4. National Collaborating Centre for Mental Health (UK). Common Mental Health Disorders: The NICE Guideline on
Identification and Pathways to Care. The British Psychological Society and The Royal College of Psychiatrists.
https://www.ncbi.nlm.nih.gov/books/NBK92266/pdf/Bookshelf_NBK92266.pdf (19 August 2020, date last accessed).
5. Merkesdal S, Ruof J, Schöffski O, Bernitt K, Zeidler H, Mau W. Indirect medical costs in early rheumatoid arthritis:
Composition of and changes in indirect costs within the first three years of disease. Arthritis Rheum 2001;44(3):528–34.
6. Boonen A, Severens JL. The burden of illness of rheumatoid arthritis. Clin Rheum 2011;30(1):3–8.
7. Nikiphorou E, Norton S, Young A on behalf of ERAS and ERAN, et al. Association between rheumatoid arthritis disease
activity, progression of functional limitation and long-term risk of orthopaedic surgery: combined analysis of two prospective
cohorts supports EULAR treat to target DAS thresholds. Ann Rheum Dis 2016;75;2080–6.

British Society
for Rheumatology
Bride House
18-20 Bride Lane
London, EC4Y 8EE
xx-xxxx-xxxx
xxx@xxx.xx
rheumatology.org.uk
BSR-NEIAA-PATIENT-JAN21