Arthritis Research UK

The Arthritis Research UK Epidemiology Unit is a unique research institution internationally, in terms of its major focus being understanding the epidemiology of the major rheumatic and musculoskeletal disorders. The Unit receives substantial core funding from Arthritis Research UK (formerly the Arthritis Research Campaign, arc) of approximately £2.7 million. The Unit also receives financial support from The University of Manchester and the major grant receiving bodies such as the Medical Research Council, The Wellcome Trust, Department of Health and other funding agencies. These resources support approximately 100 individuals working on a wide variety of different programmes and projects.

Arthritis Research UK and the British Society for Rheumatology (BSR) have welcomed the introduction of a best practice tariff for early inflammatory arthritis, including rheumatoid arthritis.

Rheumatoid arthritis is the most common form of inflammatory arthritis, affecting around 400,000 people in UK. It is a chronic, disabling condition in which the body’s immune system attacks the joints. It can begin at any age and there is often a rapid onset of severe symptoms.

Within a very short time period, the disease can affect a person’s ability to complete day to day activities including work and independent living. Research has shown that early identification and intensive treatment can reduce pain, prevent disability and induce remission.

Despite the existence of NICE guidance, which recommends that patients should start treatment within 3 months of symptom onset, there is wide variation in treatment and outcomes across the country.

To encourage consistent and high quality clinical care for people with early inflammatory arthritis, BSR and Arthritis Research UK have worked with the Department of Health in England to develop a Best Practice Tariff (BPT) for early inflammatory arthritis.

As of April 2013, people who develop inflammatory arthritis should expect:

• To be seen by a rheumatologist within three weeks of a GP referral
• To receive their diagnosis and start treatment within six weeks of a GP referral
• To have regular review appointments with their rheumatologist until their arthritis is adequately controlled.

This work has been jointly clinically led by the BSR President Dr Chris Deighton and Dr Benjamin Ellis of Arthritis Research UK.

Dr Chris Deighton, BSR, commented, “This is an exciting opportunity to further embed the principles of improving clinical outcomes within the recommended time-frames for treatments including disease-modifying anti-rheumatic drug (DMARD) therapy and biologics.
"There is existing wide variation in treatment and outcomes, for example the National Audit 2009 found only 10% of patients are put onto DMARDs within 3 months of symptom onset in spite of NICE guidelines.”

Senior clinical policy advisor, Arthritis Research UK, Dr Benjamin Ellis, explained, “Early intervention and intensive treatment can prevent long term pain and disability for people with rheumatoid arthritis. Every person who develops early inflammatory arthritis deserves the best possible treatment.

"The introduction of the best practice tariff for early inflammatory arthritis means that for the first time there is a financial incentive to hospitals for every person who develops this condition to get the right treatment at the right time.

“Arthritis Research UK calls on every Clinical Commissioning Group to implement this tariff to ensure hospitals provide the early, intense treatment needed to prevent permanent pain and disability for thousands of people.”