Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the National Institute for Health and Care Excellence's webpage entitled Diagnosis and referral of inflammatory arthritis, what steps her Department is taking to increase the number of people with suspected inflammatory arthritis who receive referral to rheumatology services within three working days.

NHS England is working to ensure and improve early diagnosis of people with arthritis, as well as treatment and care in England, through the Getting it Right First Time rheumatology programme. The programme published a national report on rheumatology in 2021, which makes a series of recommendations to support equitable and consistent access to diagnostic tests. Additionally, the National Institute for Health and Care Excellence (NICE) has produced a range of guidance to support early diagnosis of conditions including rheumatoid arthritis and osteoarthritis.

NICE’s quality standard on rheumatoid arthritis in people aged 16 years old or over [QS33] states that adults with suspected persistent joint inflammation, known as synovitis, in more than one joint, or the small joints of the hands and feet, should be referred to rheumatology services within three working days of presenting in primary care.

Quality standards are important in setting out to patients, the public, commissioners, and providers what a high-quality service should look like in a particular area of care. Whilst providers and commissioners must have regard to NICE quality standards in planning and delivering services, they do not provide a comprehensive service specification and are not mandatory.

The Department has not made any assessment of the impact of waiting times for elective care on the mental health of people with arthritis. Cutting waiting lists is one of the Government’s top priorities. We are making good progress on tackling the longest waits, to ensure patients get the care they need when they need it.

To support the health of people with arthritis while they are waiting for elective treatment, NHS England has worked with Versus Arthritis on their Joint Replacement Support Package, which makes the case for local health systems, working with local communities and the voluntary sector, to deliver a support package to help to meet the needs of people with arthritis who are on surgery waiting lists. This includes mental health support to help people to manage their pain and any associated depression and anxiety.

More generally, we have made it clear to local commissioners that we expect NHS talking therapies to be integrated into physical healthcare pathways. Our NHS Long Term Plan commits to an additional £2.3 billion a year for the expansion of mental health services by 2024, so that an additional two million people can access National Health Service-funded mental health support.