Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what steps the Government is taking to ensure that patients with early inflammatory arthritis are referred from their GP to rheumatology services within three days.

The Department has not published any specific piece of guidance in relation to early inflammatory arthritis. However, evidence-based clinical guidance is published by the National Institute for Health and Care Excellence (NICE) and is disseminated to general practitioners and other health care professionals.

To help clinicians identify the symptoms of rheumatoid arthritis and make prompt referrals to specialists, NICE published Rheumatoid arthritis: The management of rheumatoid arthritis in adults in 2009. This best practice guideline sets out the signs and symptoms of the disease and emphasises the need for early diagnosis with urgent referral to a specialist rheumatologist on suspicion of rheumatoid arthritis. For those diagnosed with the condition, the guidance also recommends they should be offered the opportunity to take part in educational activities, including self-management programmes.

The NICE Rheumatoid Arthritis Quality Standard, published in 2013, is based on the NICE guideline. One of the seven quality statements it includes recommends that 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. Although providers and commissioners must have regard to these standards in planning and delivering services, they do not provide a comprehensive service specification and are not mandatory.