Asked by: Munira Wilson (Liberal Democrat - Twickenham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether she plans to incorporate training on axial spondyloarthritis as a core component of continuous professional development within primary care.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Getting It Right First Time Rheumatology Programme is working to improve the early diagnosis of people with conditions such as axial spondyloarthritis. 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.
The programme has also worked with the National Axial Spondyloarthritis Society to develop a pathway for axial spondyloarthritis to support clinicians to provide the best patient care and allow patients and commissioners to see what they can expect from a service.
Additionally, the National Institute for Health and Care Excellence (NICE) has produced a range of guidance to support early diagnosis of conditions such as axial spondyloarthritis. Its Quality Standard on spondyloarthritis [QS170] sets out that adults with suspected axial or peripheral spondyloarthritis should be referred to a rheumatologist. 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.
General practitioners are responsible for ensuring their own clinical knowledge remains up-to-date and for identifying learning needs as part of their continuing professional development. This activity should include taking account of new research and developments in guidance, such as that produced by NICE, to ensure that they can continue to provide high quality care to all patients.
Asked by: Munira Wilson (Liberal Democrat - Twickenham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether her Department is taking steps to reduce waiting times for axial spondyloarthritis diagnosis.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Getting It Right First Time Rheumatology Programme is working to improve the early diagnosis of people with conditions such as axial spondyloarthritis. 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.
The programme has also worked with the National Axial Spondyloarthritis Society to develop a pathway for axial spondyloarthritis to support clinicians to provide the best patient care and allow patients and commissioners to see what they can expect from a service.
Additionally, the National Institute for Health and Care Excellence (NICE) has produced a range of guidance to support early diagnosis of conditions such as axial spondyloarthritis. Its Quality Standard on spondyloarthritis [QS170] sets out that adults with suspected axial or peripheral spondyloarthritis should be referred to a rheumatologist. 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.
General practitioners are responsible for ensuring their own clinical knowledge remains up-to-date and for identifying learning needs as part of their continuing professional development. This activity should include taking account of new research and developments in guidance, such as that produced by NICE, to ensure that they can continue to provide high quality care to all patients.
Asked by: Tom Randall (Conservative - Gedling)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether he is taking steps through the forthcoming Major Conditions Strategy to help improve the diagnosis and management of axial spondyloarthritis.
Answered by Will Quince
On 24 January 2023, we announced our plan to publish the Major Conditions Strategy. This strategy will explore how we can tackle the key drivers of ill-health in England, reduce pressure on the National Health Service and reduce ill-health-related labour market inactivity.
The Strategy will focus on six major groups of conditions, including musculoskeletal (MSK) disorders. MSK conditions affect people across the life course and cover a range of conditions, including inflammatory conditions such as axial spondyloarthritis.
We have now published our initial report ‘Major Conditions Strategy: Case for change and our strategic framework’. It sets out what we have learned so far, and shares what we plan to focus on next to develop the final strategy.
For MSK conditions, it sets out that we will look to: improve secondary prevention and the use of non-pharmaceutical interventions, embedding a biopsychosocial and personalised approach and building upon the progress made through the NHS Long Term Plan; advocate the use of population health management methodologies to target the right kind of support based on individual circumstances and need to those who need it most; and aim to improve services where medical treatment is necessary.
Following publication of the strategic framework, we will continue to develop the strategy, informed by the Call for Evidence and ongoing engagement with stakeholders.
Asked by: Fiona Bruce (Conservative - Congleton)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to reduce the diagnosis time for people with Axial Spondyloarthritis (a) in the Congleton constituency and (b) nationally.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
NHS England’s Getting It Right First Time programme has worked with the National Axial Spondyloarthritis Society to create a pathway to support clinicians to improve the diagnosis of Axial Spondyloarthritis, including in Congleton. The pathway is available at the following link:
Asked by: Tom Randall (Conservative - Gedling)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the effectiveness of NICE Quality Standard 170 on spondyloarthritis in reducing delays in diagnosis for people with axial spondyloarthritis.
Answered by Edward Argar - Minister of State (Ministry of Justice)
We have made no such assessment. Quality standards issued by the National Institute for Health and Care Excellence are based on a thorough assessment of the available evidence and represent best practice for the health and care system. National Health Service organisations and healthcare professionals should take them fully into account in ensuring that services meet the needs of patients.
Asked by: Caroline Lucas (Green Party - Brighton, Pavilion)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking with stakeholders to ensure the implementation of the June 2018 NICE Quality Standard on Spondyloarthritis; and if he will make a statement.
Answered by Steve Brine
The Department is not involved in the direct promotion of quality standards.
Whilst healthcare and other professionals in the National Health Service are expected to take clinical guidelines which offer education and self-management for patients diagnosed with arthritic conditions fully into account. Clinical guidelines do not override the responsibility of healthcare clinicians to make decisions appropriate to the circumstances of each patient.
On 28 June 2018, the National Institute for Health and Care Excellence published a new Quality Standard (QS) on spondyloarthritis. The QS includes four quality statements identified as the markers of high quality spondyloarthritis care. The first statement sets out that adults with suspected axial or peripheral spondyloarthritis are referred to a rheumatologist. The standard advises that this may be monitored through local data collection, such as audit of patient records.
Asked by: David Amess (Conservative - Southend West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the effect of the implementation of the new NICE Quality Standard on Spondyloarthritis, QS170 on the time taken for the diagnosis of ankylosing spondylitis; and if he will make a statement.
Answered by Steve Brine
No assessment has been made.
On 28 June 2018, the National Institute for Health and Care Excellence (NICE) published a new Quality Standard (QS) on spondyloarthritis. The QS includes four quality statements identified as the markers of high quality spondyloarthritis care. The first statement sets out that “Adults with suspected axial or peripheral spondyloarthritis are referred to a rheumatologist.” The standard advises that this may be monitored through local data collection, such as audit of patient records.
QSs 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 QSs in planning and delivering services, they do not provide a comprehensive service specification and are not mandatory.
Asked by: Jeremy Lefroy (Conservative - Stafford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what the timetable is for the publication of the Rheumatoid and Early Inflammatory Arthritis Annual Report; and whether that report will include additional data collection for spondyloarthritis patients.
Answered by Steve Brine
In August 2017, a new three year Rheumatoid and Early Inflammatory Arthritis Audit was commissioned by the Healthcare Quality Improvement Partnership (HQIP). HQIP manages the National Clinical Audit and Patient Outcomes Programme on behalf of NHS England.
The British Society for Rheumatology was awarded the contract to run the audit, which will assess the care provided by rheumatology services in England and Wales, and the health outcomes this achieves for people living with inflammatory arthritis conditions, including rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis.
Building on the previous audit, which ran from 2014-16, it will provide more focused and precise data and employ real-time feedback to support local quality improvement. The audit is expected to launch in May this year, with first reports expected in the autumn of 2019. More information can be found at the following link:
www.rheumatology.org.uk/Knowledge/Excellence/Audits