NICE: new era for thousands with rheumatoid arthritis

Arthritis Care has welcomed the clear and constructive guidelines on the management of rheumatoid arthritis (RA) published today by the National Institute of Health and Clinical Excellence (NICE).

RA affects around 400,000 people of all ages in the UK. The condition causes a person's immune system to attack their joints, as well as other parts of the body, causing chronic pain and often leading to severe disability when not treated properly.

The new guidelines published by NICE outline the level of care people with arthritis should expect from their healthcare providers. This includes the process for diagnosing the condition and a clear guide for both service-users and their healthcare team for managing the conditon.

Arthritis Care particularly welcomes the emphasis on patient-centred care, including access to information and self-management programmes. Arthritis Care has long argued for self-management for people with arthritis in the UK and our training courses have consistently attracted excellent feedback from people with arthritis.

As the guidelines recognise, access to timely and accurate diagnosis is vital to improving long-term outcomes for people with RA. Referring people to a specialist and beginning treatment as early as possible can significantly reduce the impact of the condition.

Any delay in this process can increase the risk of preventable joint damage which can lead to severe disability and a reduced capacity to participate in society.

NICE recommends the inclusion of self-management in the range of options available to people with RA. This needs to be adequately articulated, and its availability clearly communicated.

Self-management is more than just providing information and education: it helps people with arthritis take control of their condition through changing behaviour (e.g. eating well and remaining active) as well as putting people in touch with others who may be dealing with similar challenges. Access to self-management services should be made available throughout the patient pathway, not just at the point of entry into the system.

It is also important that people with RA receive a service that considers the full range of their needs, including, as the guidelines state, an annual review that will check for associated conditions and assess the wider impact of RA on their life.

Only by listening to the real needs of service users can the NHS genuinely provide an effective and holistic service to patients, so it is important that service users are directly involved in all stages of their design.

The new RA guidelines provide a good foundation on which a truly holistic and patient-centred model of service delivery can be built for people with RA. In order for this to be successful, however, it is paramount that the guidelines are properly implemented. This should include a strategy for publicising the guidelines and putting in place strong monitoring and reporting mechanisms to encourage compliance across the health service.