Toolkit for Health Care Professionals
We have been developing a toolkit of resources to help you as Health Care Professionals with improving axial SpA care and driving down diagnostic delay. Here is where you will find all the tools, presentations, posters and other materials in one place. Please use them in your work.
As a healthcare professional, what tools are available to me?
There are lots of things to help you in your everyday practice.
We have created posters, videos, presentations, educational materials and other resources you can access, print out and use to improve time to diagnosis. Access everything you need here:
Act on axial SpA presentations
As part of the act on Axial SpA campaign we have developed a range of presentations that will help you in your work. You can find and download our standard presentations here:
Presentation for a primary care audience – full version
This presentation is designed for an audience of primary care HCPs and contains information on NASS, what axial SpA is and the key signs and symptoms, what the act on axial SpA campaign is, what we are doing in primary care and where to find useful resources.
Presentation for a primary care audience – short version
This is a shorter more focused presentation to fit in with teaching sessions or slots and will take roughly 15 to 20 minutes. Which you can access here: Short Presentation
Video for First Contact Physiotherapists – James Holland Champion in Primary Care
James Holland NASS Champion in Primary Care shares tips for First Contact Physiotherapists on how to identify and diagnose axial SpA including solutions
James provides an overview of the importance of improved diagnosis in axial SpA, in addition to providing tips for recognising axial SpA for first contact physiotherapists (FCP), and gives an overview of some of the solutions being developed by the NASS Champions in Primary Care.
Click on the icon below to launch the short 7 minute video.
Presentation for gastroenterology – full version
This presentation is designed for an audience of clinicians from gastroenterology, including IBD nurses and gastroenterologists. It contains information on NASS, what axial SpA is and the key signs and symptoms, what the act on axial SpA campaign is, what we are doing in secondary care and where to find useful resources. This was developed as part of our work with gastroenterologists and rheumatologists on the links between axial SpA and IBD, it includes guidance on when to refer and how, with tools to help differentiate inflammatory from mechanical back pain.
Act on axial SpA 1st impact report
This presentation sets out the achievements from the first 18 months of the campaign and is to be used to showcase the programme and its successes to date:
Inflammatory Back Pain – Pathways, Processes, Protocols and Guidance:
Salford Royal Hospital - IBP pathway
SWAG - Inflammatory Back Pain referral criteria
Newcastle Hospitals - axSpA pathway
Salford Royal Hospital - axial SpA pathway
Royal Berkshire - Referral Pathway
Royal Free London - IBP referral form
Clinical guidelines and protocols:
GIRFT / Best MSK axial Spondyloarthritis pathway
ASAS criteria for Axial Spondyloarthritis (SpA)
Msk? Think SpA! NICE guidance on recognition and referral of Spondyloarthritis
Dr Carol McCrum was awarded a NICE Fellowship (2017-2020) and has developed a clinical guide leaflet for clinicians to increase awareness of axial and peripheral spondyloarthritis.
The leaflet (right) is a brief guide outlining the recommendations in the NICE guideline on spondyloarthritis in over 16s on recognition, imaging recommendations and when to refer to rheumatology.
This resource is a useful tool for clinicians in digesting the NICE guidance and put it into practice, with lots of hints and tips on how to recognise and refer for spondyloarthritis.
You can also find an overview of the guidance in the following article:
McCrum C. When to suspect spondyloarthritis: A core skill in musculoskeletal clinical practice. Musculoskeletal Science & Practice. 2019 Dec;44:102079. doi: 10.1016/j.msksp.2019.102079. Epub 2019 Oct 31. PMID: 31711934.doi
Download our posters by clicking on the images below:
Use our campaign videos in your presentations about axial SpA:
We worked with members of our community and comedians to shed light on the realities of life with axial SpA. These videos use humour to explain the issues of delayed diagnosis and ongoing, undiagnosed symptoms of axial SpA.
Use these videos (example below) as a light-hearted way to explain two major issues in axial SpA diagnosis and care, click here to view all videos.
Key act on axial SpA reports and research:
Act on axial SpA: A Gold Standard Time to Diagnosis document (June 2021)
First Act on axial SpA impact report (October 2022)
The economic cost of delayed diagnosis of axial Spondyloarthritis in the UK (October 2022)
What do patients value and need in the diagnosis, treatment and care of axial spondyloarthritis? (November 2022)
Review of direct referrals to rheumatology for suspected axial SpA (November 2022)
The use of MRI in the diagnosis of axial SpA (April 2023)
IBD and axial SpA: how can we join the dots to ensure timely diagnosis and joint management? (June 2023)
In June 2023 NASS, in collaboration with Crohn’s & Colitis UK, and with support from the British Society for Gastroenterology (BSG), are launching the findings from our landscape review into diagnosing axial SpA in people living with inflammatory bowel disease.
As part of the NASS Act on axial SpA campaign, launched in June 2021, we developed a 22-question survey in conjunction with key clinical advisors, Crohn’s & Colitis UK and the BSG. There are two major themes emerging from this analysis to help ensure swift recognition, identification, and referral of suspected axial SpA: education and joint working with rheumatology.
Despite there being positive detection of inflammatory back pain symptoms and high confidence to refer, the survey highlights the need for regular educational sessions and resources on axial SpA that are accessible to all clinicians. Also, within secondary care, standardised screening tools and formal referral pathways could support clinicians.in identification.
Read the full report below:
Axial SpA – How long are patients waiting for a diagnosis? (September 2023)
NASS, in collaboration with rheumatology teams from our Aspiring to Excellence programme have developed a patient survey tool to measure and monitor how long patients wait for a diagnosis of axial SpA, from symptom onset in the UK.
In September 2023 we launched the first results from the survey.
This report presents the initial results of the first four-nation UK audit of time to diagnosis in axial SpA. We don’t yet have a comprehensive picture across the UK, and the numbers of patients per department are small overall. Thus, we cannot with confidence refer to the results in the report as providing a baseline position. Nevertheless, this is already the largest current data set in the UK on diagnostic delay.
This survey and audit tool is funded by the Aspiring to Excellence programme which is led by NASS in partnership with BRITSpA and the NHS Transformation Unit and sponsored by Abbvie, Biogen, Lilly, Novartis and UCB.
The key facts from the survey based on 325 patients who submitted data and had been diagnosed since 2021 are shown below and the full report can be read by clicking on the image.