Belfast pilot

In partnership with NHS Belfast and Queens University Belfast we are embarking on a pilot project in South and East Belfast. The aim is to transform the Belfast axial SpA diagnostic pathway to achieve a sustainable reduction in the time to diagnosis of patients with axial SpA.

It encompasses four core elements:

1. Raising public awareness of axial SpA and its symptoms amongst the general population through integrated marketing activities.
2. Increasing the awareness and confidence of primary care health professionals to identify and refer patients with inflammatory back pain.
3. To implement a new dedicated 2 week rapid inflammatory back pain pathway in primary care.
4. To establish a new ‘one stop shop’ diagnostic inflammatory back pain clinic in rheumatology.

We will measure the time to diagnosis throughout the project, working alongside the rheumatology department and Queens University Belfast.

The pilot in Belfast will run for a year, with opportunities for both health care professionals in the region and patients to get involved.

The project lead for the Belfast team is Dr Neil Heron, a GP and Clinical Lecturer (GP and Consultant Sport, Exercise and Musculoskeletal Medicine), Centre for Public Health, Queen’s University Belfast, Northern Ireland. He said of the pilot:

“It is very exciting for us as clinicians and researchers to be working with NASS. Utilising key inputs from NASS around axial SpA patient knowledge and local healthcare knowledge from clinicians and researchers, we hope to put together an education programme and new clinical pathway to allow the early diagnosis of axial SpA.

This project has enormous potential for patient benefit, particularly in raising awareness of axial SpA, reducing the time to diagnosis and therefore time to treatment. This is a very exciting project for the Belfast primary and secondary care clinicians and researchers to be involved in and we look forward to working together with NASS.”

AxSTARS project – collaboration with the South West Axial Spondyloarthritis Group (SWAG)

SWAG is a clinical led coalition of health care professionals working in rheumatology from across the South West of England with a special interest in axial SpA. They form a multi-professional community of clinicians who share the NASS ambition and enthusiasm needed to achieve the Act on Axial SpA goals.

The Axial SpA transformation and redesign of services (AxSTARS) project is a collaborative project grounded in data across SWAG to develop a common network-wide axial SpA pathway and streamline processes to drive down diagnosis times. It will be led by the rheumatology teams from the Royal Hospital for Rheumatic Diseases Bath, the Bristol Royal Infirmary, the North Bristol Trust and Torbay Hospital. This smaller cohort of the SWAG will test and refine changes to be then rolled out across the whole South West region.

It encompasses four core elements:

1. Establishing a common data set for axial SpA.
2. Development of a common standardised axial SpA pathway across SWAG.
3. Increasing the awareness and confidence of primary care health care professions to identify and refer patients with inflammatory back pain.
4. Increasing the awareness and confidence of secondary care clinicians to identify and refer patients with inflammatory back pain and associated conditions such as inflammatory bowel disease, psoriasis, and uveitis.

The AxSTARS project will focus on service redesign in the first instance, building in a public awareness campaign next year when the pathway is in place.

The pilot in South West England will run for a year, with opportunities for both health care professionals in the region and patients to get involved.

Tom Williams, Consultant Rheumatologist at the National Hospital for Rheumatic Diseases, Bath summarises what the SWAG team want to achieve as:

“My colleagues in the South West Axial Spondyloarthritis Group (SWAG) and I are excited to work with NASS in the integrated pilot phase of the Act on Axial SpA campaign, building on the existing quality improvement projects initiated during the Aspiring to Excellence programme.

When we founded SWAG in 2021, our core objectives were to bring clinicians with an interest in axial spondyloarthritis together in order to share good practice, reduce diagnostic delay and effectively implement NICE guidance, in order to improve patient outcomes and experience. Our collaboration with NASS and the NHS Transformation Unit has already provided focus and momentum for our relatively young organisation. We hope through the integrated pilot to have even greater engagement with our colleagues across the healthcare system, people living with axial spondyloarthritis and the wider public, in order to improve awareness, optimise early recognition and referral pathways, ultimately leading to patients more consistently being able to obtain timely and high quality care across our region.”