Rheumatic diseases – State of the Nation 2025 (NEIAA)
The National Early Inflammatory Arthritis Audit, referred to as the National Early Inflammatory Autoimmune Diseases Audit in this publication*, has published a report on care received by people with rheumatic diseases between 1 April 2024 and 31 March 2025 in England and Wales.
Access to treatment has improved over the course of the audit, with 60% of patients receiving disease-modifying antirheumatic drug (DMARD) treatment within 6 weeks of referral
The report found that, since the COVID-19 pandemic, patients with early inflammatory arthritis (EIA) are experiencing symptoms for longer before being referred to rheumatology services (38% of people had symptom durations of 6 months or more when referred). However, once symptoms of EIA are recognised, the data suggest that increasing numbers of patients are being referred within the recommended time frame. This is important, because delays in treatment can lead to disability, reduced quality of life, and loss of productivity in the workforce. Overall remission rates at 3 months remain static at 34%, although there is significant geographic variation.
In addition to an exemplar case study, five recommendations for improvement can also be found in the report:
- Funding should be provided to support awareness-raising of the importance of early presentation to primary care of people with symptoms of suspected EIA
- NEIAA dashboard data should be used to pinpoint unwarranted variation, track improvement and inform planning and investment
- Patient-reported outcome measures should be integrated into clinical pathways to identify individuals experiencing significant psychological burden, and facilitate timely referral to mental health support services
- National guidance should be developed and implemented to ensure timely treatment of EIA and minimise regional disparities in care delivery
- Widespread implementation of the GIRFT National Axial Spondyloarthritis Society National (NASS) playbook within primary care.
*The National Early Inflammatory Arthritis Audit (NEIAA) Senior Governance Group, in consultation with HQIP, will be launching communications regarding a change to the name of the audit, to better realise the extended scope of the audit and the incorporation of the rarer diseases. The original purpose of the audit remains unchanged from the original contract. The proposed name of the audit will be The National Early Inflammatory Autoimmune Diseases Audit, hence its use in this report.
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