Innovation/Service Improvement Synopsis
Direct Access system for patients with regular outpatient reviews
Patient led service. Through a direct access system (DAS), regular rheumatologist – initiated reviews were replaced by patient initiated reviews, accessed through a telephone helpline run by the rheumatology nurse specialists. DAS ensures timely care during episodes of urgent need, such as a flare-up of the disease, and reduces the number of routine but unnecessary reviews
Long Term Condition
Rheumatoid Arthritis
Meets National Priority Area
Fast Track Service
Benefits to Patient
Patients request fewer appointment found direct access more acceptable and needed a third less medical outpatient appointments
Benefits to Staff
Need fewer appointments so able to see more patients
Cost Savings/Efficiencies
Reduction in unnecessary hospital outpatient reviews
Outcomes Measured
Two year randomised controlled trial extended to six years. Outcome measures included clinical pain, disease activity, early morning stiffness, inflammatory indices, disability grab strength, range of movement and bone erosion. Psychological status, anxiety, depression, helplessness, satisfaction and confidence in the system. Number of visits to hospital physician and GP for advice
Sustainability
Project initiated six years ago and continues to run
Transferable
Suitable for use with patients with any LTC that requires regular booked reviews,
Winner of the service delivery long term condition award sponsored by the Multiple Sclerosis Society
Project Status
Ongoing
For more information e-mail
info@nisw.co.uk
To download this case study please click icon.
Download