For Healthcare Professionals – Case for Change reports
For Healthcare Professionals – Case for Change reports
Welcome to the act on axial SpA website - providing resources to reduce time to diagnosis in axial SpA. Explore our pages below, developed by healthcare professionals across various specialties. Think we are missing something relevant to your discipline? Please reach out to the Gold Standard team: goldstandard@nass.co.uk
The case for change in diagnostic delay
The case for change in diagnostic delay
Throughout the Act on axial SpA campaign we have been developing the case for change, shining a light on the delay, the economic cost, the physical impact and the service impact. You can view and download this flyer to help in your area here.
Act on axial SpA Impact Report - 2022
Act on axial SpA Impact Report - 2022
In October 2022 at the All Party Parliamentary Group (APPG) on Axial Spondyloarthritis we launched the first impact report for the Act on Axial SpA programme. The report details the key results from the programme in its first 16 months. You can use this to showcase the impact the programme is making to diagnostic delay.
Direct referrals to rheumatology
Direct referrals to rheumatology
In November 2022 we released the results of research via a Freedom of Information (FOI) request and found that in many areas, specialties associated with the Extra Musculoskeletal Manifestations (EMMs) of axial SpA are able to routinely refer patients directly to rheumatology for suspected axial SpA. However, in other UK acute care settings, referrals are mostly reliant on consultant-to-consultant letters or calls. The report provides some practical advice on how referrals to rheumatology for suspected axial SpA should be made.
Use of MRI in axial SpA diagnosis
Use of MRI in axial SpA diagnosis
In April 2023 in collaboration with BRITSpA we are launching the results and report on the use of MRI in the diagnosis of axial SpA. The study explored if the use of MRI has changed since the 2019 BRITSpA consensus statement and shines a light on the improvements and also some new challenges. This report will give practical tools and tips on the role MRI has in the diagnostic pathway and when it is most clinically valued. Keep an eye out for our launch.
IBD and axial SpA
IBD and axial SpA
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.
UK average time to diagnosis 2023
UK average time to diagnosis 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.
Symptoms starting slowly
Pain in the lower back
Improves with movement
Night time waking
Early onset (under 40)
