Waiting times halved for rheumatoid arthritis patients, and £100k a year saved, at Manchester Royal Infirmary
Waiting times have been halved for rheumatoid arthritis
patients prescribed biologic therapies and £100,000 is being saved
every year at Manchester Royal Infirmary (MRI), following the
introduction of a Virtual Biologics Clinic.
|Sandhya and her daughter Rosa
Rheumatoid arthritis (RA) is a chronic disease which affects up
to 1.5% of the population. It is a significant health burden
for patients, who can experience pain, reduced mobility and
premature death unless they receive effective treatment.
The introduction of biologics has revolutionised the care of
patients with RA, reducing these symptoms and longer-term risk of
joint damage and disability. As such, these drugs are now a major
component of modern-day treatment for the disease.
However, they are not the most suitable medication for all
patients, who differ greatly in their needs, and they are
significantly more costly than other treatments. This is why
Manchester Royal Infirmary has taken action to avoid an unnecessary
financial burden on the NHS, while providing biologics to the
patients who will benefit from them as quickly as possible.
Sandhya Sharma, a patient with rheumatoid arthritis from
Withington explains, "I was diagnosed soon after my daughter, Rosa,
was born. I was continually exhausted and the pain was
excruciating; I had to move back up to Manchester so that family
could help me out.
"At the Kellgren Centre for Rheumatology in the MRI I was given
the opportunity to take part in a clinical trial. Since
starting on biologics, my life has totally changed - I can be a
bigger part of my daughter's life, and I've even started
volunteering in the field I'm passionate about - women's
rights. I'm really happy to have been part of a trial. I have
benefitted from having increased care and support which has been
extremely positive. Someone has to step forward to test new
ideas. I never thought it would be me, but it's really important to
be that person and hopefully make a difference to other
The Virtual Biologics Clinic at the Kellgren Centre for
Rheumatology was introduced in August 2013 to ensure that the
prescription of biologic therapies was based primarily on the needs
of patients and not on cost, to increase the speed at which
patients gain access to the treatments, and provide more
opportunities for patients to participate in clinical research so
they may benefit from cutting-edge therapies and to improve the
medical community's knowledge of the disease.
Its aims are in line with the regional biologics pathway for RA,
which was devised by the Greater Manchester rheumatology community
in June 2013, and the aim of the National Institute for Health
Research (NIHR) Manchester Musculoskeletal Biomedical Research
Unit (BRU) to treat arthritis "right first time".
Consultant Rheumatologist at the Kellgren Centre for
Rheumatology and honorary senior lecturer at The University of
Manchester, Dr Ben Parker*, explains: "It is a weekly hour-long
clinic that brings together nurses, consultants and pharmacists to
assess a patient's needs. As well as making the process more
efficient for patients and the NHS, the Virtual Biologics Clinic
supports our research.
"Every patient is assessed for possible research participation
and if eligible is approached to discuss their potential
involvement. This is good for patients, because those offered
the chance to participate in trials often have improved health
outcomes and a better experience of healthcare."
Professor Ian Bruce, Director of the NIHR Manchester
Musculoskeletal BRU adds, "Dr Parker and the team have had
a real impact in using the best available evidence to drive up the
quality of care we provide for our patients with RA. They have also
achieved this whilst making real cost efficiencies and widening the
access to clinical research in our centre".
The Virtual Biologics Clinic was supported through the MAHSC Improvement Science for
Academics (IS4Ac) course, delivered by Haelo, Salford's innovation and
improvement science centre, for MAHSC's Population Health and
*Dr Ben Parker is partly funded by the NIHR
Manchester Musculoskeletal BRU.