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.

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 patients."

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 Implementation Domain.

More information:
Lucy Prosser
0161 701 0260
Lucy.prosser@cmft.nhs.uk

Central Manchester University Hospitals NHS Foundation Trust (CMFT) is a leading provider of specialist healthcare services in Manchester, treating more than a million patients every year. Its eight specialist hospitals (Manchester Royal Infirmary, Saint Mary’s Hospital, Royal Manchester Children’s Hospital, Manchester Royal Eye Hospital, University Dental Hospital of Manchester and Trafford Hospitals) are home to hundreds of world class clinicians and academic staff committed to finding patients the best care and treatments. (www.cmft.nhs.uk)

The NIHR Manchester Musculoskeletal Biomedical Research Unit was created by the National Institute for Health Research in 2012 to advance scientific breakthroughs from the laboratory, through clinical assessment into improved outcomes for adults and children with musculoskeletal disorders such as arthritis. As a partnership between Central Manchester University Hospitals NHS Foundation Trust and The University of Manchester, the Biomedical Research Unit is designated as a specialist centre of excellence in musculoskeletal diseases. (www.manchestermskbru.org)

The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (www.nihr.ac.uk).

MAHSC (the Manchester Academic Health Science Centre) is a partnership between The University of Manchester and six NHS organisations. Our NHS partners are some of the most highly rated NHS Trusts in the country, and The University of Manchester is one of the top three UK research universities (RAE 2008). We are proud to be one of only six centres in the country currently designated as an AHSC. AHSC designation recognises excellence across research, innovation, education and patient service, and in particular the potential to excel in translational medicine.

Through partnership with the Greater Manchester Academic Health Science Network, MAHSC acts as a beacon within the local health system, providing clinical leadership and helping health care organisations reap the benefits of research and innovation to drive improvements in care. www.mahsc.ac.uk
The MAHSC partners are:

• The University of Manchester
• Central Manchester University Hospitals NHS Foundation Trust
• Manchester Mental Health and Social Care Trust
• Salford CCG (formerly NHS Salford) as lead representative for GM CCGs
• Salford Royal NHS Foundation Trust
• The Christie NHS Foundation Trust
• University Hospital of South Manchester NHS Foundation Trust

Haelo (www.haelo.org.uk) is an innovation and improvement centre based in Salford that works to improve population health and healthcare. We do this by investing in learning partnerships with like-minded providers which centre on shared ambitions for excellence, inclusion and learning.

We work closely with colleagues at the University of Manchester and Salford Royal NHS Foundation Trust aim to improve health outcomes in a region known to have considerable health needs.

Provided by Central Manchester University Hospitals