Excellence in Healthcare Collaboration and Partnerships

Summary of work

"An excellent initiative that has brought together the voices of RA patients, healthcare professionals and commissioners." National Rheumatoid Arthritis Society

Rheumatoid arthritis (RA) can cause irreversible joint damage and affects more than 690,000 UK adults. Treat to Target (T2T) represents an important advance providing clear direction on tight RA control. A previous T2T education programme, led by a UK Steering Committee (SC), was awarded Communiqué and PMEA awards in 2012.

To drive T2T in today’s NHS, we embarked on a journey to change clinical behaviour. Qualitative expert interviews revealed barriers to T2T and highlighted the need for a collaborative approach, including RA patients, commissioners and healthcare professionals.

Underpinned by an evidence-based model for changing clinician behaviour, we developed a multifaceted programme that engaged all stakeholders:

• Multicentre T2T audit: assessing current practice and providing outcomes data for commissioners
• T2T CONNECT: advancing HCP-patient communication
• Rheumatologist-commissioner co-creation workshops: formulating solutions to organisational barriers
• T2T Summit: including peer-to-peer Experience Exchange.

Interim results of the audit demonstrated a positive impact of T2T awareness. Following our multi-stakeholder programme a survey of 192 rheumatologists showed improved T2T implementation vs preliminary audit findings, specifically around monitoring disease activity (44% to 76%) and appropriate treatment escalation (72% to 83%).

Judges comments

This programme was evolved – it was well designed and well implemented. It is multifunctional and shows a wider scale of collaboration that is supported and therefore sustainable. Through improved stakeholder engagement it led to patients, HCPs and CCGs working towards a common goal of improving outcomes in rheumatoid arthritis. It genuinely changed the way people behaved in consultations.