Bright rheumatology future

The Rheumatology Futures Group (RFG) – a coalition of pharmaceutical companies, professional and patient organisations – commissioned research from the King's Fund to assess the impact of NHS structural reorganisation and service redesign on 1,400 patients and rheumatology health professionals. The research found that patients were experiencing "alarming and unacceptably wide variations" in the levels and quality of care. The RFG developed and implemented a communications and engagement campaign, targeting media, policy-makers and the NHS, to devise practical solutions to some of the problems identified. The RFG worked with the Department of Health (DH) and a consensus group to develop much-needed guidance and a commissioning pathway for the NHS.

Challenge
Historically, rheumatoid arthritis (RA) has been given relatively low priority within the NHS in terms of policy pressure, service provision and commissioning. Anecdotal feedback from patients and healthcare professionals suggested that the extent and quality of NHS rheumatology services in England varied markedly. In particular, patients faced problems with the speed of access and location of care, both of which were being affected by ongoing service redesign, and there was no clear guidance or consistent pathway for service commissioners.

Solution
The Rheumatology Futures Group (RFG) commissioned comprehensive research from the King's Fund to assess:

• What is the impact of service configuration on patients and staff? How is the patient experience and the ability of multidisciplinary teams to provide care affected?

• How is access to, and provision of, specialist care affected by service redesign?

• What action should be taken to influence improvements in RA care?

• How can decision-makers be best supported in this?

The RFG developed and implemented a communications and stakeholder engagement plan to:

• Communicate the main findings and outcomes of research project

• Drive awareness of RA

• Engage with key stakeholder groups and gain buy-in for policy change

• Identify policy solutions to the problems of commissioning and delivering services.

Results
• Detailed, robust research assessed the view of 1,400 patients and rheumatology health professionals, and a report entitled Perceptions of patients and professionals on rheumatoid arthritis care was written by the King's Fund

• Over 1,000 copies of the report were mailed to policy-makers, patient and professional organisations, every primary care trust and strategic health authority

• The launch event attracted 41 attendees and resulted in over 60 pieces of media coverage in national/regional print, online  and broadcast outlets

• A Parliamentary briefing session was con­ducted and mailings sent to 255 politicians. One-to-one meetings were held with Dame Carol Black, Andrew Lansley MP, Health Select Committee members, the Healthcare Commission, National Audit Office and more than 20 backbench MPs

• A commissioning pathway was developed and the RFG was given approval to work directly with the DH's 18-week team

• More than 50 stakeholders participated in the development of the pathway, including nurses, commissioners and RA patients

• The final pathway was approved by the DH in June 2009 and endorsed for NHS use.

Client verdict
"This was a much-needed piece of work and a unique collaboration, showing that, with the right commitment, operating framework and honesty, the impossible can be achieved in a short period of time – just two years from the creation of the group to the publication of the Futures Report and DH agreement to develop consistent guidance for rheumatology service commissioners."

Susan Oliver and Ailsa Bosworth, co-chairs, Rheumatology Futures Group

Case study details

Client: Rheumatology Futures Group
Agency: In-house, with Helen Johnson Consulting Limited
Campaign: Rheumatology Futures Project
Timescale: January 2009 to November 2009

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