Regional variability in trajectories of Barn Swallow populations across Canada are not predicted by breeding performance

Summary Conservation measures providing food-rich habitats through agri-environment schemes (AES) have the potential to affect the demography and local abundance of species limited by food availability. The European Turtle Dove Streptopelia turtur is one of Europe’s fastest declining birds, with breeding season dietary changes coincident with a reduction in reproductive output suggesting food limitation during breeding. In this study we provided seed-rich habitats at six intervention sites over a 4-year period and tested for impacts of the intervention on breeding success, ranging behaviour and the local abundance of territorial turtle doves. Nesting success and chick biometrics were unrelated to the local availability of seed-rich habitat or to the proximity of intervention plots. Nestling weight was higher close to human habitation consistent with an influence of anthropogenic supplementary food provision. Small home ranges were associated with a high proportion of non-farmed habitats, while large home ranges were more likely to contain seed-rich habitat suggesting that breeding doves were willing to travel further to utilize such habitat where available. Extensively managed grassland and intervention plot fields were selected by foraging turtle doves. A slower temporal decline in the abundance of breeding males on intervention sites probably reflects enhanced habitat suitability during territory settlement. Refining techniques to deliver sources of sown, natural, and supplementary seed that are plentiful, accessible, and parasite-free is likely to be crucial for the conservation of turtle doves.

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P092 NICE biologics pathways for inflammatory arthritis exhibit regional variability due to modification by CCG’s: results from a national survey of pathways in England

Rheumatology ◽

10.1093/rheumatology/keab247.090 ◽

2021 ◽

Vol 60 (Supplement_1) ◽

Author(s):

Jatin Mistry ◽

Diane Hill ◽

Ailsa Bosworth ◽

Arvind Kaul

Keyword(s):

Inflammatory Arthritis ◽

Good Practice ◽

National Study ◽

Freedom Of Information ◽

Inadequate Response ◽

Limited Sample ◽

Regional Variability ◽

Nice Guidance ◽

Information Requests ◽

Individual Funding

Abstract Background/Aims NICE publishes guidance underpinned by act of Parliament and legally enforceable, on the use of biological therapies in the treatment of rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) which should allow harmonisation of access independent of region. However, sufficient guidance is not provided on the use of sequential biologics nor is a numerical cap placed on the number of biologics a patient can attempt if they have had an inadequate response. We have previously reported that in a limited sample, Clinical Commissioning Groups (CCGs) interpret NICE guidance variably and restrict access to NICE approved treatments depending on geography, the so-called “postcode lottery”. We determined the variability of biologics pathways in all CCG’s in England to examine whether a potentially unfair postcode lottery exists for sequential biologics use. Methods All 135 England CCGs covering over 55 million people, were sent Freedom of Information requests, for their biologic pathways for RA, PsA and AS. Where CCGs did not have this information, the relevant acute trusts were contacted, with responses recorded under that CCG. For every CCG the local biologics pathways were examined for detail on the number and type of biologics commissioned before an Individual Funding Request was needed. “No Cap” was recorded if CCG’s responded with no restriction on the number of biologics. Results Responses were obtained from 124/135 CCG’s for RA, 122/135 for PsA and AS, all covering an estimated population in excess of 45 million people. For RA, 55% CCG’s had no cap on the number of commissioned RA biologics. 45% had a variable cap from 3 to 6 commissioned biologics. For PsA, the figures were 54% with no cap and 46% with variable capping between 2-5 biologics allowed, for AS the figures were 51% and 49% respectively. In total this represented 41 different local pathways for RA, 29 different pathways for PsA and in AS where fewer biologics choices exist, 25 different pathways depending on CCG and location. Conclusion There is wide regional variation in the interpretation of NICE guidance by CCG’s resulting in many different local pathways depending on geography. Approximately 50% of pathways restricted biologics prescribing by mandating the type and sequence of biologics used, potentially compromising patient care and delaying treatment by requiring an IFR for a NICE approved biologic. Moreover, pathways varied as to which biologics could be used at any point of management by region as well. As exemplars of good practice, approximately 50% of CCG’s had no cap, allowing clinical freedom to prescribe the most appropriate biologic. The results of this national study demonstrate the variability of biologics pathways in many areas of England ensuring a postcode lottery still exists in many regions. Disclosure J. Mistry: None. D. Hill: None. A. Bosworth: None. A. Kaul: None.

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