EP26 Do early synovitis clinics triage patients with RA affectively?

Background In 2013, the UK National Institute for Health and Care Excellence (NICE) published quality standards for the treatment of rheumatoid arthritis (RA); emphasising the importance of early diagnosis and treatment of RA and these were updated in 2018. NICE quality statement 1 recommends that patients with a suspected inflammatory arthritis are referred to a rheumatology service within 3 working days of presentation. Quality statement 2 recommends that these patients are assessed in a rheumatology service within 3 weeks of referral. In view of these quality standards and the benefit of treating patients with RA, early Early Synovitis Clinics (ESC) were set up at the Royal Wolverhampton Trust (RWT). GPs were invited to refer patients electronically to the ESC if they had a swollen joint, positive antibodies (RhF or anti CCP) and if they suspected RA. All referrals to the ESC and all other new patient referrals were triaged by a consultant rheumatologist to determine if they were suitable for the ESC. Methods This is a retrospective service evaluation based on new patients seen in the ESC at the RWT over a 12month period, January to December 2018. The electronic records of patients seen in the ESC were retrospectively accessed and data was collected including gender, age and diagnosis. Results 284 new patients attended the ESC in 2018; 186 (65.49%) were female, 98 (34.51%) were male. The patients age ranged 18-95years with a mean age of 58.75. 72 patients (25.4%) were classified as having RA. 135 patients (47.54%) were classified as having inflammatory arthritis, diagnoses within the inflammatory arthritis group were: psoriatic arthritis, crystal arthritis, Palindromic rheumatism, polymyalgia rheumatica, Reactive arthritis and undifferentiated inflammatory arthritis. 84 patients (29.58%) patients received a diagnosis of osteoarthritis, 12 patients (4.22%) were classified as having a connective tissue disease, 44 (15.49%) of the 284 patients were diagnosed with a condition classified in the category of soft tissue rheumatism. Conclusion This analysis found while 47.54% of patients referred to the ESC at RWT received a diagnosis categorised as inflammatory arthritis, only 25.4% of patients had RA. This compares to the recent National Early Inflammatory arthritis audit where only 35% of patients seen in rheumatology clinics with suspected inflammatory arthritis had a subsequent confirmed diagnosis of an inflammatory arthritis. This suggests more guidance needs to be provided to primary care services regarding the indications for referral to the ESC in order to provide appropriate capacity for patients with RA to be reviewed and treated quickly. Disclosures N. Cleaton: None. T. Khan: None. S.R. Raizada: None.