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Chris  Deighton

Simple Tasks campaign: Why early treatment is crucial for the one million people in the UK living with rheumatic conditions

Authors: Chris Deighton Chris Deighton

24 October 2013

 

 The 5th Fit for Work Summit  last week highlighted the need for clinicians, employers and government departments to coordinate action, so that people with Musculoskeletal Disorders (MSDs) are better supported to enter and remain in work. Early intervention and best practice were key discussion points on the day. Here, Chris Deighton - President of the British Society for Rheumatology - talks about the Simple Tasks campaign and how early treatment can greatly improve an individual’s ability to remain in employment.

 

Earlier this month, the British Society for Rheumatology launched Simple Tasks, a campaign designed to raise the profile of rheumatic conditions and their devastating effects on up to one million people in the UK. When I first started as a rheumatologist 20 years ago, there were often severe delays in seeing people for their first appointment; by the time they arrived in my clinic, opportunities to reverse much of their disability were limited. If I am honest, I did not ask about work issues too often, because the main challenges were in helping patients with the basic activities of daily living, such as mobility and independence – things we all take for granted. If a patient found these to be a challenge, I assumed that work was impossible.

 

Today we can afford to be much more ambitious. I typically see people earlier and have better evidence for how to make best use of drugs in the early stages of rheumatic conditions. This can make a huge difference to short and long term outcomes. As a result, I am inclined to enquire much more about important aspects of a patient’s life – such as work – because the chances are I can do much more to help people to continue in employment.

 

However, from my experience, there are still occasions when patients with rheumatic conditions experience unnecessary delays before seeing a specialist. Sometimes people who develop symptoms suggesting inflammation in joints (like pain, swelling, morning stiffness, and generally feeling tired and unwell) ignore them, hoping they will go away or that over the counter ibuprofen will cure their problems. Sometimes there are delays in referral by GPs, particularly if the symptoms have developed gradually. And finally, it is sometimes clear that hospital services are not as responsive as they need to be in these situations. Occasionally all of these potential delays will amalgamate, increasing the time someone remains untreated; this is frustrating for them and me.

 

A key message of the Simple Tasks campaign is raising awareness around the “window of opportunity”: a 12 week period after symptom onset, during which a referral to a rheumatologist will drastically reduce the physical impacts of conditions, as well as the costs.

 

There are also other hurdles in the system. If NHS England introduced changes that incur an initial cost in resources but kept people in work, it is likely that the overall cost to the economy would be considerably lower. It is estimated that timely referrals to rheumatologists could save the NHS £31 million a year. The National Institute of Health and Care Excellence are committed to take the full socio-economic costs of a condition as part of Value Based Pricing to determine the cost effectiveness of drugs, but this has yet to materialise for rheumatic treatments. This lack of joined up thinking means that, at the highest levels of government and among other policy makers, there is a disconnect between health, disease and work.

 

Furthermore, we often forget that a rheumatic condition not only has an impact on the individual affected, but also on family and friends who are caring for them. The sudden onset of a disabling rheumatic condition may not only affect the ability of the afflicted individual to work, but also those around them. It is then worth noting that 57% of carers for rheumatic patients say they experienced a negative or very negative impact on their household incomes after they started caring for their loved ones, and 41% believe it had a negative impact on their relationship.

 

With the Simple Tasks campaign we are trying to raise the profile of rheumatic conditions so that policy makers, referring doctors and the public are aware of these diseases, the need to intervene early and the consequences of not doing so. Delays in seeing patients with rheumatic conditions cost individuals and society huge amounts of money every year, even more so in times of economic challenge; we cannot afford to continue ignoring them.

 

 The key objectives of the campaign are:

 

 - To raise the profile of rheumatology in the UK

-  To increase the understanding of the work of rheumatologists and allied health

    professionals

-  To emphasise the window of opportunity for preventing pain and disability in autoimmune

    and inflammatory arthritis    

    

To read more on the Simple Tasks campaign and to help us spread the message please go to www.simpletasks.org.uk.