1. Call to action First point of contact with the NHS Public Health messages Access to Information education Rapid & Equal access to specialist/MDT Parity With other Long Term Conditions Knowledge that something can be done Knowledge of early referral benefits to improve outcomes

2. Call to action Ongoing Care Improve community/specialist knowledge of local services to signpost Individual Care Plans Rapid & Equal access to prompt specialist/MDT for flares Build Self Management Principles

3. Call to action Specialist intervention Teams to identify innovative management approaches Access to Information education Self management Rapid & Equal access to specialist/MDT Commissioners Scope with clinicians Patient needs in pathway design Recognise systems change Implement Care Pathways that reflect patient need Identify outcomes/ data that reflects true activity costs

4. Other on-going work streams National Audit Office Review of RA care NICE RA Guidelines Patient organisations –enhance self management programmes for example in collaboration with Expert Patient Programme & other organisations RCN Nurse and BHPR allied healthcare professional survey of competencies & productivity.

5. Next steps Professional and patient organisations –cascade this report –Seek implementation of recommendations Public health messages Improve knowledge of all healthcare professionals Individualised care plans Early diagnosis – team access Rapid access for flares – nurses, MDT, doctors. Rheumatology Futures Group –Developing an inflammatory arthritis commissioning pathway –Commissioning toolkits Endorsement to be sought from the Department of Health Explore coding/activity data to reflect true costs of RA