Longer waiting times for rheumatology appointments increasing risk of "long-term disability"

The average waiting time for rheumatology appointments in Scotland is the highest it has been in eight years.

Figures show the typical length of wait for a new, routine outpatient appointment stood at 79 days in the first half of 2018, up from 69 days in 2016 and 49 days in 2010.

The statistics are highlighted in a new report by the British Society for Rheumatology (BSR) and the Scottish Society for Rheumatology (SSR).

They said swift access to treatment can make a real difference to people with arthritis and other conditions of the joints and muscles.

BSR president Dr Elizabeth Price said: "These delays are a huge concern as we know that prompt access to treatment and support can make a real difference to long-term outcomes.

"Rheumatoid arthritis is one of the major chronic diseases in Scotland.

"After the onset of symptoms there is a 12-week window when a referral to a rheumatologist can dramatically reduce symptoms.

"Lack of action risks leading to long-term disability and can have a damaging impact on lives.''

The Scottish Government has set a target that 90% of people should wait no more than four weeks from referral to their first clinical outpatient appointment.

The percentage of patients seen within four weeks has "remained around 50% over the last few years'', the report notes.

It acknowledges, however, that demand for appointments is "markedly higher'' than it was around a decade earlier.

In 2016-17, there were 114,588 attendances at rheumatology outpatient appointments, up from 84,766 appointments in 2005-06.

The report, entitled Rheumatology in Scotland: The State of Play, is described by the body as the largest and most comprehensive study of its kind.

The report describes rheumatoid arthritis (RA) as one of the major chronic diseases in Scotland and 44,000 individuals currently have a diagnosis of the condition.

Its conclusions on average waiting times are based on Scottish Government statistics and a parliamentary question answered by Health Secretary Jeane Freeman in September.

The publication also reflected the views of staff on developments in rheumatology services over the past three years.

It noted: "In our survey, BSR and SSR members highlighted the severe pressure that rheumatology services were experiencing in Scotland, with one respondent commenting 'our clinics are running at greater than 100% capacity'.''

The document further highlighted concerns over staffing vacancies, saying: "Whilst numbers of consultants have improved, the vacancy rates of consultants is alarmingly high at 12% with 8 vacancies, 3 of which have been vacant for 6+ months.

"It has been reported that some advertised posts in the last 12 months have received no applicants.''

SSR president-elect Dr Anne McEntegart said: "Our latest report reminds us that there is still much more work to be done to ensure patients with all musculoskeletal conditions receive the best possible treatment, care and support.

"We know that departments are under increasing pressure and whilst key challenges remain in rheumatology, there is much work ongoing to help tackle these issues.''

Conservative MSP Brian Whittle, convener of the Scottish Parliament's cross-party group on arthritis and musculoskeletal conditions, said: "Despite the hard work and dedication of NHS staff throughout Scotland, it's clear that more needs to be done if we want to deliver a high quality, sustainable level of care.''

A Scottish Government spokeswoman said: "The Health Secretary published the waiting times improvement plan at the end of last month, which directs more than £850 million of investment to substantially and sustainably improve waiting times by increasing capacity, clinical effectiveness and efficiency as well as implementation of new models of care.

"This investment will see a phased and sustained improvement over the next 30 months with the aim that no patient will wait more than the waiting standards and guarantee."