We are currently working to resolve technical issues preventing us from processing applications or payment for membership. Please email Membership on subscriptions@rheumatology.org.uk with any queries.

In the last of our series of blogs highlighting our Best Practice Award winners, we look at the work of the Nuffield Orthopaedic Centre in Oxford. The team won the award for its innovative project supporting patients virtually during the pandemic.

As a result of the COVID-19 pandemic, the rheumatology team had around 7,000 patients that needed to be assessed but they didn’t have the capacity to review them face-to-face.

"We couldn’t offer telephone or video consultations either because the clinic slots were already full,” explains Prof Raashid Luqmani from Oxford University Hospitals NHS Foundation Trust. “These patients have long term conditions that need frequent review to check their treatment is working and their symptoms are under control."

The team decided to build a digital way of working to remotely monitor the health and wellbeing of patients with rheumatological conditions. It involved patients being sent links to a set of online questionnaires via text or email. The answers are sent securely to the hospital where the medical team can view the summarised data together with the patient’s record. It helps the team assess medications, pick up any new problems, and patients can let them know how their health is affecting their quality of life.

Doctors review all the information and produce a report which is automatically sent to the patient and their GP. Once completed, rheumatologists make recommendations on the best outcome for each patient. This might be a telephone call, video call, an in-person assessment or more remote monitoring. This new system has meant more patients can be assessed in less time, it prevents missed appointments, and avoids unnecessary travel to hospital for people with conditions which are under control.

Prof Luqmani said: "In one of our clinics before the pandemic, we might’ve assessed 10-12 patients in an afternoon. With the digital system we already have a lot of the information we need meaning we can assess 6-8 patients in only an hour, and they don’t need to come into hospital unnecessarily."

The Best Practice Award judges were impressed at how the team had integrated digital ways of working into routine care, with compelling evidence of improvements.

Ali Rivett, BSR Chief Executive and judge for the awards said: "This approach has enabled cost efficiencies and drawn the attention of other services, which makes this innovation a worthy best practice winner."

It’s hoped that the concept can be developed for other specialties. "It could apply for patients with other chronic conditions, like interstitial lung disease or inflammatory bowel disease," explains Prof Luqmani. "Essentially it could work wherever you can use the experience of patients, using validated patient reported outcome measures alongside any laboratory or imaging results to make decisions on the need for treatment changes."

The next piece of work will be introducing the concept to patients on biologic therapies. The team is also embedding it into the Trust’s patient-initiated follow-up programme.

Congratulations to the Nuffield team and thank you to all our winners for sharing their experience. You can read more about our other Best Practice Award winners here.