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In the second of our series of blogs showcasing our 2022 Best Practice Award winners, we speak to the rheumatology team at Leeds Teaching Hospitals NHS Trust; they're pioneering a referral pathway for patients with suspected giant cell arteritis.

The rheumatology team wanted to improve the referral pathway for patients with suspected giant cell arteritis, a condition that needs treating promptly as it can lead to blindness or stroke.

Dr Sarah Mackie, consultant rheumatologist, said: “We wanted to be able to assess patients quickly, give a prompt diagnosis and get them the right treatment.”

The project aimed to decrease waiting times, reduce over-diagnosis, optimise treatment and make the best use of hospital resources. The team worked together to design a new way of working, listening to ideas from everyone involved in the pathway including administrative staff, the whole MDT and patients.

“From a sonographer’s point of view, being involved in discussions from the start means we’ve been able to influence the decisions,” said Kate Smith, research sonographer at Chapel Allerton Hospital Biomedical Research Centre. “Co-designing the pathway means it works for everyone.”

To improve the speed and accuracy of diagnosis, the team introduced several changes including:

  • streamlining how GPs and A&E can refer a patient to specialists
  • introducing temporal artery ultrasound, a quicker, cost-effective and non-invasive way to diagnose the condition
  • reviewing patients’ cases in a diagnostic meeting with clinicians, sonographers and histopathologists to reach joint decisions on diagnosis and treatment.

As a result of the changes, the time from referral to a definitive decision on long-term treatment has declined from an average of 28 days to 7 days.

The Best Practice Award judges felt the project was a great example of identifying a challenge and drawing on the expertise of both patients and medical professionals to drive improvements.

Award judge and BSR Chief Executive Ali Rivett said: “The new pathway has improved the service against a wide and impressive range of metrics, including the speed at which patients are seen.”

The team are thrilled with the award, and it’s had many positive impacts. “We’ve been able to share our experience at BSR’s annual conference to help others,” explained Kate Smith. “The win has also helped raise awareness of the condition and opened up conversations with other specialties and wider networks who are keen to understand more about what we’ve done.”

The team is now developing the pathway further using the data they collected during the project. “We’re improving the pathway all the time, like making the referral paperwork easier for people to fill in,” said Dr Mackie. “We’ve got a continuous improvement mindset, so it’s about small steps to develop it every year.”

Congratulations to the Leeds team. You can find out more about our other Best Practice Award winners here