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The NEIA audit aims to improve the quality of care for people living with inflammatory arthritis, collecting information on all new patients over the age of 16 in specialist rheumatology departments in England and Wales.

2020 winner: Richard Driscoll Award for Patient and Public Involvement

Commissioned by the Healthcare Quality Improvement Partnership as part of the National Clinical Audit Programme, the National Early Inflammatory Arthritis Audit is carried out by BSR with support from King's College London and Netsolving.

Each audit generates unit-level data across the UK, benchmarked to regional and national comparators against NICE Quality Standard 33 and other key metrics. It then measures how reconfiguration and staffing changes have changed practice and patient care from audit to audit.

Data is collected for patients with a diagnosis of rheumatoid or rheumatoid pattern arthritis at three time points across 12 months, assessing waiting times, time to treatment, clinical response to treatment, provision of education and patient-reported outcomes.

For patients with axial spondyloarthritis, data collected is the referral time and waiting time to first appointment, along with a few additional questions on diagnosis.

The audit has five regional champions, based on the NHS Regions and Wales, who work with units to address emerging issues and facilitate communication with the society.


Driver diagrams

Driver diagrams show step-by-step approaches that identify multiple small interventions that influence the primary aim. There are context-specific facilitators and barriers to high-quality care at each site. Driver diagrams should be modified for local circumstances and involve input from across the MDT.

The driver diagrams can be edited and some spaces are left blank. Instructions for completion and further resources are in the ‘instructions’ tab at the bottom of the page within each diagram.

  1. NICE Quality Statement 1 Driver Diagram

  2. NICE Quality Statement 2 Driver Diagram

  3. NICE Quality Statement 3 Driver Diagram

  4. NICE Quality Statement 4 Driver Diagram

  5. NICE Quality Statement 7 Driver Diagram

Clinic prompts

Developed by the NEIAA clinical team to support decision-making, these can be used as a training tool at induction and for educational interventions.

There are prompts for new suspected inflammatory arthritis, the review of inflammatory arthritis patients, and newly-diagnosed axial spondyloarthritis.


QS33 covers assessing, diagnosing and managing rheumatoid arthritis in over 16s. It describes high-quality care in priority areas for improvement. This guidance was initially published in June 2013 and was updated in January 2020.

It provides guidance on the quality of care that healthcare professionals should deliver and also informs patients, service users and carers on what they should expect.

The January 2020 version covers five quality statements around referral, treatment, patient education, rapid access to specialist care and annual review. QS2 on assessment and QS5 on disease control were removed. BSR was a supporting organisation in reviewing the standards, as we recognise the benefit of updating it to improve care.

NB: we currently use QS2 for outlier ascertainment in this audit, and will continue to do so until further notice, as it is still referenced as supported by evidence and is useful at a local level.

Archive reports and case studies


  • Supplementary report: focusing on the seventh metric (annual reviews) alongside 12-month clinician- and patient-reported outcome data. Find out more

  • Trust and health board data: provider-level admission, annual review and disease activity score data. Find out more


  • Clinical annual report: analyses data from 20,668 patients, who were recruited between 8 May 2018 and 7 May 2019. Find out more

  • Patient and public annual report: focused look at patients referred with suspected inflammatory arthritis, seen in a rheumatology clinic for the first time and followed up over three months. Find out more

  • Trust and health board data: provider-level organisational data and performance against each of the 2018 NICE Quality Statements. Find out more

  • Annual report slideset: key findings from the first year of the NEIAA (for presentations). Find out more


  • Clinical annual report: analyses data from 5,002 patients, who were recruited between 1 February 2015 and 29 January 2016. Find out more

  • Patient annual report: assesses the early management of patients referred to rheumatology providers with suspected inflammatory arthritis. Find out more

  • 2016 annual report presentation of key findings. Find out more

  • 2015 clinical annual report: analyses data on 6,354 patients, who were recruited to the audit between 1 February 2014 and 31 January 2015. Find out more

  • 2015 patient annual report: in-depth look at patients over 16 years of age in England and Wales with suspected rheumatoid or other types of early inflammatory arthritis within the crucial first three months of referral to a specialist. Find out more

  • 2015 annual report presentation of key findings: Find out more

  • 2014-16 National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis case studies: Find out more