LAUSR

Disease modifying anti rheumatic drugs (DMARDs) play a vital role in controlling autoimmune disease. They are complex medications requiring nurse counselling to initiate. Staff vacancies and increasing referrals led to 12-week waiting times from decision to treat in our Trust. We wanted to improve the efficiency of the medication counselling process, but at the same time use it as an opportunity to educate our patients on their disease, management and self-care. We designed and delivered a successful group clinic to improve patient experience, reduce waiting times and improve efficiency. As well as covering the necessary DMARD information, the clinic includes patient education on general, physical and mental well-being, dietary advice as well as physiotherapy and occupational therapy input. The clinic format consists of a presentation/discussion, peer support and individual consultation, providing truly holistic care. Waiting times: reduction from 84 days to 7-14 days from decision to treat for our two main DMARDS and 56 days to 14 days for our anti TNF therapies. Clinical outcome/patient safety: Earlier initiation of DMARDs has been shown to reduce morbidity. Financial: Additional £444 income per clinic (compared with previous clinic process) at a tariff of £111 per patient. Group clinics currently run weekly. Patient feedback: 50 patient feedback forms have been collected and reviewed. Of these 50 patients 97.8% of questions asked were marked as agree or strongly agree to a positive experience. Shared learning: The clinic format was presented at a regional meeting and at our Trusts Quality Improvement Day. There is interest in adopting a similar approach in other departments in the Trust and in other rheumatology departments in the region. Our group consultation model provides a holistic model to care that has been very popular with our patients. We have subjectively had an increase uptake in physiotherapy services and patients seem to be persevering and tolerating their medications better. Our group consultations have been running successfully for a year, and we have expanded the sessions to cover more drugs including our anti TNF therapies. It is yet early days to comment on the long-term impact our clinic has on patients, but with our clinic providing patient education and empowering patients through self management we are hopeful that we will be improving the long-term outcome of our patients. K. Nadesalingam None. C. Short None.