Specialist nurses ‘better than doctors’ in treating rheumatoid patients

A trial led by Leeds University says there may even be clinical benefits from clinics run by nurse specialists, in particular in pain control, disease activity, physical function and general satisfaction with care.

Treatment for the condition, which can lead to severe disability or even prove fatal, has changed significantly in the last decade mainly due to earlier diagnosis and better drug treatments. The nationwide trial found that, although nurses made fewer changes to patients’ medication and ordered fewer X-rays and steroid injections, their patients saw greater improvements than those under the care of doctors and had fewer unplanned hospital admissions or visits to A&E. Their clinics were also cheaper, with numbers of patients on expensive drug treatments remaining constant compared with a doubling in those run by doctors.

Jackie Hill, who co-led the study, said specialist nurses had led to “great improvements” in services.

“At a time when deficiencies have come to light in some areas of the NHS, it’s good to know that in rheumatology there are high levels of satisfaction with the care we provide,” Dr Hill added.

Prof Alan Silman, of the charity Arthritis Research UK, which funded the work, said: “There will obviously always be a place for specialist medical input at certain times in the patient journey, but this study shows the importance of specialist rheumatology teamwork, and is a future model of care which requires serious consideration for widespread implementation within the NHS.”