A report into JIA care from the National Confidential Enquiry into Patient Outcome and Death has just been published. Joint Care? A review of the quality of care provided to children and young adults with juvenile idiopathic arthritis covers care pathways, transition to adult services, access to medications, holistic care and education and training. It sets out recommendations for improvement.
Recommendations
- Raise awareness of juvenile idiopathic arthritis and its symptoms with the healthcare professionals who will see this group of patients.
- Streamline and publicise local referral pathways with clear measurable timelines for patients with suspected juvenile idiopathic arthritis.
- Provide timely access to appropriately trained physiotherapy, occupational therapy, pain and psychology services at the diagnosis of juvenile idiopathic arthritis, and then as needed through adolescence and adulthood.
- Offer age-appropriate information about juvenile idiopathic arthritis and medication risks and benefits to patients and their parents/carers at diagnosis and on an ongoing basis.
- Provide training to the patient, if age-appropriate, and/or their parents/carers on how to administer subcutaneous injections for juvenile idiopathic arthritis at the point treatment is initiated.
- Ensure timely access to intra-articular steroid injections by staff who have been trained to deliver age-appropriate care in units where local or general anaesthesia can be delivered.
- Provide a holistic, developmentally appropriate rheumatology service for patients with juvenile idiopathic arthritis.
- Develop NICE guidance for the management of juvenile idiopathic arthritis.
The recommendations highlight areas that are suitable for regular local clinical audit and quality improvement initiatives. The results of which should be presented at quality or governance meetings, and action plans to improve care should be shared with executive boards. Suggested target audiences are listed under each recommendation.