P175 Creating a social movement for change to transform care and drive down diagnostic delay in axial SpA

Abstract

Abstract Background/Aims It should be possible for every person experiencing symptoms of axial SpA to receive a diagnosis within one year of symptom onset. In June 2021, NASS published a route map to achieve a gold standard time of one year. Starting from a current baseline average of 8.5 years, the achievement of this goal will require transformational change. Above all, to attain such a dramatic change in time to diagnosis, we must win hearts and minds, build a movement of people who want to work with us to create change, and demonstrate proof of concept for our ideas. Methods Our campaign is designed around two key considerations. Firstly, a broad theory of change that describes how we can create system-wide change. Secondly, an understanding of the patient journey from symptom onset to diagnosis by a rheumatologist. Our theory of change first builds a ‘burning platform’, setting out why action and change is needed; we will use this to influence the thinking and behaviour of the public, policy makers and health care professionals. We will use a range of levers to create change in care processes; these will result in earlier diagnosis. Our first impact report described our work and impact to date in implementing this theory of change. Results We have been successful in building the burning platform for change, including commissioning the first economic model of the economic costs of delayed diagnosis. We have brought these, and other new data, to the attention of Ministers, other parliamentarians, policymakers, and HCPs. We have influenced the funders of the National Early Inflammatory Arthritis Audit to include new datapoints on time to diagnosis so that, for the first time, we will have comprehensive national audit data to track changes in performance. We have supported the Best MSK Health Collaborative to embed our approach in a new national axial SpA patient pathway. We are working with 19 rheumatology departments to implement the gold standard through our Aspiring to Excellence programme, and our new cadre of 12 Champions in Primary Care will be working together to drive improvement in identification and referral of suspected axial SpA patients. We have presented our burning platform to conferences and regional SpA academies. We have demonstrated proof of concept in our public awareness campaign which has reached 1.5 million people through social media, with 900,000 people watching our campaign videos, and already 5,000 people completing the online symptom checker. Conclusion We are building a social movement for change. We are influencing the thinking and behaviour across rheumatology. We are starting to see tangible changes in care processes. We have more work to do to translate this into the achievement of a one year time to diagnosis. Disclosure J. Eddison: None. D. Webb: None. J. Hamilton: None. L. Marshall: None. F. MacAuley: None.