The Luton and Dunstable University Hospital NHS Foundation Trust rheumatology department established a centralised, patient-focussed and multidisciplinary Early Arthritis Service (EAS) to achieve key financial and clinical outcome targets the department was failing to meet. The EAS aimed to increase the department’s capacity to accommodate referrals from general practitioners (GPs) and other sources, decrease the time between diagnosis and starting therapy, establish standardised treatment algorithms and reduce biologic use. The EAS was established in January 2016 and comprised the following: introduction of a dedicated referral proforma and early arthritis (EA) educational programme for GPs, pooling of all sources of referral, running of 6 EA clinics per week with availability of ultrasound and longer appointments, funding of a Clinical Nurse Specialist to achieve prescriber status, introduction of a standardised approach to the early initiation of therapy and timely review of treatment outcomes. The introduction of the EAS was associated with improved clinical outcomes (EA patients achieving a Disease Activity Score 28 (DAS28) <3.2 in 2015: 38.0% [N=113] vs 78.5% [N=220] in 2016) and overall patient experience (mean waiting time for EA patients’ first appointment in 2015: 12 weeks vs 2.5 weeks in 2016; 74.0% [N=102] of patients recommended the rheumatology service in 2015 vs 92.0% [N=167] in 2016). The total cost associated with introducing the EAS was ∼£201,362. Use of biologics decreased from 26.0% to 5.6% between 2015 and 2016, resulting in a cost saving of ∼£394,932. Other cost savings associated with the EAS included reductions in the overall cost/patient seen (2015: £198.88; 2016: £74.98) and not running any premium rate initiative clinics to meet waiting list targets (saving ∼£26,500 in 2016). Efficiency gains from the introduction of the EAS have improved patients’ health and overall satisfaction with their treatment, whilst saving costs at this NHS Trust.