New NICE quality standard aims to tackle variations in osteoarthritis care

A new quality standard relating to the provision of care for osteoarthritis patients within the NHS has been introduced by the National Institute for Health and Care Excellence (NICE).

It covers the diagnosis, assessment, management, ongoing review and referral for joint surgery of adults who have osteoarthritis, with the aim of reducing and eliminating variations in care quality across the country.

Efforts will be made to ensure that adults aged 45 or over are clinically diagnosed with osteoarthritis, without the need for further investigation, if they have activity-related joint pain and any morning joint stiffness lasts no longer than 30 minutes. Newly-diagnosed patients will undergo an assessment that includes pain, its impact on daily activities and quality of life.

Exercise will be recognised as a key pillar of treatment, with patients to be advised to participate in muscle strengthening and aerobic activities. Meanwhile, overweight or obese patients will be offered support to lose weight, as this will lead to better outcomes.

Moreover, the provision of relevant information about osteoarthritis, activity, exercise and weight loss will be prioritised as a key objective in helping patients to manage their own condition, while sufferers will be supported with non-surgical core treatments for at least three months before any referral for consideration of joint surgery.

Finally, the quality standard advises against the use of scoring tools to identify which adults with osteoarthritis are eligible for referral for consideration of joint surgery, with any decision on this front to be made collaboratively with the patient, taking into account their individual needs.

Currently, osteoarthritis affects around 7.3 million people in England alone, a figure that is likely to rise due to an ageing population and increasing rates of obesity. The new NICE quality standard aims to improve the capacity of the NHS to manage this effectively.

A spokeswoman for Arthritis Research UK said: "Exercise is an important way for people with osteoarthritis to manage the pain of their condition effectively. There is a prevailing myth that exercise makes arthritis worse and it's important that we continue to champion the important role that physical activity can play in reducing pain and improving quality of life.

"Obesity is a major risk factor for developing knee osteoarthritis. We know that weight loss can improve the symptoms of osteoarthritis and we welcome the emphasis on supporting people to lose weight. When weight loss is combined with physical activity, it can reduce pain and disability.

"It's important that local commissioners of healthcare assess their services - especially exercise support programmes and weight-loss services - to ensure there is sufficient capacity to meet the needs of people with osteoarthritis."

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