To support healthcare professionals in the early diagnosis and management of arthritis, the National Institute for Health and Care Excellence has published expert guidance for both rheumatoid arthritis and osteoarthritis, which are available at the following links:

https://www.nice.org.uk/guidance/ng100

https://www.nice.org.uk/guidance/ng226

The Royal College of General Practitioners also has a range of e-learning materials to support general practitioners (GPs) and other primary care professionals in the diagnosis and management of arthritis, including a rheumatoid arthritis hub and an osteoarthritis hub.

We are supporting better care for patients with arthritis through the Getting It Right First Time Programme (GIRFT) for Rheumatology. The GIRFT rheumatology programme is supporting the National Health Service to deliver care more equitably across England and closer to patients’ homes, and improve services nationally.

To support people with musculoskeletal (MSK) conditions, we are working to deliver the GIRFT MSK Community Delivery Programme. GIRFT teams are working directly with health system leaders to reduce MSK community waiting lists, including for people with arthritis, and support the recovery, long-term transformation and ongoing delivery of high-quality accessible community MSK services.

As part of a major transformation of the NHS under the 10-Year Health Plan, patients with MSK conditions will also soon be able to directly access community services, including physiotherapy, pain management and orthopaedics, in the NHS App. The landmark change will deliver faster treatment for the flare up of existing conditions including arthritis, backpain and joint pain, while enabling GPs to focus on more complex cases, reducing pressure on hospitals and freeing up GP practices.

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing evidence-based recommendations for the National Health Service on whether new, licensed medicines represent a clinically and cost-effective use of NHS resources. The NHS in England is legally required to fund medicines recommended by NICE.

NICE has unfortunately been unable to develop guidance for the NHS on the use of baricitinib for treating juvenile idiopathic arthritis in people two years old and over because the company, Eli Lilly, did not provide an evidence submission. NICE will review its decision if the company decides to make a new evidence submission.

Decisions on whether to fund medicines in the absence of NICE guidance are for NHS commissioners. NHS England does not fund medicines where the company has not engaged with NICE. This is to avoid a potential pathway for circumventing the NICE appraisal process. NHS England’s policy on non-submission of data to NICE is available at the following link:

https://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2018/09/NHS-England-Procedural-Note-non-submission-of-data-to-NICE.pdf

We are supporting better care for patients with arthritis through the Getting It Right First Time Programme (GIRFT) for Rheumatology. The GIRFT rheumatology programme is supporting the National Health Service to deliver care more equitably across England and closer to patients’ homes, and improve services nationally.

As part of the GIRFT MSK Community Delivery Programme, GIRFT teams are working with health system leaders to reduce MSK community waiting times, including for patients with arthritis, and improve referral pathways to wider support services.

As part of a major transformation of the NHS under the 10-Year Health Plan, patients with MSK conditions, such as arthritis, will also soon be able to directly access community services, including physiotherapy, pain management, and orthopaedics, in the NHS App. The landmark change will deliver faster treatment for the flare up of existing conditions, including arthritis, back pain, and joint pain, while enabling general practitioners (GPs) to focus on more complex cases, reducing pressure on hospitals and freeing up GPs.

Diagnosis Connect, which was announced in July 2025, will ensure that patients are signposted to trusted charities and support organisations when they are diagnosed with a long-term condition, providing personalised advice, information, and guidance to help them manage their condition and feel more in control. This support is designed to complement, not replace, their usual NHS care. A national partnership has now been developed, with NHS England, the Richmond Group of Charities, which includes Arthritis UK, and wider voluntary, community, and social enterprise partners working together to bring this vision to life. This is being backed by a £10 million investment.

Initial testing will begin with one condition being diagnosed in primary care. This testing will provide an opportunity to demonstrate what is possible before expanding to other conditions. Following initial testing, other conditions will be added to the programme.

We are supporting better care for patients with arthritis through the Getting It Right First Time Programme (GIRFT) for Rheumatology. The GIRFT rheumatology programme is supporting the National Health Service to deliver care more equitably across England and closer to patients’ homes, and improve services nationally.

As part of the GIRFT MSK Community Delivery Programme, GIRFT teams are working with health system leaders to reduce MSK community waiting times, including for patients with arthritis, and improve referral pathways to wider support services.

As part of a major transformation of the NHS under the 10-Year Health Plan, patients with MSK conditions, such as arthritis, will also soon be able to directly access community services, including physiotherapy, pain management, and orthopaedics, in the NHS App. The landmark change will deliver faster treatment for the flare up of existing conditions, including arthritis, back pain, and joint pain, while enabling general practitioners (GPs) to focus on more complex cases, reducing pressure on hospitals and freeing up GPs.

Diagnosis Connect, which was announced in July 2025, will ensure that patients are signposted to trusted charities and support organisations when they are diagnosed with a long-term condition, providing personalised advice, information, and guidance to help them manage their condition and feel more in control. This support is designed to complement, not replace, their usual NHS care. A national partnership has now been developed, with NHS England, the Richmond Group of Charities, which includes Arthritis UK, and wider voluntary, community, and social enterprise partners working together to bring this vision to life. This is being backed by a £10 million investment.

Initial testing will begin with one condition being diagnosed in primary care. This testing will provide an opportunity to demonstrate what is possible before expanding to other conditions. Following initial testing, other conditions will be added to the programme.

The Sherwood Forest Hospitals NHS Foundation Trust, which provides rheumatology services for those living in the Ashfield constituency, currently reports an average wait of approximately four weeks for a first rheumatology appointment. The trust is meeting the National Health Service constitutional standard, with 100% of patients seen within 18 weeks and no patients waiting over 52 weeks. Nationally, the average wait to see a rheumatologist is approximately 10 weeks, meaning patients in Ashfield are seen significantly sooner than the national average.

While no Ashfield constituency‑specific programme is separately published, these improvements reflect work to enhance clinic capacity, referral pathways, and operational efficiency. The Nottingham and Nottinghamshire Integrated Care Board also participates in NHS England’s Referral to Treatment improvement framework, using monthly performance data to support continued progress.

Specialist care is provided through rheumatology services at Kings Mill Hospital, offering diagnosis, medication management, joint injections, and monitoring for inflammatory and degenerative arthritis. Community‑based services, including physiotherapy, podiatry, and dietetics, are available locally and monitored through the Community Health Services Monthly Situation Report. Additional support is available through national resources such as NHS My Planned Care and Arthritis Action, which provide guidance on pain management, exercise, and self‑management.

Nationally, we are supporting better care for patients with arthritis through the Getting It Right First Time Programme (GIRFT) for Rheumatology. The GIRFT rheumatology programme is supporting the NHS to deliver care more equitably throughout England and closer to patients’ homes and improve services nationally.

Additionally, as part of the GIRFT Musculoskeletal (MSK) Community Delivery Programme, GIRFT teams are working with health system leaders to reduce MSK community waiting times, including for patients with arthritis, and improve data, metrics, and referral pathways to wider support services. Patients with MSK conditions, such as arthritis, will also soon be able to bypass their general practitioners and directly access community services, including physiotherapy, pain management, and orthopaedics, in the NHS App.

The Sherwood Forest Hospitals NHS Foundation Trust, which provides rheumatology services for those living in the Ashfield constituency, currently reports an average wait of approximately four weeks for a first rheumatology appointment. The trust is meeting the National Health Service constitutional standard, with 100% of patients seen within 18 weeks and no patients waiting over 52 weeks. Nationally, the average wait to see a rheumatologist is approximately 10 weeks, meaning patients in Ashfield are seen significantly sooner than the national average.

While no Ashfield constituency‑specific programme is separately published, these improvements reflect work to enhance clinic capacity, referral pathways, and operational efficiency. The Nottingham and Nottinghamshire Integrated Care Board also participates in NHS England’s Referral to Treatment improvement framework, using monthly performance data to support continued progress.

Specialist care is provided through rheumatology services at Kings Mill Hospital, offering diagnosis, medication management, joint injections, and monitoring for inflammatory and degenerative arthritis. Community‑based services, including physiotherapy, podiatry, and dietetics, are available locally and monitored through the Community Health Services Monthly Situation Report. Additional support is available through national resources such as NHS My Planned Care and Arthritis Action, which provide guidance on pain management, exercise, and self‑management.

Nationally, we are supporting better care for patients with arthritis through the Getting It Right First Time Programme (GIRFT) for Rheumatology. The GIRFT rheumatology programme is supporting the NHS to deliver care more equitably throughout England and closer to patients’ homes and improve services nationally.

Additionally, as part of the GIRFT Musculoskeletal (MSK) Community Delivery Programme, GIRFT teams are working with health system leaders to reduce MSK community waiting times, including for patients with arthritis, and improve data, metrics, and referral pathways to wider support services. Patients with MSK conditions, such as arthritis, will also soon be able to bypass their general practitioners and directly access community services, including physiotherapy, pain management, and orthopaedics, in the NHS App.

The Sherwood Forest Hospitals NHS Foundation Trust, which provides rheumatology services for those living in the Ashfield constituency, currently reports an average wait of approximately four weeks for a first rheumatology appointment. The trust is meeting the National Health Service constitutional standard, with 100% of patients seen within 18 weeks and no patients waiting over 52 weeks. Nationally, the average wait to see a rheumatologist is approximately 10 weeks, meaning patients in Ashfield are seen significantly sooner than the national average.

While no Ashfield constituency‑specific programme is separately published, these improvements reflect work to enhance clinic capacity, referral pathways, and operational efficiency. The Nottingham and Nottinghamshire Integrated Care Board also participates in NHS England’s Referral to Treatment improvement framework, using monthly performance data to support continued progress.

Specialist care is provided through rheumatology services at Kings Mill Hospital, offering diagnosis, medication management, joint injections, and monitoring for inflammatory and degenerative arthritis. Community‑based services, including physiotherapy, podiatry, and dietetics, are available locally and monitored through the Community Health Services Monthly Situation Report. Additional support is available through national resources such as NHS My Planned Care and Arthritis Action, which provide guidance on pain management, exercise, and self‑management.

Nationally, we are supporting better care for patients with arthritis through the Getting It Right First Time Programme (GIRFT) for Rheumatology. The GIRFT rheumatology programme is supporting the NHS to deliver care more equitably throughout England and closer to patients’ homes and improve services nationally.

Additionally, as part of the GIRFT Musculoskeletal (MSK) Community Delivery Programme, GIRFT teams are working with health system leaders to reduce MSK community waiting times, including for patients with arthritis, and improve data, metrics, and referral pathways to wider support services. Patients with MSK conditions, such as arthritis, will also soon be able to bypass their general practitioners and directly access community services, including physiotherapy, pain management, and orthopaedics, in the NHS App.

Through the joint work and health directorate the Department for Work and Pensions and Department for Health and Social Care work collaboratively together to support people who are managing health conditions, helping them to get into, stay, and thrive in work.

The government recognises that musculoskeletal (MSK) problems were one of the leading causes of sickness absence in 2025, whereby an estimated 27.3 million days were lost as a result of them.

The Government is committed to supporting disabled people and people with health conditions, including arthritis and MSK conditions, at all points of their employment journey. We therefore have a range of initiatives available, including support from Work Coaches and Disability Employment Advisers in Jobcentres and Access to Work grants, to more specialised locally commissioned and delivered support such as WorkWell.

We are working to deliver the Getting It Right First Time (GIRFT) MSK Community Delivery Programme. GIRFT teams are working with health system leaders to reduce community MSK waiting lists and transform community services to support people with MSK conditions to get into and remain in employment.

People with MSK conditions can get access to support from WorkWell which provides integrated holistic early help for people with health-related barriers to work, such as arthritis and MSK conditions. WorkWell will be expanded to delivery across all of England backed by up to £259m over the next three years.

WorkWell is led by Integrated Care Boards and accepts participants from a range of sources including local health services which can allow for signposting at the point of diagnosis. Participants receive a range of support based on their needs and can include advice on workplace adjustments, access to physio services and employer liaison. Over one fifth of all WorkWell participants during the pilot phase (22%) consider their primary health barrier to be MSK related.

We are supporting better care for patients with arthritis through the Getting It Right First Time Programme (GIRFT) for Rheumatology. The GIRFT rheumatology programme is supporting the National Health Service to deliver care more equitably across England and closer to patients’ homes and improve services nationally.

As part of the GIRFT Musculoskeletal (MSK) Delivery Programme, GIRFT teams are working with health system leaders to reduce MSK community waiting times, including for patients with arthritis, and improve referral pathways to wider support services.

As part of a major transformation of the NHS under the 10-Year Health Plan, patients with MSK conditions, such as arthritis, will also soon be able to directly access community services, including physiotherapy, pain management, and orthopaedics, in the NHS App. The landmark change will deliver faster treatment for the flare up of existing conditions, including arthritis, back pain, and joint pain, while enabling general practitioners to focus on more complex cases, reducing pressure on hospitals, and freeing up general practices.

National Institute for Health and Care Excellence (NICE) guidelines are informed by clinical expertise, are evidence-based, and represent best practice. While NICE guidance is not mandatory, the Government expects commissioners and service providers to take them fully into account in designing services that meet the needs of their local population and to work towards their implementation over time.

The Government recognises the importance of improving public awareness of arthritis and its symptoms to support early diagnosis and timely access to care. On its NHS.UK website, NHS England provides extensive, publicly accessible information regarding the symptoms and management of arthritis. This includes information about general symptoms alongside specific manifestations for different types of the condition, and when to seek medical advice.

Charities and patient organisations also play a key role in role in raising awareness, and the NHS.UK website includes information and links to charities, helplines, and patient groups across its various arthritis informational pages to help people access further advice and support.

The Government is committed to supporting children and young people with arthritis to ensure they get timely, quality care.

Services for children with suspected arthritis are commissioned in line with the national service specification for paediatric rheumatology services.

The national service specification helps to reduce waiting times for diagnosis by mandating clear referral pathways and rapid access to specialist paediatric rheumatology teams. It sets national standards requiring timely triage of suspected cases, prioritisation of urgent referrals, and availability of multidisciplinary expertise for early assessment. The specification ensures consistency across regions, minimises delays caused by local variation, and supports faster initiation of diagnostic tests and treatment planning.

NHS England’s Getting It Right First Time Paediatric Rheumatology programme is aimed at improving care for children and young people with inflammatory, autoimmune, and rheumatic conditions. Led by specialists, it uses data-driven, "deep-dive" peer reviews of all National Health Service trusts to reduce unwarranted variations, improve transition services, and standardise best practice.

Additionally, the 10-Year Health Plan’s commitments to expand community diagnostic centres for quicker access to tests, introduce digital tools to support early symptom monitoring and triage, and improve the integration between primary care and specialist services will further streamline referral pathways and ensure children receive timely assessment and treatment.

The Department is committed to improving timely diagnosis and management of arthritis and other musculoskeletal (MSK) conditions across England.

The National Institute for Health and Care Excellence (NICE) has published guidance to support health and care professionals in the early diagnosis and management of rheumatoid arthritis and osteoarthritis. These guidelines help ensure that patients receive evidence-based care as early as possible.

NHS England is working to improve early diagnosis rates through its Getting It Right First Time (GIRFT) rheumatology programme. This initiative focuses on reducing variation in care, improving referral pathways, and ensuring patients with suspected arthritis and other MSK conditions are assessed promptly by specialists.

The Government has funded NHS England’s GIRFT programme to deploy its proven Further Faster model for MSK community services. The programme has been designed to reduce waiting times for community MSK appointments and to enhance access to quality treatment, working with integrated care board leaders to improve data and metrics and referral pathways to wider support services.

We are working together to further develop the approach to better enable integrated care systems to commission the delivery of high quality MSK services in the community, which will benefit patients now and into the future.

The Royal College of General Practitioners has produced e-learning modules on a number of musculoskeletal (MSK) and rheumatic conditions, such as inflammatory arthritis, osteoarthritis, and axial spondyloarthritis, which are designed to help general practitioners and other primary care professionals recognise the symptoms of these conditions.

Additionally, to support health and care professionals in the early diagnosis and management of different rheumatological conditions, the National Institute for Health and Care Excellence has published expert guidance on rheumatoid arthritis, osteoarthritis, and spondyloarthritis, with guidance for all three available, respectively, at the following three links:

https://www.nice.org.uk/guidance/ng100

https://www.nice.org.uk/guidance/ng226

https://www.nice.org.uk/guidance/ng65

The Getting It Right First Time (GIRFT) Programme for Rheumatology has made recommendations on the diagnosis and management of a range of rheumatic and MSK disorders and will support the National Health Service to deliver care more equitably across the country and closer to patients’ homes, and to improve services nationally. The GIRFT National Speciality Report included a number of recommendations designed to help support patients with non-inflammatory MSK conditions to be cared for in primary and community settings, freeing up capacity for those who need it to have urgent referrals to outpatient rheumatology services.

Services for children with suspected juvenile idiopathic arthritis are commissioned in line with the national service specification for paediatric rheumatology services.

The national service specification helps to reduce waiting times for diagnosis by mandating clear referral pathways and rapid access to specialist paediatric rheumatology teams. It sets national standards requiring timely triage of suspected cases, prioritisation of urgent referrals, and availability of multidisciplinary expertise for early assessment. The specification ensures consistency across regions, minimises delays caused by local variation, and supports faster initiation of diagnostic tests and treatment planning.

Additionally, the 10-Year Health Plan’s commitments to expand community diagnostic centres for quicker access to tests, introduce digital tools to support early symptom monitoring and triage, and improve the integration between primary care and specialist services will further streamline referral pathways and ensure children receive timely assessment and treatment.

Healthcare in Northern Ireland is devolved, and is therefore a matter for the Northern Ireland Executive. In England, to support health and care professionals in the early diagnosis and management of arthritis, the National Institute for Health and Care Excellence has published expert guidance for both rheumatoid arthritis and osteoarthritis, which are available, respectively, at the following two links:

https://www.nice.org.uk/guidance/ng100

https://www.nice.org.uk/guidance/ng226

The Royal College of General Practitioners also has a range of e-learning materials to support general practitioners and other primary care professionals in the diagnosis and management of arthritis, including a rheumatoid arthritis hub and an osteoarthritis hub, which are both available, respectively, at the following two links:

https://elearning.rcgp.org.uk/course/view.php?id=496

https://elearning.rcgp.org.uk/course/view.php?id=580

We are working to deliver the Getting It Right First Time (GIRFT) Musculoskeletal Community Delivery Programme. GIRFT teams are working with integrated care board leaders to further reduce MSK community waiting times, including for young people with arthritis, and improve data and metrics, and referral pathways to wider support services.

NHS England Specialised Commissioning has a Clinical Reference Group for specialised paediatric rheumatology, which has produced a service specification for these services. This service specification names juvenile idiopathic arthritis as one of the conditions that should be managed by a specialist paediatric rheumatology team. It also sets out that specialised paediatric rheumatology teams will provide transitional care to facilitate transfer and ongoing care in adult rheumatology. Transitional care planning will involve paediatric rheumatology teams, adult rheumatology teams and local hospitals under a shared care arrangement. Specialised paediatric rheumatology services are expected to be commissioned in line with this service specification.

Our recently published 10-Year Health Plan outlines the three big shifts our National Health Service needs to be fit for the future: from hospital to community; from analogue to digital; and from sickness to prevention. All of these are relevant to improving arthritis care for young people in all parts of the country. More tests and scans delivered in the community, better joint working between services, and greater use of apps and wearable technology will all support young people, and their families to manage their long-term conditions, including arthritis, closer to home.

Services for those with musculoskeletal (MSK) conditions, including arthritis, are commissioned locally by integrated care boards (ICBs), including NHS Lincolnshire ICB, which serves the South Holland and the Deepings constituency. The Department expects MSK services to be fully incorporated into integrated care system planning and decision-making.

In Lincolnshire, arthritis patients at United Lincolnshire Teaching Hospitals NHS Trust (ULTH) are seen as part of two cohorts, namely early inflammatory arthritis (EIA) or arthritis patients identified during grading of referrals and then put into ULTH’s general rheumatology urgent/routine cohort. For early inflammatory arthritis, ULTH works to a target of six weeks to treatment. This broadly necessitates patients having their first appointment at between two and three weeks. At present, most new patients referred today would be seen in clinic at approximately six to seven weeks and commence treatment within a few further weeks.

Our recently published 10-Year Health Plan will deliver the three big shifts our National Health Service needs to be fit for the future: from hospital to community; from analogue to digital; and from sickness to prevention. All of these will help deliver improvements to arthritis care in all parts of England.

More tests and scans delivered in the community, better joint working between services, and greater use of apps and wearable technology will all support people to manage their long-term conditions, including arthritis, closer to home.

Services for those with musculoskeletal (MSK) conditions, including arthritis, are commissioned locally by integrated care boards (ICBs). The Department expects MSK services to be fully incorporated into integrated care system planning and decision-making.

As announced in the Get Britain Working white paper, we are delivering the joint Department for Work and Pensions, Department of Health and Social Care, and NHS England Getting It Right First-Time (GIRFT) MSK Community Delivery Programme. Launched in December 2024, with 17 ICBs selected in the first cohort, including the Hampshire and Isle of Wight ICB, GIRFT teams have deployed their proven Further Faster model to work with ICB leaders to reduce MSK community waiting times, including for those with arthritis, and improve data, metrics, and referral pathways to wider support services. The GIRFT programme is continuing to develop the approach to better enable integrated care systems to commission the delivery of high-quality MSK services in the community, which will benefit patients now and into the future.

Our recently published 10-Year Health Plan will deliver the three big shifts our National Health Service needs to be fit for the future: from hospital to community; from analogue to digital; and from sickness to prevention. All of these will help deliver improvements to arthritis care in all parts of the country.

More tests and scans delivered in the community, better joint working between services, and greater use of apps and wearable technology will all support people to manage their long-term conditions, including arthritis, closer to home.

Services for those with musculoskeletal (MSK) conditions, including arthritis, are commissioned locally by integrated care boards (ICBs). The Department expects MSK services to be fully incorporated into integrated care system planning and decision-making.

As announced in the Get Britain Working white paper, we are delivering the joint Department for Work and Pensions, Department of Health and Social Care, and NHS England Getting It Right First-Time (GIRFT) MSK Community Delivery Programme. Launched in December 2024, with 17 ICBs selected in the first cohort, including the Hampshire and Isle of Wight ICB, GIRFT teams have deployed their proven Further Faster model to work with ICB leaders to reduce MSK community waiting times, including for those with arthritis, and improve data, metrics, and referral pathways to wider support services. The GIRFT programme is continuing to develop the approach to better enable integrated care systems to commission the delivery of high-quality MSK services in the community, which will benefit patients now and into the future, including those in Gosport constituency.

The 10-Year Health Plan will deliver the three big shifts our National Health Service needs to be fit for the future: from hospital to community; from analogue to digital; and from sickness to prevention. All of these will help deliver improvements to arthritis care in all parts of the country.

More tests and scans delivered in the community, better joint working between services, and greater use of apps and wearable technology will all support people to manage their long-term conditions, including arthritis, closer to home.

Additionally, to support health and care professionals in the early diagnosis and management of rheumatoid arthritis, the National Institute for Health and Care Excellence (NICE) has published expert guidance for rheumatoid arthritis, which is available at the following link:

https://www.nice.org.uk/guidance/ng100

Whilst guidelines published by NICE are not mandatory, their implementation by ICBs will improve the quality and efficiency of healthcare services.