The team [at North Bristol Trust] worked together with pharmacists, specialist nurses and doctors, the wider rheumatology team and a patient representatives group to redesign their b/tsDMARD follow up pathway: moving from default F2F clinic appointments to incorporate hybrid clinics. This involved integrating non-F2F modalities (telephone/video/virtual) with traditional F2F clinic appointments.

In addition to remote appointments, the team also rolled out a smartphone app (provided by Living With Ltd.) for patients to allow them to regularly report their disease activity using validated patient reported outcome measures (PROMs; RAPID3/HAQ/self-assessed DAS28/BASDAI).

Key findings:

• Over £70,000 has been saved per year in unnecessary appointments.
• The service change has released over 140 hours of specialist nurse and specialist pharmacist clinical time which has been reinvested in the service to improve efficiency.

You can find out more on the NHS website.