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April 30, 2026Lara D. Veeken0 citations

P075 Paediatric rheumatology and timely access to care for children and young people with inflammatory conditions: findings and recommendations from the Getting it Right First Time (GIRFT) report

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FMFlora McErlaneSOSarah OlsonCPClaire Pidgeon

Key Points

  • To evaluate timely access to care for children with inflammatory conditions and identify factors affecting care delivery.
  • Analyzed data from Hospital Episode Statistics and Referral to Treatment metrics for paediatric rheumatology encounters.
  • Considered self-reported data from GIRFT peer review visits at 16 tertiary providers in England.
  • Calculated median wait times for referrals and appointments.
  • Median wait from referral to first appointment was 4.2 weeks for inpatient care and 12.2 weeks for outpatient care.
  • 75% of centres reviewed suspected inflammatory presentations within four weeks.
  • Most providers reported delays in accessing joint injections and paediatric phlebotomy services.

Abstract

Abstract Background/Aims Paediatric-onset inflammatory rheumatological conditions impose substantial burdens on families and healthcare services. Timely access to care and reducing the duration of active inflammation are associated with improved clinical outcomes and patient experience. The 2025 paediatric rheumatology Getting It Right First Time (GIRFT) review, designed to identify and address unwarranted variation in care, presented a novel opportunity for a data-driven review of inflammatory care across the 16 tertiary paediatric rheumatology providers in England. Methods Patient-level Hospital Episode Statistics (HES), Referral to Treatment data and the associated Waiting List Minimum Dataset (WLMDS), were analysed for all inpatient and outpatient paediatric rheumatology encounters between April 2023 and March 2024. These data were contextualised using self-reported data collected during the GIRFT peer review visits at the 16 providers. Results In relation to inpatient RTT pathways, there was a median length of 4.2 weeks from referral to first appointment (range 0-13 weeks). Most providers (11/16) reported always or sometimes experiencing delays arranging admissions. Seven centres reported always or very often experiencing delays of 7 days accessing day-case care. Considering outpatient RTT pathways, there was a median wait of 12.2 weeks from referral to first appointment (range 4.57 - 25.14 weeks). Self-reported inflammatory care data indicate that 10/16 (75%) centres always or usually review suspected inflammatory presentations within 4 weeks. There can be further delays accessing multidisciplinary team (MDT) review Table 1. Only three providers deliver general anaesthetic (GA) joint injections within 7-14 days. Four providers offer same day non-GA joint injections whilst 11 report delays of 7 days. Thirteen centres expressed concern about timely access to paediatric phlebotomy services. Conclusion Self-reported GIRFT data suggest that most tertiary paediatric rheumatology providers see suspected new inflammatory patients within four weeks of referral, meeting minimum standards. However, timely access to MDT care, joint injections, and day-unit infusions remains variable. Between-centre differences in case-mix and variable regional service models, combined with non-mandated outpatient diagnostic coding, limit the quality and completeness of national data. Standardised reporting of outpatient diagnostic data is essential to identify unwarranted variation and guide improvements in timely access to care. Disclosure F. McErlane: None. S. Olson: None. C. Pidgeon: None. R.D. Sandler: None. C. Tranter: None. G. Ward: None. G. Cleary: None.

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Cite This Study

McErlane et al. (2026) studied this question.

synapsesocial.com/papers/69f2a47b8c0f03fd6776384dhttps://doi.org/10.1093/rheumatology/keag121.111
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