NASS Allies

We are working with the Royal College of Chiropractors and Institute of Osteopathy to help reduce the 8.5 year delay to diagnosis

GP Referral Template launched

At the Primary Care and Public Health Conference 2019, NASS was able to raise awareness of our brand new referral template which was developed in conjunction with the Royal College of Chiropractors and Institute of Osteopathy. It has been endorsed by the Royal College of GPs and the Chartered Society for Physiotherapy. The template is designed to help osteopaths and chiropractors to recommend referral into rheumatology via GPs more easily. The template is fully editable and comes with supporting documentation. In order to track the success of the template, we are asking osteopaths and chiropractors using the template to share their patients’ details with NASS (with their consent) so that we can follow their journey from referral through to diagnosis.

Download the template and additional documents:

Referral Template

Referral Template by hand

Referral Template guidance for use

Patient Information

Patient consent form


Sign up for our seminars

We are pleased to be holding more of our seminars in 2019. The first event was held be held in Basildon on 16 April, with further events confirmed at the Freeman Hospital in Newcastle on 17 September and Royal Berkshire Hospital inn Reading on 23 October. Events run from 5.30pm to 8.30pm.

Torquay and Portsmouth will also host an event each, with dates and details to follow.

Download the agenda

Sign up for upcoming seminars at the bottom of this page


In a survey conducted by NASS, 68% of people had visited a chiropractor before a diagnosis of axial SpA (AS) and 60% had visited an osteopath before diagnosis. This clearly shows that chiropractors and osteopaths are on the front line in NASS’s bid to reduce the current delay to diagnosis.

An advisory board meeting was held in August 2017 involving NASS, Professor Karl Gaffney, Dr Raj Sengupta, Dr Jane Martindale (physiotherapist), Katie Griffiths of the Institute of Osteopathy (iO) and Jatinder Benepal of the Royal College of Chiropractors (RCC) and a new steering group was formed. NASS’s sincere thanks go to the Institute of Osteopathy and Royal College of Chiropractors for embracing this project and allowing the charity many opportunities to promote our work and axial SpA (AS) in general.

Project round up

Axial SpA (AS) Seminars

Two pilot seminars have been held; the first was hosted by Professor Karl Gaffney at the Norfolk and Norwich University Hospital in February 2018, and the second by Dr Raj Sengupta at the Royal National Hospital for Rheumatic Diseases, Bath in April. The events were attended by over 100 osteopaths and chiropractors and were the subject to very positive feedback. We will hold at least 5 more seminars in 2019 as well as hopefully develop a webinar from the content.

Understanding Axial SpA (AS) Survey

In the June and July 2018 382 practitioners were surveyed to provide some baseline data around the understanding of axial SpA (AS) amongst osteopaths and chiropractors and also help to shape the future of the project. The survey was advertised via the institute of Osteopathy and Royal College of Chiropractors via their e-news, journals and social media.

Almost all respondents were confident in their understanding of the term AS, but only 57% were confident about axial SpA. Recognition of the main signs and symptoms of axial SpA was good. The two most striking outcomes were that there is still a belief that axial SpA affects only men, and uveitis was not as commonly recognised as an extra articular manifestation in axial SpA despite its high  prevalence in those with the condition (26%). Most respondents recognised the need for their knowledge to be updated to cover the full spectrum. A greater understanding in how best to treat a patient with axial SpA was also a recurring theme. The difficulty in establishing a relationship between allied health care professionals and GPs was strongly reflected in the lack of confidence around recommending onward referral.

Referral Template

In response to the feedback given both in the pilot seminars and the survey about the difficulties hey have encountered when recommending onward referral, the group has been working to develop a template that osteopaths and chiropractors can use when writing to GPs about their patient having suspected axial SpA (AS). We are delighted that this tool has now been endorsed by the Royal College of GPs and Chartered Society for Physiotherapy; and launched on 15 May 2019.

Royal College of Chiropractors

NASS has worked separately with the Royal College of Chiropractors on a number of activities:

  • Jill Hamilton attended the Summer Conference with an information stand and specially developed materials for attendees.
  • A website article about the project was published.
  • A journal article about the project was published.
  • Professor Karl Gaffney spoke at the Annual Winter Conference on 30 January 2019 and Jill Hamilton attended with an information stand.

Institute of Osteopathy

NASS has worked separately with the Institute of Osteopathy on a number of activities:

  • Articles in Osteopathy Today in Sept/Oct 18, Jul/Aug 2018, May/Jun 18, March/April, Jan/Feb 2018, Nov/Dec 2017 (attached), including a CPD article.
  • A website article about the project was published.
  • Dr Raj Sengupta ran a workshop at the Institute of Osteopathy Annual Conference in October 2018. This session was fully booked with 60 attendees. Jill Hamilton attended for 2 days with an information

Update on Axial SpA

Read more