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Seventh All Party Parliamentary Group Meeting Puts Primary Care in the Spotlight

Primary care was the focus of conversation during the 7th meeting of the All Party Parliamentary Group on Axial Spondyloarthritis (APPG). 

The meeting, which took place on 20 October 2021, was chaired by Tom Randall MP, who lives with axial SpA. It brought together people living with the condition, healthcare professionals and key policy makers to discuss the role that GPs and First Contact Practitioners (FCPs) – the physiotherapists who work in GP surgeries and specialise in musculoskeletal conditions play in identifying axial SpA.

During the meeting our CEO, Dr Dale Webb, introduced the Primary Care Clinical Champions programme. Part of the Act on Axial SpA programme, it will create a team of clinicians who are experts in the diagnosis, treatment and care of axial SpA. They will receive leadership development training and will learn how to roll out improvement projects within their local healthcare system. They will work together to exchange ideas and solidify best practice across the UK.

NASS will be accepting applications from people interested in being part of the Primary Care Clinical Champions programme as of 4 January 2022. More information on the programme will be available in the coming months.

Discussions during the rest of the session focussed on some of the key issues faced by primary care practitioners such as GPs and First Contact Practitioners (FCPs). Speakers outlined problems and suggested solutions which could improve the situation without increasing burden on already stretched services.

Dr Louise Warburton highlighted how difficult it can be for GPs to identify a patient with possible axial SpA. She described it as a ‘needle in the haystack’ when an individual is presenting with multiple symptoms which could be linked to a variety of different conditions. She also outlined possible solutions such as fast track assessment clinics.

Abigail Henderson of the Chartered Society for Physiotherapy (CSP) spoke about the key role FCPs play in the diagnosis of axial SpA. She said that as specialists in musculoskeletal conditions they should be able to help identify people who need referral quickly have a greater understanding of axial SpA and its symptoms. They are also usually well connected with the local primary care teams, rheumatology departments and other services that people might be first referred into when getting a diagnosis, such as a back pain triage team.

We were also delighted that Dr Dinny Wallis from University of Southampton Hospital, took to the stage to showcase the work that the team have been doing as part of the Aspiring to Excellence programme. In particular, Dr Wallis talked about the team have done to redesign the local axial SpA care pathway, with a focus on improvements to their electronic-referral system.

Chris Mercer, who leads the primary care workstream on the NHS England Best MSK Health programme, highlighted the opportunity for musculoskeletal conditions (including axial SpA) to be in the spotlight. The Best MSK Health Collaborative is a programme of work that is addressing the issues that exist within the system in England.  It is working to improve MSK services for everyone, everywhere in England. There will be some specific work on data which it is hoped will help to identify people with axial SpA. This will also feed into the rheumatology workstream within the programme, as well as the path that a person with suspected axial SpA might follow when navigating the healthcare system.

The evening closed with a fascinating Q and A, which saw healthcare professionals and people with axial SpA take to the stage to take a deeper dive into some of the topics discussed.

If you missed it, you can watch the meeting here.

Notes for editors

1. About the All Party Parliamentary Group on Axial Spondyloarthritis

NASS formed the All-Party Parliamentary Group (APPG) on Axial Spondyloarthritis in December 2018 to provide national oversight of the implementation of the NICE guidelines and Quality Standard for Spondyloarthritis conditions. The APPG is chaired by Tom Randall MP and co-chaired by Lord Campbell-Savours.

Learn more about the APPG.

2. About the Act on Axial SpA campaign

The Act on Axial Spa campaign is part of the Gold Standard Time to Diagnosis programme. It is the first programme in the world to call for a Gold Standard time to diagnosis of axial spondyloarthritis. It aims to reduce the average time for diagnosis from eight-and-a-half years to just one. 

Over the next four years, we will work closely with people living with axial SpA, primary and community care, secondary care, professional bodies, commissioners, Parliamentarians and policy makers, to focus and streamline efforts to reduce the time to diagnosis to no more than one year from symptom onset.  

We will also run a campaign to improve public awareness of the condition and its signs and symptoms, encouraging people with persistent lower back pain to find out if they could be living with axial SpA. 

About the programme partners

The Gold Standard Time to Diagnosis programme is led by the National Axial Spondyloarthritis Society (NASS) in partnership with Norfolk & Norwich NHS Foundation Trust and RUH Bath NHS Foundation Trust. 

The campaign is funded by UCB (, a global biopharmaceutical company focused on the discovery and development of innovative medicines and solutions to transform the lives of people living with severe diseases.