What do patients value and need in the diagnosis and management of axial Spondyloarthritis?

NASS seeks a research supplier to undertake a large-scale study to determine the values and needs of people in the diagnosis and management of axial Spondyloarthritis

Deadline for tenders 12 Noon 21 June 2021


Context of the study

We want to ensure that axial SpA (AS) care is person-centred and reflects the values and needs of patients. Although anecdotally we have some sense of the health service attributes to which patients attach value, we don’t have any rigorous assessment of this. To our knowledge, there hasn’t been any research that has derived a comprehensive, quantitative, patient definition of quality in axial SpA (AS) diagnosis and management anywhere in the world.

The proposed study is a critical component of a broader programme of work through which NASS is trying to bring greater health policy attention to axial SpA (AS) and stimulate improvements at local level. In 2017 NICE published its first comprehensive guideline on the diagnosis and management of spondyloarthritis[1], and followed this in 2018 with a Quality Standard[2]. In the absence of any existing mechanism to review the implementation of the NICE guidance, NASS established in early 2019 an All Party Parliamentary Group (APPG) with a specific focus to create national oversight of the implementation of the guideline and standard. The APPG commissioned a national inquiry which was published in January 2020[3]. We are now using the report within Parliament, and with Clinical Commissioning Groups, NHS Trusts and Local Authority Scrutiny Committees to draw attention to widespread failings in the implementation of the guideline.

In 2019 the Assessment of Spondyloarthritis International Society (ASAS) published quality standards to improve patient services[4]. Overall, this was a welcome development. However, the standards reflect a predominantly clinical view (120 clinicians and 2 patients contributed to its development).

Finally, in order to help stimulate bottom-up improvements in care, in 2018 NASS launched Aspiring to Excellence, a healthcare improvement programme using the Breakthrough Collaborative Series model, and the first six participating rheumatology services joined in late 2019[5]. Five new services are joining in 2021, to be announced shortly. At the moment, the quality framework that underpins the programme is based on the NICE Guideline.

What we want to develop in the medium-term is an integrated clinical-patient articulation of healthcare quality. The proposed study will provide a critical counter-balance to the clinical view of quality defined by NICE and ASAS.

Scope of the study

The scope of the study is likely to include the following:

  1. Domains of care articulated by NICE and ASAS:
  2. The internationally recognised domains of quality established the US Institute of Medicine[6]:
  3. Areas that are not (or partially covered) by NICE and ASAS
  4. The study should look at key sub-populations including younger people generally, and women of reproductive age in particular

The full tender can be found in the Specification of the Requirement.

Tendering your bid to undertake this study

Please complete the Declaration and Information form and send it in with your bid document(s).


Important Terms and Conditions for the Tender

Please review the Instructions and Information on the Tendering Procedures document for our complete Terms and Conditions for the tender before you submit your bid.


Your bid documents and any other attachments

These can be in pdf or PPT format.


Submission of your bid and completed Declaration and Information form

Please send all documents to lisaswingler@nass.co.uk and cc aspiringtoexcellence@nass.co.uk no later than 12 noon on 21 June 2021.



For an informal discussion about the proposal, please contact

NASS CEO, Dr. Dale Webb dalewebb@nass.co.uk.


For queries about process, please contact lisaswingler@nass.co.uk.


All answers to queries will be posted anonymised below on our website. Please see our Instructions and Information on the Tendering Procedures for more information on this.

[1] https://www.nice.org.uk/guidance/ng65

[2] https://www.nice.org.uk/guidance/qs170

[3] https://nass.co.uk/wp-content/uploads/2020/01/Axial-Spondyloarthritis-Services-in-England-FINAL.pdf

[4] https://ard.bmj.com/content/79/2/193.long

[5] https://nass.co.uk/news/nass-announces-the-first-six-hospitals-to-join-its-aspiring-to-excellence-programme/

[6] https://www.ahrq.gov/talkingquality/measures/six-domains.html