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Abstract Background/Aims Rheumatologist-led ultrasound (USG) clinics were established at UCLH over 10 years ago with an intention to improve speed of diagnosis and/or execution of treatment plan with the benefit of clinical assessment and diagnostic imaging in one appointment. The benefits for patients may include reduced time taken from work and reduced anxiety. This project aimed to evaluate reasons for referral to this clinic, the outcome of a patient review and the impact of this service. Methods Retrospective Health-record data were collected from EPIC using Google forms for patients who had USG of their hands in the specialist clinics for 3 months (Jan - March 2022). Data included patient demographics, clinical data, USG findings, intended change or initiation of treatment, and outcome of the review. Results 54 patients had been reviewed in the three months. More than half (61%) were referred to help answer a treatment-related question and the remaining were to confirm diagnosis (39%). Most patients referred for diagnosis had their diagnosis confirmed (86%). Majority (62%) also had appropriate follow up and two were discharged; a further six had potential to be discharged at this time. Out of the 33 referred for treatment questions, there were 23(70%) patients who needed no change to their treatment; 15(65%) of these would have potentially been initiated on biologics otherwise. This resulted in potential savings of between £76,497-£107,601 per 6-month (trial of DMARD) period due to drug cost. Table 1 lists potential indirect savings. Conclusion This service evaluation found considerable direct and indirect savings that emphasises the need for such specialist service in the cost-strapped NHS. The direct cost savings relate to the drugs that were not required to be initiated, with the majority attributed to the avoidance of biologics. In addition to the indirect cost savings to the NHS , the reduction of risk to the patient of unnecessary immunosuppression remains undefined. As a result of this service evaluation, to enhance potential discharges from this clinic, referring clinicians manage patient expectations at referral and communicatepotential for discharge at referral to the scanning clinician. Disclosure A. Zmuda: None. J. Manson: None. M. Castelino: None.
Zmuda et al. (Mon,) studied this question.