National Early Inflammatory Autoimmune Diseases Audit

The contract is expected to initially be delivered for NHS-funded care in England and Wales, and publicly funded care in Jersey for a period of three years, at a maximum total budget of up to £933,979.20 GBP including VAT and £778,316.00 GBP excluding VAT. Bids exceeding this limit will be rejected.

There is potential to extend the contract for up to two additional years as well as the option to include other Devolved Nations and/or Crown Dependencies, aspirational measures and discretionary inflationary uplifts (all of which will be defined in the service specification). The maximum budget ‘core’ value of £933,979.20 GBP including VAT and £778,316.00 GBP excluding VAT, excludes the potential two-year extension and aspirational intent as included in section 14.4 of Annex A - Service Specification The contract may be extended for up to 24 months at a pro rata value of the core three- year funding, estimated at up to £518,877 excluding VAT.

This proposed extension value may also include pro rata funding of any additional aspirational measures invoked in the first three years of the contract. For example: If an aspirational annual requirement costing £500,000 per year is invoked in year three, then the extension funding (if the aspirational measure is continued) will be the above figures plus the additional £500,000 per year.

Further to this funding, the specification contains a list of aspirational measures which will be expected to be modified into the contract should the need and funding become available. The aspirational intent value, including the potential two- year extension and core 3 year value means an overall ceiling value for this contract of up to £6,417,788 excluding VAT and £7,701,346 including VAT.

Outcomes are benchmarked against available national guidance and standards e.g. quality standards from the National Institute for Health and Care Excellence (NICE), and those from other established professional and patient sources. Successful national audits are those where the individuals who are engaging with and using the audit results are also in a position to improve the system, and where there is a shared understanding of what good care looks like.

National clinical audits are expected to: a.Develop a robust, high-quality audit designed around key quality metrics likely to best support local and national healthcare quality improvement. b.Detect, describe and help reduce unwarranted clinical variation by systematically benchmarking performance, identifying outliers, and supporting services to understand variation in outcomes, processes and experience. c.Achieve, articulate and maintain close alignment with relevant NICE national guidance and quality standards throughout the audit, as appropriate. d.Enable healthcare quality improvement through the provision of timely, high-quality data that compares providers of healthcare, and comprises an integrated mixture of named Trust or Health board, Integrated Care System (ICS), commissioner, multidisciplinary team (MDT), possibly consultant or clinical team level and other levels of reporting. e.Engage patients, carers and the public in a meaningful way, achieving a strong patient voice which informs and contributes to the design, functioning, outputs and direction of the audit. f.Consider the value and feasibility of linking data at an individual patient level to other relevant national datasets either from the outset or in the future and plan for these linkages from the inception of the contract. g.Ensure robust methodological and statistical input at all stages of the audit. h.Identify from the outset the full range of audiences for the reports and other audit outputs and plan and tailor them accordingly. i.Provide audit results in a timely, accessible and meaningful manner to support healthcare quality improvement, minimising the reporting delay and providing continual access to each unit for their own data. j.Utilise strong and effective project and programme management to deliver audit outputs on time and within budget. k.Develop and maintain strong engagement with local clinicians, networks, commissioners, patients and their families and carers and charity and community support groups to drive improvements in services. l.Deliver high-quality audit outputs, benchmarking and quality improvement as a priority. At the time of writing the specification, requirements include (but please also refer to the potential future aspirational intent section): 1.

Audit Purpose The overall ambition of the audit is to continue to capture and report data on the performance of individual healthcare providers against the National Institute for Health and Care Excellence (NICE) Quality Standard QS33: Rheumatoid Arthritis in Adults, Quality standard QS214: Rare diseases, and other relevant national standards and guidance, (see Appendix 1). 2. Paediatric Inflammatory Arthritis Pathway The supplier should work with the wider Dataset and Methodology Stakeholder Group to develop, maintain and report against a minimum viable paediatric inflammatory arthritis pathway.

The initial focus should be on establishing a clinically meaningful dataset and reporting framework sufficient to describe the patient pathway and support audit activity. Initial measures should focus on a limited number of priority areas agreed with funders and stakeholders, for example referral, diagnosis and treatment timelines.

The updated GIRFT Paediatric Inflammatory Arthritis Pathway guidance, anticipated for publication in January 2027, should be considered a key reference for the future development of the dataset, measures and reporting framework. The supplier should work with the wider Dataset and Methodology Stakeholder Group to review and align the dataset, metrics and reporting outputs with the recommendations and standards set out within the GIRFT guidance, ensuring ongoing relevance and consistency with national best practice.

Any expansion beyond the core pathway, including additional metrics, PROMs/PREMs, transition measures and broader pathway development, should be considered future aspirational intent subject to feasibility, resources and further funding. 3. Data Collection and Audit Design The supplier should continue to deliver a continuous prospective clinical audit and work with the Dataset and Methodology Group to ensure the audit dataset remains clinically relevant and proportionate.

The supplier is expected to collaborate with specialist disease-specific clinical groups to support interpretation of findings and improve case ascertainment and recruitment rates. 4. Organisational Survey and Quality Improvement The supplier should review and maintain the organisational survey to ensure it remains proportionate and aligned with audit objectives.

Priority should be given to maximising analysis and utilisation of existing data rather than increasing data collection burden in collaboration with the wider Dataset and Methodology Stakeholder Group. The organisational survey should support the audit's quality improvement objectives by enabling a deeper understanding of service delivery, workforce capacity, variation in practice and barriers to high-quality care. 5.

Benchmarking and Improvement The audit is expected to support continuous improvement across all services. While identifying high-performing and outlier services remains important, the audit should also support improvement among services performing at or around the national average, where the greatest overall gains may be achieved.

Benchmarking should encourage year-on-year improvement within individual services and provide meaningful insights that motivate all providers to improve, regardless of their current position relative to national performance. 6. Targeted improvement support The supplier should provide targeted quality improvement support following each annual audit cycle.

Activities should build on existing professional networks, collaboratives and stakeholder infrastructure wherever possible rather than creating wholly new arrangements. Improvement support should be designed to benefit healthcare providers across the performance spectrum, including those performing at a middle level where the greatest overall gains may be achieved, while also supporting services experiencing significant challenges or demonstrating exceptional practice.

Learning generated through quality improvement activities should be shared with all participating healthcare providers to maximise the impact of the audit programme. The anticipated outputs are: 1.Near real-time dynamic and interactive metric results. 2.Publication of an annual state of the nation report with the inclusion of an organisational survey. 3.Incorporation of validated Patient Reported Outcome Measures. 4.Quality improvement resources. 5.The identification and notification of outliers. For further information on the current audit, currently delivered by the British Society for Rheumatology (BSR) please head to: https://www.rheumatology.org.uk/improving-care/audits/neiaa