National Early Inflammatory Autoimmune Diseases Audit (NEIAA)
Latest NEIAA report shows earlier treatment for inflammatory arthritis can lead to clinical remission
Arthritis UK welcomes the latest findings from the National Early Inflammatory Autoimmune Diseases Audit (NEIAA) which highlights that earlier diagnosis and treatment continue to be associated with better patient outcomes.
The annual ‘State of the Nation’ report compiled by the British Society for Rheumatology (BSR) and commissioned by the Healthcare Quality Improvement Partnership (HQIP) provides key findings on how quickly people with inflammatory arthritis, connective tissue diseases and systemic vasculitis are diagnosed and treated across England, Wales and Jersey. It enables decision makers and healthcare providers to identify areas for improvement and track progress over time.
Arthritis affects every part of people’s lives. Without timely treatment, it can have a devastating impact on health, work and day-to-day wellbeing. Arthritis UK’s lived experience report found that people with inflammatory arthritis often struggle without prompt treatment and face long waits for a diagnosis, affecting their ability to live well
Importantly, in early inflammatory arthritis, longer symptom duration before treatment starts is associated with poorer treatment response and achieving remission. Therefore, earlier recognition and rapid access to specialist assessment remain critical. This is something that was also reflected in Arthritis UK’s, The Silent treatment: Why an arthritis diagnosis matters.
Focusing on what matters most to patients
There is a welcome focus on what matters most to patients. The report recommends that Patient reported outcome measures (PROMs) are routinely collected and used throughout early inflammatory arthritis pathways.
PROMs represent an important component of helping to ensure that care is focused on the holistic needs of the patient. If PROMs are used routinely, they can also help identify patients who may benefit from occupational therapy, physiotherapy and psychological support.
Ensuring consistency in services and outcomes
As the report is published annually, we can see what has changed overtime in relation to diagnosis, treatment and outcomes. These latest results tell us that while national performance has remained stable, variation between providers has increased. The report highlights the need to address this variation to ensure consistency across services and care, regardless of where someone lives.
Arthritis UK welcome the results of this important clinical audit and urges policymakers and clinicians to implement its recommendations to ensure that people with inflammatory arthritis receive timely treatment and holistic support.
We particularly welcome the recommendation on collecting PROMs alongside clinical measures, to ensure that services and care is tailored to what matters most to patients.
You can read the full report including the data and recommendations here:
NEIAA State Of The Nation Summary Report 2026
NEIAA 2026: About the audit and FAQs
About NEIAA
The National Early Inflammatory Autoimmune Diseases Audit (NEIAA) is the only national clinical audit examining how quickly people with inflammatory arthritis, connective tissue diseases and systemic vasculitis are diagnosed, assessed and treated across England, Wales and Jersey.
By measuring access to specialist care, treatment and patient outcomes, NEIAA helps healthcare providers, commissioners and policymakers identify unwarranted variation, benchmark performance and improve the quality of care.
About BSR
The British Society for Rheumatology (BSR) is the leading UK specialist medical society for rheumatology and musculoskeletal care professionals. BSR supports its members to deliver the best possible care across the patient pathway, helping improve the lives of children and adults with rheumatic and musculoskeletal conditions. Its work includes clinical guidance, education, quality improvement, research, policy and professional support.
Who commissions and funds NEIAA?
NEIAA is commissioned by the Healthcare Quality Improvement Partnership (HQIP) and funded by NHS England and the Governments of Wales and Jersey as part of the National Clinical Audit and Patient Outcomes Programme.
Who participates?
NEIAA collects information on eligible patients aged 16 and over who are newly diagnosed with inflammatory arthritis, connective tissue diseases and systemic vasculitis within rheumatology services across England, Wales and Jersey.
Participation remains high. In Year 8, 96% of eligible providers participated, with 122 of 127 providers submitting data for 10,695 patients. This included 114 of 117 eligible providers in England, seven Welsh Health Boards and the Jersey service.
What does NEIAA measure?
NEIAA captures data across the patient pathway, including timeliness of referral and specialist assessment, access to treatment, treatment response and patient outcomes.
Provider performance is measured against relevant NICE quality standards.
The audit includes patient-reported outcome measures (PROMs), helping services understand the impact of inflammatory disease and treatment on aspects of health and quality of life that clinical measures may not fully capture, including pain, fatigue, mental health and work.
Why does collecting this data matter?
NEIAA gives rheumatology services a national benchmark against which they can understand their own performance. Teams can use the data to identify delays or variation, investigate the reasons behind them and monitor whether changes are improving care.
The 2026 report includes a case study from Oxford University Hospitals NHS Foundation Trust, where regular review of NEIAA data helped identify bottlenecks and inform service changes. Treatment timeliness improved from 20% to 65% within 12 months.
What does the audit tell us about quality of care?
NEIAA provides evidence about several important aspects of care, including access to specialist assessment, treatment timeliness, service pathways, treatment response and patient-reported outcomes.
It can therefore identify where services are performing well, where variation exists and where further investigation or improvement may be needed.
How can services use their NEIAA data?
There are several complementary ways for services to explore their performance.
Local trust and health board reports provide a static view of each trust and health board’s performance against key measures for the audit year.
The publicly accessible NEIAA dashboard provides a live view of key performance data and can be used to monitor performance over time.
Participating services can also download their own data and use the secure online platform’s data analysis tool to explore it in greater detail. This can help teams investigate challenges and identify practical solutions.
NEIAA dashboard: Dashboard
Local trust and health board reports: NEIAA Trust/Health board Report
NEIAA information and quality improvement resources: NEIA Audit | British Society for Rheumatology
Frequently asked questions
Why does the 2026 State of the Nation report matter?
The report provides a national picture of how quickly patients are accessing rheumatology care and treatment, what outcomes they are experiencing and where significant variation remains between services.
One of its clearest findings is the association between earlier treatment and better outcomes. Patients who started disease-modifying anti-rheumatic drug (DMARD) treatment at their first rheumatology appointment had 48% higher odds of achieving clinical remission at three months. Modelling suggests that up to 534 additional patients could have achieved early clinical remission if treatment had started at that first appointment.
The findings give individual services an opportunity to compare their own performance with the national picture and identify areas where changes to pathways or service delivery could improve care.
Where does the 2026 report identify the biggest variation?
Significant variation between services remains one of the clearest challenges.
Across providers, the percentage of patients with early inflammatory arthritis (EIA) receiving treatment within six weeks ranged from 4% to 98%. There was also wide variation in waiting times for first rheumatology appointments for patients with connective tissue diseases and systemic vasculitis.
Dedicated EIA pathways also appear to make a difference. Patients referred through an EIA pathway were more likely to be assessed within three weeks and treated within six weeks than those referred through other routes.
How can I see how my service is performing?
Yes. Local trust and health board reports allow services to view performance against key measures for the audit year, while the live NEIAA dashboard can be used to explore and monitor performance over time.
What should rheumatology teams do in response to the 2026 findings?
Rheumatology teams should review the national findings, use the local trust and health board reports and dashboard to understand their own performance, discuss the data within their MDT or service, and identify practical areas for improvement.
The report shows how improvement may be supported by practical changes that do not necessarily require complete service redesign. Changes such as regular data review, pathway mapping, effective triage, appropriate clinical capacity and better use of the wider MDT can make a measurable difference.
Teams should also continue submitting accurate and timely NEIAA data so that local performance can be monitored and the national picture remains robust.
How do teams submit data?
Participating services submit their data through the NEIAA platform.
Users with Clinical Admin access can also download their service's data and use the data analysis tool to investigate performance in greater detail. Contact audit@rheumatology.org.uk with any queries.