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1813 Service Provision for Children with Juvenile Idiopathic Arthritis (JIA) in the East Of England (EOE); A Comparion with National Centres
  1. PJ Bale1,
  2. K Armon2,
  3. A Kavirayana3
  1. 1Paediatric Department, Ipswich Hospital NHS Trust, Ipswich
  2. 2Jenny Lind Children’s Hospital, Norfolk and Norwich University Hospital, Norwich
  3. 3Paediatric Rheumatology Department, Bristol Royal Hospital for Children, Bristol, UK


Introduction The EoE has no regional centre or clinical network for paediatric rheumatology. JIA has a prevalence of 1:100 (2), which suggests an estimated 1,200 cases managed in the 17 hospitals of the EoE. What sort of service do these children get, compared with agreed standards, and that provided by national and ‘grid training’ tertiary centres?

Aim To assess the service provision for children with JIA in the EoE against recommended standards of care as set out by ARMA/BSPAR 2010(1), and compare our results to national data.

Methods A questionnaire was sent to the Paediatric Rheumatology leads of the 17 hospitals in the EoE, focused on the service provision for paediatric rheumatology patients, against BSPAR/ARMA standards. Follow-up phone calls were made where necessary to ensure accuracy. Data from 15 National centres, including all 8 UK grid training centres were used for comparison (3).

Results 16 of 17 hospitals responded in the East of England.

Table 1. Shows the percentage of hospitals achieving each of the audited ARMA/BSPAR standards in EoE, compared with national centres, and grid training tertiary centres data alone. In summary, in grid tertiary centres 17 of 21 standards audited are achieved to a good standard (>85%), whereas in the EoE only 3.

Conclusion The EoE hospitals fall seriously short in providing trained, specialist care for the estimated 1,200 children with JIA, suggesting serious inequality of access. Many standards are unachievable without commissioned resource. Our challenge is to improve provision within existing funding.


  1. Arthritis and Musculoskeletal alliance (ARMA) Standards of Care for children and young people with Juvenile Idiopathic Arthritis 2010.

  2. Children’s Chronic arthritis association website. HYPERLINK “”

  3. Dr Akhila Kavirayana (SpR Paediatric Reumatologist) personal communication of data presented at BSPAR Sept 2011, as yet unpublished.

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