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Can specialist nurses treat arthritis patients effectively? asks major Leeds-based study

A leading Leeds nurse specialist is aiming to prove that nurses provide a good and effective service when it comes to treating arthritis patients.

Dr Jackie Hill, an experienced rheumatology nurse specialist in Leeds is setting up a major multi-centre clinical trial which will compare clinics led by consultant rheumatologists to those run by nurse practitioners.

Dr Hill, an Arthritis Research Campaign senior lecturer in rheumatology nursing at the University of Leeds, heads a team that has been awarded more than £200,000 by the medical research charity to run the three-year study.

Around 12 hospitals in the UK will take part and up to 260 rheumatoid arthritis patients will be recruited into the trial when in begins in March next year.

Dr Hill stressed that her study was not about nurses versus doctors. "The main aim is to determine whether nurse-led clinics are clinically and cost effective, and the only way to do that is to compare them to the gold standard which in this case means the medical clinics run by our consultant rheumatologist colleagues," she said.

"We are not saying that we think that nurses are any better; it may be that nurses do some things better and doctors do other things better. I think we need both."

Although senior nurses and consultant rheumatologists both take clinics, nurses have longer consultation times, have fewer patients, and less complicated cases to deal with, but this will be taken into account by the trial. Nurses spend longer on patient education, for example, explaining how patients can help themselves and deal with the condition on a day-to-day basis.

Dr Hill said that at a time when the posts of many nurse specialists were under threat because of cuts by NHS trusts, it was more important than ever to prove that their work was both valuable and cost-effective. "There have never been any UK economic studies that showed the value of nurse specialists and this is a very good time to do that," she said. "We expect they would be cheaper, but we don't know that."

Over the past few years the creation of nurse specialist posts has seen senior nurses move away from their traditional roles as carers of patients. They now take on extended roles once considered sole province of the rheumatologist; leading clinics, and managing caseloads and are regarded as an essential part of the multi-disciplinary team looking after arthritis patients.

Many who work in the arthritis field, like Dr Hill, have also gone into academic research, encouraged by new funding streams from organisations like the Chesterfield-based medical research charity the Arthritis Research Campaign. Dr Hill is now one of the directors of the Academic and Clinical Unit for Musculoskeletal Nursing (ACUMeN) at the university, which aims to improve research, education and practice in nursing. She is a longstanding advocate of extended clinical roles and improved research expertise for nurses in the UK.

Editor's Note: The Arthritis Research Campaign is the fourth largest medical research charity in the UK and funds research and education into all kinds of arthritis and musculoskeletal conditions.

It currently funds almost £3m of research on numerous research projects in Leeds.

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Please contact the University of Leeds Press Office on +44 (0)113 343 4031 or email pressoffice@leeds.ac.uk

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