In arthritis patients, the longer inflammation continues, the greater the degree of functional impairment. The Directorate was unable to meet NICE Quality standards, in particular starting treatment within 6-8 weeks. Routine patients were waiting beyond 28 weeks. We underwent a three year transformational plan aimed at delivering a high quality integrated patient care. As a result, we have been able to achieve; • Job Planning: Up to 40% improvement in productivity (seeing new rheumatology patients) • Referral-to-treat (RTT) < 12 weeks. This is maintained despite long-term absence of a consultant colleague and another recent vacancy • Priority ultrasound Hands arrangement with Radiology: referrals are scanned within 2 weeks of referrals. • 85% patients with suspected inflammatory arthritis are seen and treated within 6 weeks of referral. • A self injecting Methotrexate programme • A Biologics drugs protocol based on NICE guidance has been implemented For further information, please contact: Dr Syed Ayas, Aneurin Bevan Health Board (firstname.lastname@example.org).