The Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle Upon Tyne, Tyne And Wear, NE7 7DN (the “CW Partner”)

Project Name: Newcastle Musculoskeletal Ultrasound (US) Training Programme & Psoriasis US Clinic

Project Summary:

The CWP will establish a Musculoskeletal (MSK) Ultrasound (US) Training Programme (the “Training Programme”).  The CW Partner will recruit a Senior Registrar, National Health Service (NHS) band level ST5+, up to Post Certificate of Completion of Training (CCT) (the “Trainee”). The Trainee and training, funded by Novartis through the CWP, under the supervision and observation of the CW Partner’s clinical team.  The Trainee will qualify as a Fellow undergoing MSK US, documenting protocols for duplication of the Training Programme among other NHS Trusts, and a business case for future funding of the role and Training Programme, post this project.

In addition, the CWP will establish whether the use of MSK US, with 50 to 75 psoriasis (PsO) patients, has the potential to identify psoriatic arthritis (PsA) earlier, thus creating a new treatment pathway.

Planned Milestones:

Expected Benefits:

Patients:

• MSK US will provide the patient with clear diagnosis and ensure patient clinical care pathway is optimised
• Patients can be prioritised based on clinical outcomes, potentially earlier than in existing pathways
• Patients can avoid potential over diagnosis through Psoriasis Epidemiology screening tool (PEST)

CW Partner:

• Demonstrates pro-active governance in identifying potentially under and over diagnosed PsA patients
• The new model may act as a vanguard for the diagnosis and treatment of PsA patients previously diagnosed with PsO across HCSs in the future
• Limits the risk to the Trust of a ‘missed’ PsA diagnosis
• Clinicians to treat PsA early with effective treatment and interventions, potentially limiting future societal and healthcare costs down the Patient pathway
• Improved understanding and awareness of the scope and size of the problem for PsO and PsA to co-exist for Dermatology and Rheumatology.
• Demonstrates through publication of the results, the Trust’s ongoing commitment to providing the best care possible for their patients
• Provide potential case study for NHS RightCare Pathways, to improve variation and improve population health

Novartis: 

• To be seen as a partner of choice by the Rheumatology clinical community by working jointly with the NHS to improve PsO progression to PsA patient care, whilst supporting service improvements within the NHS
• Improved use of medicines (including Novartis medicines) in patients in line with National Institute for Health and Care Excellence (NICE), Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) and British Society of Rheumatology (BSR) guidance
• Demonstrable evidence of working with a CW Partner that improves care to patients through future publication of the US results

Start Date & Duration: 01-February-2023 for 25 months

FA-11306864 | November 2024

Project Name: Newcastle Musculoskeletal Ultrasound (US) Training Programme & Psoriasis US Clinic

Partner Organisation(s): The Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle Upon Tyne, Tyne And Wear, NE7 7DN (the “CW Partner”)

Completion Date: 01 March 2025

Outcome Summary:

The CWP established a Musculoskeletal (MSK) Ultrasound (US) Training Programme (the “Training Programme”). The CW Partner recruited a Senior Registrar, National Health Service (NHS) band level ST5+, up to Post Certificate of Completion of Training (CCT) (the “Trainee”). The Trainee and training, funded by Novartis through the CWP, under the supervision and observation of the CW Partner’s clinical team. During the CWP, the Trainee documented protocols for duplication of the Training Programme among other NHS Trusts, and a business case for future funding of the role and Training Programme, post this project.

The CWP established a training programme which enabled the CW Partner  Fellow to become an independent and competent Rheumatology Sonographer. 

The CWP completed a literature review on the ultrasound features of psoriatic arthritis, and a Service Improvement Project (SIP) involving the assessment with ultrasound of patients with suspected Psoriatic Arthritis across Newcastle and Northumbria Trusts.¹

Post project, the Trainee has now been appointed as a Consultant Rheumatologist at Northumbria Trust.

Key Project Outcomes Data:

The CWP saw the recruitment of a post-CCT Rheumatology registrar, who, under the supervision and observation of the CW Partner’s clinical team, scanned more than 700 patients as part of their training, and completed relevant national and international training courses.

The SIP assessed 41 patients with psoriasis (PsO) and suspected psoriatic arthritis (PsA). Clinical and ultrasound findings were collected and compared. 6 patients were confirmed as having definite PsA. Ultrasound was able to confirm clinical suspicion of joint and tendon inflammation, facilitating prompt treatment commencement and escalation. Equally, it reduced the need for additional follow ups for 17 patients with MSK symptoms but no ultrasound evidence of PsA.

Outcomes: 

• A competent, independent consultant rheumatologist sonographer who can train others in MSK Ultrasound.
• Developed an evidence based ultrasound protocol for the scanning of patients with suspected psoriatic arthritis
• 41 additional new patients seen due to the project.
• 6 patients with PsO were confirmed to have PsA and provided with subsequent follow up treatment.
• 17 patients who were discharged safely without the need for further follow up.
• The Fellowship as a training resource and the SIP are being presented at the British Society for Rheumatology Annual Conference in April 2025.
• Novartis has developed a better relationship with and understanding of the patient pathway, the service and the impact of scanning.

Quote from Partner: 

“Working with Novartis provided us with the opportunity to increase the pool of rheumatologists who are able to provide training in ultrasound, and ultimately to recruit a rheumatologist to the North East. We were able to complete an extremely valuable and novel service improvement project and increase our knowledge about how to set up effective and efficient referral pathways for suspected psoriatic arthritis. We are extremely grateful for the support that we received and are confident this will improve the quality of patient care within the wider rheumatology community.”

Dr Ben Thompson, Consultant Rheumatologist at Newcastle Hospitals.

Conclusion: 

• This was a novel collaborative working project which sought to address deficiencies in rheumatology ultrasound training and improve the assessment of patients with psoriasis and musculoskeletal symptoms. The CWP partner recruited a post CCT rheumatology trainee i.e., a trainee who had completed their normal clinical training and provided a unique one year of experience in ultrasound training alongside clinical experience in Spondyloarthritis.
• The project achieved the goal of providing training to achieve independent scanning skills, and completing a literature review to enable us to develop an evidence based protocol for scanning patients with suspected psoriatic arthritis.
• The project was able to demonstrate the additional value of including ultrasound in the assessment of these patients through a service improvement project. This project enabled patients to be seen more rapidly, increased the capacity of the rheumatology department to see new patients, and provided evidence for how these pathways can be run efficiently in the future.

FA-11484422 | August 2025

References: 

1. A Post-CCT Ultrasound Fellowship in Rheumatology: a Novel Model for Training in Musculoskeletal Ultrasound (MSK US), available on line at E034 A post-CCT ultrasound fellowship in rheumatology: a novel model for training in musculoskeletal ultrasound (MSK US), last accessed 26 September 2025.