A wide range of work is therefore in hand to address it, including: The exploration of a Managed Clinical Network approach to RA services; The revision of Scottish Intercollegiate Guidelines Network (SIGN) Guideline 48 and the associated implementation programme being developed by NHS QIS; The commissioning of the Scottish Public Health Network to undertake an update of the needs assessment for RA published by the Scottish Needs Assessment Programme in 2002; Consideration of the approach to the management of RA that has been developed in the East of England; Our general work on developing a musculo-skeletal programme based on integrated multi-disciplinary teams within community settings, incorporating the service model for pain management services that we are also developing; and The work of the Orthopaedics Task & Finish group set up as part of the 18 weeks referral to treatment programme.