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Background ‘Getting it right first time' includes seeing the right patient, at the right time, in the right place, by the right person. This includes seeing suspected inflammatory arthritis patients within 3 weeks of referral. An understanding of the case mix of new referrals is therefore required. Such an audit would allow capacity planning for early arthritis, follow up, and therapy appointments. We have audited the case mix of our new patient referrals 3 times over 7 years. Methods All new patient referrals, to a single hospital trust, seen in a 3-6-month period in 2011, 2015 and 2018 were audited. Data was collected on primary rheumatological diagnosis (by rheumatologist), outcome (discharge/follow-up), if it was a re-referral for the same problem within 12 months, and onwards referrals (AHPs, injection clinic, ultrasound). In 2018, additional data captured included GP reason for referral. Data was entered onto an electronic proforma and analysed with descriptive statistics. Results Data was collected on 547 patients in 2011, 335 patients in 2015 and 305 patients in 2018. The primary diagnosis made by the rheumatologist in 2011, 2015 and 2018 respectively was: inflammatory arthritis (18%, 15%, 13%); gout (9%, 4%, 2%); osteoarthritis (19%, 19%, 17%); fibromyalgia (6%, 15%, 19%); spondyloarthropathy (4%, 4%, 3%); PMR (6%, 3%, 4%); soft tissue (9%, 6%, 3%). In 2018, comparison between GP reason for referral, and diagnosis by rheumatologist was, respectively, 33% and 13% for inflammatory arthritis; 2% and 17% for OA; 23% and 19% for fibromyalgia. Discharge at first appointment was 33% (2011), 38% (2015) and 39% (2018). Re-referral rates were 4.1% (2015) and 3% (2018). Onward referrals in 2011, 2015 and 2018 were, respectively 26.5%, 28.1% and 41% for physiotherapy; 23.4%, 20.9% and 10% for joint injection clinics; 10.1%, 17.3% and 21% for ultrasound. Conclusion Detailed case mix audit can help with service planning and delivery; suspected inflammatory arthritis (&amp;lt; 3 weeks) requires a third of the new patient capacity. Over the 7 years, the proportion of patients diagnosed with an inflammatory arthritis has remained stable, as has the two-thirds of new patients who are followed up; capacity in early arthritis and follow-up clinics is required to match this demand. Demand for ultrasound has significantly increased, and units may need to consider local ways to meet his demand. Local therapy teams will find this audit helpful to ensure capacity can match demand. Over the 7 years there has been a tripling of the proportion of patients diagnosed with fibromyalgia, such that it now represents a fifth of all new patient referrals. Seeing these patients 'in the right place, by the right person' could include developing community clinics and the role of a GP with a specialist interest. Disclosures M. Ford None. S. Panchal None. H. John None.

P79 The changing face of rheumatology referrals 2011-2018