Primary care plays a vital role in continuity, patient-centred follow-up, and long-term disease monitoring. NICE provides guidelines on a comprehensive annual review, including an assessment of functional ability, comorbidity risk and complications. General practitioners (GPs) are well-equipped to deliver personalised care by addressing the patient’s unique needs, concerns, and preferences. By engaging in patient education and shared decision-making, patients are empowered to take an active role in managing their own health. Additionally, the GP’s holistic approach facilitates access to social care, caregivers, and council services – addressing wider emotional and social determinants of health.This audit reviews the existing clinical practice for RA annual reviews compared to the NICE guidelines. It particularly focuses on identifying opportunities to enhance medication adherence, comorbidity detection, and holistic follow-up.Forty-seven patients were randomly reviewed for documentation of annual RA monitoring, comorbidity screening, and complications. Functional ability was assessed using a Health Assessment Questionnaire (HAQ), which was completed by 24 patients over the telephone.Only 5 patients had a coded annual RA review. CVD risk screening was consistent; however, osteoporosis and depression screening were under-recorded. Only 15% of patients underwent all three risk assessments. The mean HAQ score was 2, indicating moderate functional disability. Approximately 10% of patients had no contact with the practice despite repeated outreach.This audit highlights multiple challenges specific to primary care. A high workload, competing long-term conditions, and tight time constraints limit the depth of review, reducing opportunities for thorough, patient-centred follow-up. Non-attendance further restricts the clinician’s ability to identify deterioration early.Addressing health literacy and patient education is crucial in combating this issue. The HAQ revealed functional decline that was not clear in routine consultations. This highlights the value of structured assessments in unmasking unmet needs. These, however, are time-consuming, exaggerating the time bottleneck that GPs already face.Delivering holistic care through better patient education, improved comorbidity screening and technology implementation through pre-appointment digital HAQs, will vastly improve RA follow-up in primary care.