Only 20% of patients who see a GP with suspected inflammatory arthritis are referred to a specialist within the target three days, an audit suggests.
The report, based on data from 5,000 patients in England and Wales, said awareness of the early symptoms of the condition must improve.
However, most patients said they were happy with the care they received.
In the UK, one million people suffer from inflammatory arthritis and 700,000 of those have rheumatoid arthritis.
The condition affects the joints, causing pain, stiffness and swelling. The hands and feet are often the first joints to be affected.
Those with a severe form of the condition may not be able to dress or bathe themselves, and some will have to stop working.
This is the second audit of rheumatology services across England and Wales by the British Society for Rheumatology.
It assessed experiences of patient care against the standards set down by the National Institute for Health and Care Excellence (NICE) for the diagnosis and management of rheumatoid arthritis in adults.
It found that as well as delays in early referrals, fewer than half of the patients analysed were seen by a specialist with three weeks, another target set by NICE.
But the report acknowledged there could be a number of reasons for the delays, including staffing levels, the number of specialist consultants in the area, the level of detail contained in referral letters from GPs and whether or not a patient rescheduled their appointment.
For example, in London, the average waiting time for patients to be seen by a specialist was 23 days, compared with 34 days in Wales.
But patients in Wales only had to wait an average of five days to be referred. Across England and Wales, the average wait was 20 days.
The report said a number of providers had made changes in the way care was provided based on the findings in the first audit, but concluded it was too early to see the impact of many of these recent changes.
There were signs of improvement in arthritis care too.
Around 95% of patients who responded to questions about their experience of care said it was good, the report found, an increase on the last audit.
And 86% received steroid therapy to alleviate their early symptoms and more than two-thirds of patients had started taking anti-rheumatic drugs for rheumatoid arthritis within six weeks.
Dr Liam O’Toole, chief executive officer at the charity Arthritis Research UK, said results of the audit were disappointing.
“We urge that immediate action is taken to improve access to these services, so that people with inflammatory arthritis get the treatment they need and the quality of life they deserve.”