Due to the limited resources in primary and secondary care to implement these potentially transformative changes, patients may continue to struggle to secure a diagnosis in primary care, and may continue to face delays in access to specialist care. Once treatment is initiated, local restrictions and other barriers to treatments, in contradiction of NICE guidance, mean patients can be cycled through the same treatment, often for years, and unable to access a potentially more effective treatment. This paper sets out a perspective on the optimal care management pathway for patients with inflammatory skin conditions, focusing specifically on eczema and psoriasis, and compares this to how patients are actually accessing care, services, and treatment in practice. It also begins to explore what financial cost savings to the NHS could be made by speeding up the management of this pathway in line with national guidance. It is split into four parts:
Part 1 maps out the optimal care management pathway for eczema and psoriasis patients, as set out in national guidance.
Part 2 explores challenges and barriers across the system, which results in a fragmented pathway with regional variation in access to care and treatment.
Part 3 assesses an initial element of potential costs savings to the NHS that may be created if guidance is implemented to overcome these challenges. These are based on delays in referral to specialist care and have been estimated from an analysis of the available data.
Part 4 sets out a series of actions for consideration
that would support the implementation of the new national guidance in the coming years.
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Patient Quotes Please note patient quotes in this report come from interviews with dermatology patients, one conducted by AbbVie and others provided by National Eczema Society, all with consent. They are included in this report to illustrate examples of patients’ experiences in navigating access to care and treatment – bringing to life the challenges that are described in Part 2. Extracts are highlighted in the green boxes in the report. 22 Devolved Nations Please note references to national guidance and evidence in this report refer mostly to England, although there may be some cross over in evidence cited. Many of the restrictions and themes cited within the report are applicable across devolved nations but additional devolved specific evidence will be required to make them directly relevant.
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FROM NATIONAL GUIDANCE TO LOCAL ACTION
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