From National Guidance to Local Action

Part 2 Mapping challenges in the pathway

Section Takeaways • The care pathway for many patients with eczema and psoriasis is fragmented – with barriers across different parts of the system preventing access to care in line with national guidance. • Almost one in ten people with severe eczema attend more than ten primary care appointments before being diagnosed. • According to patient surveys, around a third of patients with severe eczema have to wait four to seven months before being seen in secondary care after referral. • 56% of trusts waited for Clinical Commissioning Group (CCG) approval before using NICE approved treatments. • 98% of skin disease patients report that their condition affects their emotional and psychological wellbeing, yet only 18% have received some form of psychological support. • 67% of people with very active psoriasis surveyed, reporting that their condition affects their working life, while 43% of feel their psoriasis had limited their income and/or future earnings.

Mapping the current state of play

Restrictions in access to support services

Review and follow up

Local restrictions in access to NICE

Primary care management

Secondary care assessment

Access to treatment

Referral delays to

accessing specialist dermatology services

approved treatment services

Delays to initial diagnosis, exacerbated by limited GP training

Patients remain on same

Technology barriers and digital poverty preventing advantages of PIFU being maximised

treatment option, in

contradiction of NICE guidance

Patients offered access to effective treatments in line with NICE guidance

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FROM NATIONAL GUIDANCE TO LOCAL ACTION

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