Executive summary
Skin conditions are one of the major causes of ill-health and disability in the UK and have been the second leading cause of morbidity since 1990. 1 Two of the most common conditions are atopic dermatitis, i the most common form of eczema, affecting 5-10% of all adults, 2 and psoriasis, which affects around 1.1 million people in the UK. 3 Demand for dermatology services is significant. Skin problems account for around 13 million GP consultations and over 700,000 new referrals to secondary care each year. 4 Skin problems are the most common new presentation in primary care, representing around one in four new patient appointments. 5 Since the pandemic, challenges across the care and treatment pathway have increased due to:
Increased demand There were 900,000 fewer appointments due to cancelled follow ups and system disruption in the first 18 months of the pandemic. 6
Workforce shortages According to the British Association of Dermatologist’s (BAD) Staffing and Facilities Guidance for Dermatology Services, as of December 2022, there was a shortfall of 250 Whole Time Equivalent (WTE) Dermatology Consultants in the UK. 7 They also say more investment is needed to help train the number of dermatology nurses required. 8
Delays accessing treatment Around 434,000 patients are on the 18-week waiting list for treatment, nearly double the amount on the list at the same time before the pandemic (August 2019). 9,10
An optimal treatment pathway for patients with eczema and psoriasis in England is set out in national guidance and should see patients waiting no longer than three months for referral and diagnosis in secondary care, and a 10% improvement in quality-of-life score within another three months. 11 It also includes full access to all NICE approved treatments for all patients, regardless of geographic location, in line with the NHS Constitution. 12
i For the basis of public recognition atopic dermatitis will be referred to as atopic eczema within this report
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FROM NATIONAL GUIDANCE TO LOCAL ACTION
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