From National Guidance to Local Action

Long waits in accessing treatment Even once individuals are diagnosed, many of those who require specialist care face considerable waiting times.

As of August 2023, over 434,000 patients are on the 18-week waiting list for treatment. This is almost double the 237,000 on the list in August 2019, before the COVID-19 pandemic. 9,10

In spite of these challenges, opportunities do exist to speed up the treatment pathway for patients with inflammatory skin conditions, including:

• The 2023 NHS England Long-Term Workforce Plan. 19 The Plan sets out a series of commitments to improve the training, retention and recruitment of staff to address shortfalls in capacity, including doubling the number of medical school places and increasing GP specialty training places by 50% by 2031/32. • NHS England’s Outpatient Recovery and Transformation Programme guidance documents. In particular, the Referral Optimisation Guidance for People with Skin Conditions 5 is designed to ensure local systems are able to embed personalised care, strengthen primary care management and streamline collaboration between generalists and specialists. Similarly, the virtual urgent skin cancer pathway is designed to speed up referrals and shorten waiting times, creating more resource capacity for non-cancer dermatological conditions. 20 • Implementing the recommendations of the Getting it Right First Time (GIRFT) review into dermatology services. 13 These expert led recommendations, if implemented, have the potential to improve care across the pathway – from diagnosis to referral and access to treatment. The Long-Term Workforce Plan, GIRFT report and NHS England’s transformation initiatives include changes that can be taken in the short-term to address challenges across the care pathway. However, local capacity and resource challenges are inhibiting the consistent adoption of these initiatives across the country, 16 which may be symptomatic of a broader concern that exists (see box 1) about the ability to translate well constructed and tested programmes of change from the national to trust level to make the impact on services that is required. “The Department has allocated £14 billion to NHSE from 2022–23 to 2024–25 specifically to recover elective and cancer care. Without timely evaluation of its programmes, including surgical hubs and clinical diagnostic centres, there is a risk that the future allocation of resources will not be informed by reality on the ground.” Managing NHS backlogs and waiting times in England, Public Accounts Committee, Thirty-Eighth Report of Session 2022–23, March 2023 21 BOX 1

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FROM NATIONAL GUIDANCE TO LOCAL ACTION

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