Doctor 2
A new report by the Patients Association has highlighted the lack of dermatological training and support available for GPs, and the resultant disconnect between the care the 2 million people living with psoriasis in the UK and Ireland need, and what they currently receive.

The report, published in partnership with LEO pharma revealed that:

  • Nearly a quarter of the population have sought GP advice on skin matters in England and Wales, yet some doctors have received as little as five days of dermatological training
  • GPs in the UK handle around 13 million appointments about skin conditions every year, but only have 650 dermatology consultants to advise and support them.

The report also highlighted vast regional variation in care and treatment, especially in the availability of secondary care consultants.

The report called for improved dermatological training and support in primary care, and for people with psoriasis to be offered regular reviews, at least annually.

Katherine Murphy, Chief Executive of the Patients Association, said: “This new report shines a light on the shortcomings of dermatological training and staffing, which inevitably give rise to sub-optimal psoriasis care. It is essential these issues are addressed if we are to improve patient outcomes, and reduce the burden of the associated comorbidities currently weighing on individuals, health services, the economy, and society as a whole.”

A survey conducted as part of the PSO What? initiative found that a third of the people with psoriasis surveyed do not regularly visit their GP each year. It also found that many GPs admitted to lacking knowledge and understanding regarding the effective management of the condition. This is particularly concerning given people with psoriasis are also at risk of developing other serious associated conditions, including psoriatic arthritis, cardiovascular disease, inflammatory bowel disease (IBD), liver disease, complications with vision and some cancers.

Murphy added: “Vitally, the report calls for people from all walks of healthcare – from universities, to GPs, consultants, payers and policy makers - to pledge their personal and professional support to drive real change by visiting People with psoriasis must be offered regular reviews, at least annually, to assess the severity and impact of their condition, their response to treatment, and the wider physical and psychological factors affecting them. However, this will only prove effective if those in primary care are given the training and support required to confidently manage and treat the physical manifestations of psoriasis, as well as its associated complications and psychological effects.”  

Dr Angelika Razzaque, GPwSI Dermatology and Vice Chair of the Primary Care Dermatology Society (PCDS), comments: “Given the right access to appropriate treatments and information, most people with psoriasis can be principally managed in partnership with their GPs, nurses and pharmacists. The onus is on all primary care professionals, to continually assess how we’re treating the psoriasis itself, and to look beyond the skin at our patients’ individual needs, screening for associated complications. By regularly reviewing patients, at least once a year, we can improve outcomes as well as help to safeguard against life-limiting psoriasis complications and reduce the potential burden on the NHS later down the line.”

Even when effectively managed in primary care, up to 60% of people with psoriasis could need specialist referral at some point, however given the dearth of consultant dermatologists this may not be possible. Contrary to recommendations from the Royal College of Physicians, no region in England has enough dermatology consultants. Dr Anthony Bewley, Consultant Dermatologist at Whipps Cross and St Bart’s NHS Trust said: “It is essential to address the current lack of training and formal assessment of practical dermatology skills that exist in medical school curricula. Beyond that, we, as healthcare professionals, need to move away from the misconception that psoriasis is ‘just a skin condition’, and look for the best possible whole-person care for each individual. The unfortunate truth is that past failings have seen some patients simply slip through the net. The PSO What? report signals a sea-change, encouraging patients to demand more from their doctors, and to make sure that medical professionals do not undermine their experience of living with psoriasis.”

To find out more visit the PSO What? website