Skin Diseases: Health Services

(asked on 12th December 2023) - View Source

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether she is taking steps to monitor the effectiveness of NHS England’s guidance on Referral optimisation for people with skin conditions.


Answered by
Andrew Stephenson Portrait
Andrew Stephenson
Minister of State (Department of Health and Social Care)
This question was answered on 18th December 2023

As advised in the Getting it Right First Time (GIRFT) national report on dermatology, published in August 2021, 56% of trusts reported that they had to wait for commissioner approval before prescribing drugs approved by the National Institute for Health and Care Excellence (NICE), and 12% of trusts said they had been told by clinical commissioning groups that they could not prescribe certain NICE-approved biologics for psoriasis at the time of NHS England’s data questionnaire in 2018/19.

During GIRFT’s subsequent deep dives into the 110 trusts with significant dermatology activity, it became apparent that there was ongoing variation in the way trusts adopt NICE guidelines. While some allow clinicians to prescribe drugs as soon as they are NICE approved, others have processes in place which can produce delays of more than a year in some cases.

GIRFT is aiming to publish trust- and system-level data for dermatology on the Model Health System in early 2024, enabling dermatology clinicians and managers to monitor their variation in provision of care, services, and treatments for skin disorders. Specific metrics for inflammatory skin disorders, including biologic prescribing for psoriasis and eczema, will be included. The aim is to use this data to inform the dermatology element of GIRFT’s Further Faster programme to help target unwarranted variation in care provision for inflammatory skin disease. The Further Faster programme supports providers to deliver rapid clinical transformation to reduce 52-week waits.

There are no plans to introduce specific targets to adopt the NHS England guidance on Referral Optimisation for people with skin conditions. The Outpatient Recovery & Transformation Programme in NHS England will continue to promote the guidance through NHS England regional teams, integrated care boards and directly to provider organisations.

In addition, specific engagement events, such as the webinar delivered on 21 November 2023, will continue to reinforce the need for appropriate and timely referral optimisation across skin care pathways. The programme is working closely with GIRFT and the Further Faster teams to ensure that referral optimisation is seen as a valuable tool to effectively manage the skin care pathway. Through this effort to engage the system combined with the publication of consistent guidance and evidence across the whole skin care pathway, it is hoped that variation can be reduced, across pathway implementation.

It should be recognised that there may be appropriate clinical reasons for some regional or local variation, so it is important to ensure that all patients who need specialist skincare have equal access. The programme will look to review data over the course of the year to understand the impact and consider relevant next steps.

Reticulating Splines