Health Boards
NICE (National institute for health and care excellence) UK have just released QS40 Quality standards for the treatment of psoriasis in the UK. This follows on from the last report about guidance for GPs which you can read here: NICE issues new guidance for GPs treating psoriasis
The QS40 is a bit long and boring to put it all on here but here a few basics.
The QS40 is a bit long and boring to put it all on here but here a few basics.
Quote:
Psoriasis is an inflammatory skin disease, which most commonly presents as red, scaly plaques. These may vary in extent from a few patches to generalised skin and associated joint involvement. The disease typically follows a relapsing and remitting course, and can result in significant functional, psychological and social morbidity.
The prevalence of psoriasis is estimated to be around 1.3–2.2% in the UK. Men and women are equally affected. Psoriasis can occur at any age, although is uncommon in children (0.71%) and the majority of cases occur before 35 years. Psoriasis is associated with joint disease in a significant proportion of patients (reported in 1 study at 13.8%).
Psoriasis has a significant impact on health and wellbeing with consequent effects on employment and income, underlining the need for prompt, effective treatment, and long-term disease control. Symptoms related to the skin, problems related to treatments, psoriatic arthritis, and the effect of living with a highly visible, stigmatising skin disease have an important bearing on wellbeing. Even people with less severe disease state that psoriasis has a major effect on their day-to-day life.
A variety of treatment options are available, ranging from topical therapies to phototherapy and systemic therapy (non-biological and biological). For most people, psoriasis is managed in primary care, with specialist referral being needed at some point for up to 60% of people. Specialist tertiary care is needed in the very small minority of people with especially complex, treatment-resistant or rare forms of psoriasis. People receiving systemic therapy need ongoing supervision in specialist settings, sometimes with shared care arrangements for drug monitoring in primary care.
A recent UK audit in the adult population found wide variations in practice, particularly in relation to access to specialist treatments (including biological therapy), appropriate drug monitoring, specialist nurse support and psychological services.
NICE quality standards are a concise set of prioritised statements designed to drive measureable quality improvements within a particular area of health or care. They are derived from high-quality guidance, such as that from NICE or other sources accredited by NICE. This quality standard, in conjunction with the guidance on which it is based, should contribute to improvements.
The quality standard for psoriasis specifies that services should be commissioned from and coordinated across all relevant agencies encompassing the whole psoriasis care pathway. A person-centred, integrated approach to providing services is fundamental to delivering high-quality care to people with psoriasis.
The quality standard should be read in the context of national and local guidelines on training and competencies. All healthcare practitioners involved in assessing, caring for and treating people with psoriasis should have sufficient and appropriate training and competencies to deliver the actions and interventions described in the quality standard.
