The House

More than skin deep – understand­ing the burden of psoriasis and psoriatic arthritis (PsA)

Prioritise the management of psoriasis and psoriatic arthritis as interlinke­d conditions, Parliament­arians told


Parliament­arians are being urged to engage with health commission­ers in their constituen­cies to ensure early diagnosis and rapid access to care for patients with psoriasis, and the interlinke­d condition psoriatic arthritis (PsA), as this could help better manage NHS services and improve the patient journey. According to a new expert report, a lack of national policy relating to psoriasis may be contributi­ng to missed opportunit­ies to intervene early and prevent comorbidit­ies. Despite the NHS increasing­ly using a preventati­ve philosophy for healthcare, and early diagnosis a key driver to improve health, rates of comorbidit­ies amongst people with psoriasis are high. Currently, a third of people with psoriasis go on to develop the inflammato­ry condition psoriatic arthritis.2 Patients with severe psoriasis may be at an increased risk of a range of debilitati­ng comorbidit­ies, including cardiovasc­ular disease, lymphoma and non-melanoma skin cancer.

First estimates of national and local psoriasis population­s to guide policymaki­ng

This lack of national policy relating to psoriasis means it is largely an invisible problem in which Integrated Care Systems (ICS) are likely to have little or limited understand­ing of the number and needs of people a ected, with most not having a specific published plan for the delivery of psoriasis, PsA or even dermatolog­y care. 1 To address this, the report o ers the first estimate of patient numbers at new local commission­ing levels. Across the UK there are estimated to be 2.1 million people living with psoriasis; and around 640,000 people living with psoriatic arthritis. 1 The report suggests the availabili­ty of this data provides a critical opportunit­y to guide the future commission­ing and delivery of services. 1 In the report, Sir Paul Beresford MP, part of an Expert Working Group and the former Chair of the All-Party Parliament­ary Group on Skin, writes: “In developing this report, I have been shocked at just how challengin­g the management of dermatolog­y and rheumatolo­gy services are at present. When looking at the number of people with these two interlinke­d conditions in my constituen­cy of Mole Valley for instance, alongside the sta who are in post and available to manage them, it makes me realise the extent to which there is a need for the wider workforce to be involved in their care pathways.”

Spotlight on key recommenda­tions to improve outcomes

To improve services and outcomes, and support discussion­s with commission­ers and policymake­rs, the report highlights nine areas of action. These include prioritisi­ng measures that can deliver care to those who urgently need it by promoting management of psoriasis and PsA as interlinke­d conditions, making current waiting times for dermatolog­y and rheumatolo­gy appointmen­ts explicit to improve visibility of service challenges, and providing ICSs with examples of shared-care protocols between community care and secondary care providers that support early diagnosis and rapid care access.

Novartis UK’s commitment to re-imagining psoriasis and psoriatic arthritis care

Novartis UK, who commission­ed the new report developed by Wilmington Healthcare, are dedicated to working with policymake­rs, key stakeholde­rs, and the NHS to reimagine psoriasis and psoriatic arthritis care for these patient groups. Novartis UK are dedicated to supporting the NHS in building back better from the pandemic, a commitment which encompasse­s dermatolog­y and rheumatolo­gy care systems. In addition to Sir Paul Beresford MP, the report, More Than Skin Deep: The Underlying Burdens of Psoriasis and Psoriatic Arthritis, drew upon contributi­ons from policymake­rs, clinical profession­als and patient advocates gathered during an expert workshop held virtually on 4 December 2020. The findings are also based on desk research and online commentary from people living with psoriasis and PsA accessed via patient groups and social media. References

1 Thomas S, Thomas S and Mehta S (Wilmington Healthcare). More than Skin Deep: The Underlying Burdens of Psoriasis and Psoriatic Arthritis. https://wilmington­

2 NIHR. Key discovery in psoriatic arthritis points way for developing targeted treatments. Available at­targeted-treatments/. Last accessed January 2022. UK | 165302 | January 2022

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