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://wilmingtonhealthcare.com/more-than-skindeep-the-underlying-burdens-of-psoriasis-and-psoriatic-arthritis/

2 NIHR. Key discovery in psoriatic arthritis points way for developing targeted treatments. Available at https://oxfordbrc.nihr.ac.uk/key-discovery-in-psoriatic-arthritis-points-way-for-developingtargeted-treatments/. Last accessed January 2022. UK | 165302 | January 2022