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The use of remote consultations via telephone or video can contribute to the management of people with psoriasis and has allowed continuity of patient care throughout the SARS-CoV-2 pandemic, though little is known about the patient experience. The present study aimed to provide insights into the views and experiences of people with psoriasis and psoriatic arthritis on their remote consultations during the SARS-CoV-2 pandemic and develop guidance for patients and healthcare professionals on how to optimise future remote consultations. We conducted a cross-sectional, on-line survey of people with psoriasis and psoriatic arthritis. Data were analysed using descriptive statistics and Thematic Analysis. Overall, 126 people reported experiences of telephone (92%) or video (8%) consultations. Most participants were satisfied with (78%), and were happy for, remote consultations to continue (21%); few were not (5%). Others did not always want remote consultations (39%) and preferred alternating with face-to-face consultations (18%). Some wanted remote care during the pandemic only (17%). Five themes were identified: (1) Advantages of Remote Consultations; (2) Disadvantages of Remote Consultations plus sub-themes (2.1) Practical Issues and (2.2) the Absence of Non-Verbal Cues and Emotions; (3) Serving a Purpose; and (4) A 'Good' Remote Consultation; and (5) Advice to Other Patients. Remote consultations form an important part of psoriatic disease management, mainly for routine follow-up appointments in patients with stable disease, and in addition to face-to-face consultations. Additional skills training for clinicians could improve the quality of remote consultations. [ABSTRACT FROM AUTHOR]

This article -- the second in their series -- looks at remote consultations, providing a summary of what they are in relation to patients with skin conditions and detailing the guidance that has been developed by the Dermatology National Outpatients Transformation Programme, which it is hoped will lead to more personalised care in the field. [ABSTRACT FROM AUTHOR]

The Psoriasis and Well-being (PsoWell)™ training programme, incorporating motivational interviewing, improves clinicians' knowledge and skills to manage complex psoriasis, including behaviour change. The aims of this study were to deliver the PsoWell™ training programme to dermatology specialists, and to evaluate the acceptability and feasibility of implementing the PsoWell™ model across dermatology services. Framework analysis of 19 qualitative semi-structured interviews was performed, following delivery of nine, 1-day PsoWell™ training days involving 119 participants. Two themes were identified: "Perceptions and Priorities" and "Awareness", sub-divided into: "Awareness Not Competence" and "Increasing Awareness". The PsoWell™ model was found to be acceptable and feasible to implement across dermatology settings. Participants were more skilled and motivated to address psychological issues, including behaviour change, but wanted further training to ensure competency. The trainees claimed that scepticism among some colleagues regarding whole-patient management might prevent uptake. Data showing the impact on health outcomes are needed and might overcome scepticism. Remote consultation could adopt the PsoWell™ approach. [ABSTRACT FROM AUTHOR]

This is the third article in a short series looking at how proposals put forward in the NHS Long Term Plan will affect patients. This article looks at referral optimisation, and the work of the National Outpatient Transformation Programme to support implementation. [ABSTRACT FROM AUTHOR]

Background: In 2006, a study reported that skin conditions were the commonest reason that patients presented with a new problem to their GP in England and Wales.1,2 Objectives: To describe the trends in episode incidence, prevalence, and consultation rates for patients with skin conditions in primary care in England over the 10-year period 2006 to 2016. Methods: Routinely collected data from patients in England registered at general practices who are members of the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC). Repeated cross-sectional data for 2006, 2009, 2011, 2013, and 2016 is reported. Results: Skin conditions remain the commonest reason that patients are seen in primary care in England with a new problem. The episode incidence of skin conditions has risen but consultation rates have not, suggesting more patients are presenting with episodes of skin disease but not returning for review. Skin infections remain the commonest skin condition presenting. There have been increases in the prevalence, episode incidence and consultation rates for skin lesions and 'symptoms involving the skin'. There has been a large increase in the episode incidence of young women presenting with acne. Conclusions: Skin conditions remain the commonest reason that people present to their general practice with a new problem. There has been an increase in episode incidence of skin conditions but not consultation rates, particularly for acne. The increase seen in 'symptoms involving the skin' suggests that our current educational approach leaves many patients with skin conditions without any specific diagnosis. [ABSTRACT FROM AUTHOR]

The NHS Long Term Plan is a commitment to redesign services by putting the patient firmly in the centre of their care. This article - the first in a short series - focuses on the development of a Patient Initiated Follow Up (PIFU) for people with skin conditions, which it is hoped will formalise the process of re-accessing care services. [ABSTRACT FROM AUTHOR]

AimTo establish how people with psoriasis in the United Kingdom today experience living with their condition including diagnosis, treatment, healthcare provision and impact on daily life.BackgroundPsoriasis is a debilitating long-term inflammatory skin disease which can result in severe itching, discomfort and soreness, and may be associated with problems beyond the specific symptoms related to the skin. For many it is accompanied by difficult-to-manage treatment regimes, emotional distress and a negative impact on their quality of life and psychosocial functioning. To date there is little published information about the health experiences of people in the United Kingdom with psoriasis.MethodsA postal self-administered questionnaire was completed by members of the Psoriasis Association and the responses analysed (n=1564).FindingsThe findings suggest some similarities to surveys in other nations, but specifically highlighted that patients feel under-informed and are dissatisfied with current treatment regimes. Responses provided an insight into aspects of the condition that treatments should be targeting. Specific areas of negative impact on psychosocial functioning were identified, including the lack of available support for those experiencing emotional distress. The research provides important information about how the care of patients with psoriasis can be improved, especially at primary care level. This includes: improved training in psoriasis knowledge and awareness at general practitioner level and greater use of dermatology specialist nurses in primary care settings; more effective and manageable treatment regimes that target visible areas and general well-being; greater support for emotional distress and psychosocial functioning. [ABSTRACT FROM PUBLISHER]

Staff at the University of Hertfordshire have adapted their teaching methods in light of the COVID-19 crisis. This article considers how things have changed over the last few months. [ABSTRACT FROM AUTHOR]

We report a case of gravitational erythema in a 13-year-old boy who presented with a blotchy erythematous rash affecting his arms when hanging down and legs and lower abdomen on standing. The cutaneous symptoms in the upper limbs would resolve rapidly on elevation of the arms, whereas the lower limb rash would disappear on lying flat. Although this is a benign condition, no effective treatment has previously been reported. Our patient was managed with compression stockings, which provided some symptomatic benefit. [ABSTRACT FROM AUTHOR]

In the evolving world of the NHS, Teledermatology (TD) using store and forward technology may be seen by some as a cost-effective solution to deal with demand for dermatology services in a timely fashion and to reduce visits to secondary care. As such it is being increasingly considered by primary care commissioners reviewing their dermatology pathways. The Department of Health has consequently hosted an independent multi-professional group to establish guidance on TD. The outcome of this work now supplements Quality Standards for Dermatology: Providing the Right Care for People with Skin Conditions launched by the British Association of Dermatologists in 2011. The document contains eight standards, key points of which are summarised below. Each standard comprises a series of recommendations with a rationale for each and background information and further information where appropriate. 1. Models of Teledermatology services: TD services should be developed around patient needs within a local service with clear pathways and links between levels of care and specialisms. This may involve a triage system, full substitution for standard face to face consultation, or an intermediate system allowing for advice only or integration with secondary care services as appropriate. The type of TD service should be clearly identified and an agreed tariff established. 2. Selection of patients: The type of service will determine the range of appropriate patients. For patients with pigmented lesions, dermoscopic images should ideally be included. 3. Informed consent: Legal consents are required prior to taking and subsequent use of images. Consent must be retained for as long as images are held. 4. Competent staff: Healthcare professionals involved in TD should have equal competence to those involved with non-TD referrals. For those in photographic roles training and feedback are important together with auditing of skills. standards as set out in legal and professional guidance on the holding, storage and transfer of patient data, TD records should be auditable and accessible as part of the patient record and as 'stand-alone' data. 8. Audit and quality control: In order to assess quality, TD services should complete at least one patient survey and one audit per year. These standards will be launched by Spring 2013 and it is hoped that they will be adopted as best practice throughout the UK. [ABSTRACT FROM AUTHOR]

The author reflects on her career as a dermatologist and receiving the Order of the British Empire (OBE) award. She relates her career decision to shift general practice to dermatology, as well as some of the advantages associated with being a part-time trainee in dermatology. Information on the author's views on developing general practitioners with special interests (GPwSIs) is provided. She highlights her efforts to pursue the right person, right place, right time concept in dermatology.