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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]

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]