Guideline Gives Hope to Psoriasis Patients

Scotland’s leading charity for people with Psoriasis and Psoriatic Arthritis saying more has been delivered by the NHS in Scotland in the last year for patients with these conditions than in than in decades before.

In a progress report since the publication of new guidance a year ago on World Psoriasis Day 2010, the charity Psoriasis Scotland Arthritis Link Volunteers’ (PSALV) says it has found significant progress being made on services and treatments across many parts of Scotland.

‘What a difference a year makes? A report into the implementation of SIGN Guideline 121, one year on’ [attached] was compiled using the responses to a series of Freedom of Information requests submitted to Scotland’s NHS Boards on implementation of the groundbreaking SIGN Guideline 121 on the “Diagnosis and Management of Psoriasis and Psoriatic Arthritis in Adults”.

The charity found that, following the publication of SIGN Guideline 121, specific changes are now planned by several Boards, and that some have already taken effect as a direct result of this publication.  The changes are particularly apparent in fields of dermatology and rheumatology, with more focus on long-term care through outpatient services and a reduction in inpatient provision.

PSALV Director, Janice Johnson, says the results are encouraging for patients such as her:

“There is no cure for psoriasis or psoriatic arthritis.  They are chronic conditions that can be physically disabling and very painful, having a major impact on both family and working life.  Yet despite that lack of a cure, there have been some major advances in the way it is treated and managed, and we have come a long way since I was first diagnosed with the condition – this report is, I think, proof of that.

“In addition to the positive steps which seem to be being taken, or at least are planned, our report also highlights the problems that do still exist, particularly the geographic differences in care and services and in the psychological support available for patients.”     

Despite the introduction of SIGN 121 and the advance in treatment, only five NHS boards have so far changed their service provision in the last five years.  The report highlights that turning the guideline into realist is being hampered by a lack of knowledge amongst GPs of the services on offer to which they can refer patients for specialist care.


The report has put forward a series of recommendations:

  1. Protocol should be introduced to ensure the joint working between primary and secondary care
  2. Dermatology and rheumatology should be included in the QOF
  3. Implementation of SIGN Guideline 121 should be part of a Local Enhanced Services Contract between NHS Boards and GPs
  4. 100% registration for patients on biologic medicines in all NHS Boards in Scotland, including NHS Scotland HEAT targets
  5. All patients with psoriasis and/or PsA should receive annual GP reviews, with all Boards developing a protocol that ensures GPs are supported through training and access to specialist colleagues.
  6. Specialist nurse-led clinics should be introduced into primary care, either by training or by redeployment of existing staff
  7. An audit should be undertaken by NHS NES of the provision of psychology services for those with long-term conditions so that the most beneficial means of providing access to psychological support are identified and provided uniformly across Scotland.

For more information contact Janice Johnson on 0131 556 4117

Janice is herself affected by Psoriasis and Psoriatic Arthritis and happy to talk from the perspective a someone who has lived with the condition for many years.  

Contact: John Macgill
Phone: 07711 548672