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We have become increasingly concerned recently that in its
preoccupation with cancer, heart disease and mental health, the Department
of Health has begun to lose sight of the quality of life issues
surrounding long-term illness. We were particularly pleased therefore
that the BMJ’s issue 7234 (26 February 2000) should have taken as its
theme the importance of considering the needs of people with chronic
conditions.
We were however disappointed not to see any examples from dermatology
in the papers presented. Unlike many other chronic conditions, skin
diseases are often stigmatising to a greater extent even than depression,
but there is little understanding amongst health professionals or the
public of the impact they can have on people’s quality of life.
In the report on its Enquiry into the training of healthcare
professionals who come into contact with skin diseases, (London, July
1998) the All Party Parliamentary Group on Skin called for funding to be
made available for skin disease management clinics in primary care
comparable with that already provided for asthma and diabetes. Since
then, we have been working with NHSE to acquire the evidence necessary to
secure such funding. Skin diseases can be notoriously difficult to
diagnose and diagnosis must, therefore, be undertaken at an appropriate
level within the healthcare system. Thereafter, though, many conditions
could most effectively be managed in (probably nurse-led) primary care
clinics, improving compliance and patient satisfaction and reducing the
burden on the NHS.
There would, of course, be a cost associated with the establishment
of clinics of this sort. At present,and as the APPG report demonstrated,
dermatology training for nurses and GPs ranges from negligible to nil.
That would have to change, but given that skin diseases occupy some
fifteen percent of the average GP’s caseload, it ought to be changing
anyway.
Management of chronic skin diseases
We have become increasingly concerned recently that in its
preoccupation with cancer, heart disease and mental health, the Department
of Health has begun to lose sight of the quality of life issues
surrounding long-term illness. We were particularly pleased therefore
that the BMJ’s issue 7234 (26 February 2000) should have taken as its
theme the importance of considering the needs of people with chronic
conditions.
We were however disappointed not to see any examples from dermatology
in the papers presented. Unlike many other chronic conditions, skin
diseases are often stigmatising to a greater extent even than depression,
but there is little understanding amongst health professionals or the
public of the impact they can have on people’s quality of life.
In the report on its Enquiry into the training of healthcare
professionals who come into contact with skin diseases, (London, July
1998) the All Party Parliamentary Group on Skin called for funding to be
made available for skin disease management clinics in primary care
comparable with that already provided for asthma and diabetes. Since
then, we have been working with NHSE to acquire the evidence necessary to
secure such funding. Skin diseases can be notoriously difficult to
diagnose and diagnosis must, therefore, be undertaken at an appropriate
level within the healthcare system. Thereafter, though, many conditions
could most effectively be managed in (probably nurse-led) primary care
clinics, improving compliance and patient satisfaction and reducing the
burden on the NHS.
There would, of course, be a cost associated with the establishment
of clinics of this sort. At present,and as the APPG report demonstrated,
dermatology training for nurses and GPs ranges from negligible to nil.
That would have to change, but given that skin diseases occupy some
fifteen percent of the average GP’s caseload, it ought to be changing
anyway.
Competing interests: No competing interests