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<p>The commissioning and configuration of dermatology services in England is a local
matter. The majority of patients with dermatological disorders are managed in primary
and community care and the local National Health Service is best placed to make decisions
that ensure services meet the needs of resident populations in the most appropriate
way.</p><p> </p><p>The National Institute for Health and Care Excellence has published
guidance on a number of dermatological conditions, including eczema, also known as
atopic dermatitis, to support commissioners to plan and deliver services for local
populations. ‘Atopic eczema in under 12’s: diagnosis and management’ includes recommendations
that healthcare professionals should adopt a holistic approach at each consultation,
taking into account severity of a condition and the impact this may have on quality
of life.</p><p> </p><p>Healthcare professionals should be aware that all categories
of severity of atopic eczema, even mild, can have a negative impact on psychological
and psychosocial wellbeing and quality of life and that assessment of wellbeing should
be carried out at every consultation. Furthermore, the guidance recommends using validated
tools in the management of patients, such as Children's Dermatology Life Quality Index,
Infants' Dermatitis Quality of Life Index or Dermatitis Family Impact questionnaire
for quality of life. Where quality of life and psychosocial wellbeing has not improved
despite treatment and improvement, patients should be referred for psychological advice.
The guidance can be found at the following link:</p><p> </p><p><a href="http://www.nice.org.uk/guidance/cg57"
target="_blank">www.nice.org.uk/guidance/cg57</a></p><p> </p><p>As set out in the
NHS Long Term Plan, published on 7 January 2019, NHS England is taking action in range
of areas to improve the care treatment and support provided to people with long term
conditions. As part of this, it is continuing its expansion of Improving Access to
Psychological Therapies (IAPT) services for adults with common mental health problems,
with a focus on those with long-term conditions. IAPT services have now evolved to
deliver benefits to people with long-term conditions, providing genuinely integrated
care. By 2023/24, an additional 380,000 adults will be able to access IAPT services.</p><p>
</p><p>No assessment has been made on the impact of atopic dermatitis on patient expenses,
work days and mental health services. No meetings regarding atopic dermatitis have
taken place in the last 12 months.</p>
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