Greater Manchester

Psoriasis Rapid Access Clinic (P-RAC)

Improving the treatment of Psoriasis

Patients with psoriasis are being empowered to better manage their condition with the launch of a rapid access clinic designed to improve access to education and personalised treatment.

The Psoriasis Rapid Access Clinic (P-RAC), which launched in Salford in October, 2018, provides newly-diagnosed patients with a complete specialist assessment of their psoriasis and education about how to best manage the disease.

Psoriasis is a long-term autoimmune disease which is characterised by red, flaky, crusty patches of skin. It can be a painful, disfiguring and disabling disease which affects not only a person’s skin but potentially also their mental health and wellbeing.

The lifelong condition affects up to 80,000 people in Greater Manchester and is mainly treated in the community through GPs, pharmacists or self-management. On average patient has psoriasis for eight years by the time they are reviewed by a dermatology specialist, according to national statistics.

The Psoriasis Rapid Access Clinic is a research study in collaboration with The University of Manchester, Salford Royal NHS Foundation Trust (Part of Northern Care Alliance NHS Group) and funded by Health Innovation Manchester. It will initially run within a community practice in Salford with patients who have recently been diagnosed with psoriasis. Care will be delivered by a specialist team including dermatology consultant, a health psychologist and a dermatology nurse.

The clinic focuses on proactive psoriasis care, personalised treatment and educating patients to empower them to take care of their own condition. Patients will receive information about psoriasis including lifestyle factors which can increase the risk of flare-ups, practical advice about using creams and details of the treatments available.

Patients will also be offered screenings for other conditions associated with the disease, such as cardiovascular disease, anxiety and depression. Blood samples collected as part of the clinic will also enable research to test for genomic factors with an aim of developing better and more personalised care in the future.

Specifically the programme will: Determine the characteristics of patients who are most likely to benefit from the P-RAC.

  • Identify the perceived barriers and facilitators to wider implementation of the P-RAC across NHS organisations.
  • Determine if the service leads to an improvement in psoriasis severity measures.
  • Establish the prevalence of CVD risk factors and unhealthy lifestyle behaviours amongst this group.
  • Determine whether a patient’s attitude towards and understanding of psoriasis improves with the P-RAC intervention and whether this influences care/self-care.
  • Describe the costs of this service and determine if it is cost-effective.

The potential impacts and outcomes of the programme could see a viable product for roll-out across Greater Manchester and a model for early-intervention and management of other long-term conditions. These are as follows:

  • Increased self-care.
  • Increased adherence to medication.
  • Early referral to hospital services for those most at risk.
  • Increased understanding of cardiovascular risk factors in this population.
  • Prevention of serious co-morbidity.
  • Reduced absenteeism and presenteeism.

Contact: Programme lead: Cath Barrow (Senior Programme Development Lead)

Case Study: Becca Darwent-Black

Becca Darwent-Black Psoriasis Shout Out

Becca (35), from Levenshulme, was just 14 when she was diagnosed with psoriasis and has been hospitalised on three occasions following serious flare-ups which left her unable to walk.

The marketing executive, who has tried a variety of treatments to help her manage the condition, said: “Psoriasis doesn’t just affect your skin, it affects the way you feel everyday. When you have a flare-up you stop socialising and can’t wear the clothes you want or even sleep due to the pain sometimes. It can take you to very dark places.

“The rapid access clinic is a brilliant idea and I honestly believe it would have helped me if I’d been able to access information and treatment earlier in my diagnosis. Having the information you need and knowing where to turn is vital and I honestly believe it will be life-changing for those diagnosed with psoriasis.”

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