A report by independent health think-tank the King’s Fund has revealed “major” failings across National Health Service dermatology services, with evidence of staff shortages, poor training, inconsistent quality in diagnosis and treatment, and large variations in access to specialist care.

Dermatology is the most frequent disease area seen by GPs, with 13 million consultations every year. Skin diseases represent 34% of disease in children, with atopic eczema affecting 20% of infants, while skin cancer is the most common cancer and the second most common cancer causing death in young adults. 

And yet the area is “poorly understood” and has received “comparatively little attention” compared with other disease areas, stress the authors of the report, commissioned by the British Association of Dermatologists.

“Commissioning has often been poor. Inadequate planning has left gaps in the workforce. The 40,000 GPs managing this workload have received little training in dermatology and there are only 650 consultants to advise them and provide the more specialist care,” they note, highlighting the magnitude of the problems in the field.

The authors makes a series of recommendations to help ensure dermatology services meet current and future patient needs, while maintaining quality of care and equitable access. These largely centre on boosting the quality of dermatology knowledge in primary care, through better education at both under- and post-graduate level, and improving commissioning.

According to the report, in a number of cases commissioning was driven by “short-term tactical decisions designed to minimise the price paid rather than to improve value for patients”, which could lead to “service fragmentation” and “models of care that make false economies”.