Concern over access to specialist skin services

Research needed to assess impact
  • Deborah Condon

Some dermatology patients have difficulty accessing specialist services because of where they live and research is needed to assess the impact this is having on them, the Irish Skin Foundation (ISF) has said.

It is calling for research into the effects that a household's distance from specialist dermatology services can have on people living with chronic inflammatory skin conditions, such as eczema, psoriasis and hidradenitis suppurativa (HS).

"We know anecdotally from the ISF helpline that disadvantaged, less-abled, and marginalised patients, who don't live near urban centres with public transport, don't or can't travel to access specialist services clustered in Ireland's major hospitals.

"This means that the most vulnerable and less well-off patients have difficulty accessing services where they are needed, leading to more suffering, poorer health outcomes and greater severity of disease," explained ISF chief executive, David McMahon.

He said that while there are a number of factors affecting health service utilisation, one critical factor is thought to be the distance of a patient's household from a specialist clinic.

The phenomenon of decreasing health care utilisation due to increasing distance from a facility is often referred to as the ‘distance-decay effect'.

"It appears that the current model for delivering services is weighted too far in favour of hubs based in major cities. It is failing to deliver equity in access for thousands of children and adults living with skin conditions in many parts of Ireland - notably in the midlands, north west and south east.

"We don't understand the full impact of the distance-decay phenomenon on people living with chronic skin disorders. Policy research is urgently needed to feed into an evidence-based service planning process, so that care is delivered in a manner that guarantees better access for all people living with a chronic skin disease," Mr McMahon insisted.

There are currently a number of outreach clinics offering services in peripheral hospitals nationwide. These see up to 20 new patients or 30 returning patients every day.

"Some services operate one or two clinics each week, others less frequently. Nationwide, such clinics can potentially care for between 250-450 patients each week depending on a number of variables. Research into service planning is needed to determine whether or not patients' long-term health outcomes can be optimised by delivering more services along this model," Mr McMahon said.

The ISF is calling for more equitable and convenient specialist access to dermatology services for patients.

Anyone with any concerns about a chronic skin disorder can contact the ISF's specialist nurse-led helpline on (01) 486 6280.

For more information on the ISF, click here.


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