Healthcare

Understanding NICE & UK Treatment System

What is NICE?

The National Institute for Health and Care Excellence (NICE) decides which treatments are available on the NHS. They ensure treatments are both clinically effective and cost-efficient.

Key Points:

  • NHS must provide NICE-approved treatments to eligible patients in England
  • Scotland uses a similar system (Scottish Medicines Consortium)
  • Ensures fair and equal access to treatments across the UK
Treatment Steps

Step 1: First-Line Treatments (GP Level)

  • Emollients for daily skin hydration
  • Topical corticosteroids of varying strengths:
    • Mild (e.g., Hydrocortisone 1%)
    • Moderate (e.g., Clobetasone butyrate 0.05%)
    • Potent (e.g., Betamethasone valerate 0.1%)
    • Very potent (e.g., Clobetasol propionate 0.05%)
  • Soap substitutes (e.g., Dermol, Oilatum)

Step 2: When First-Line Treatments Don't Work

  • Stronger topical corticosteroids
  • Topical calcineurin inhibitors for sensitive areas
  • Bandages and wet wraps
  • Oral antibiotics for infections
  • Dermatologist referral if needed
Severity Assessments

EASI (Eczema Area and Severity Index)

Measures redness, thickness, scratching, and scaling. Scores range from 0 (clear) to 72 (severe).

SCORAD (Scoring Atopic Dermatitis)

  • Mild: Less than 25
  • Moderate: 25-50
  • Severe: Greater than 50

DLQI (Dermatology Life Quality Index)

Measures impact on daily life, including work, sleep, and social activities.

Key Points to Remember
  • GPs follow NICE guidelines when prescribing treatments
  • Treatment usually starts with basic options before moving to stronger ones
  • NICE-approved treatments are covered by the NHS
  • Ask about specialist referral if eczema is severe or not improving
  • New treatments may take longer to become available compared to other countries