How can I be referred to the Royal Free London psoriasis service?
If you live in North London your GP can refer you directly via the NHS e-referral service or by paper referral. We welcome referral from outside our normal catchment area and if you are interested in attending the service please discuss with your GP.
Why does the clinic run late at times?
We do our best to see people at their appointment times, but some appointments take longer than their allocated time. Clinics are sometimes overbooked at short notice to accommodate people who have had a flare up of their psoriasis.
What happens when my psoriasis flares between appointments or after I’m discharged?
Psoriasis is a condition which waxes and wanes and it is not always predictable as to when people will need to be seen. For this reason we offer an ‘open appointment’ system, whereby you can phone the psoriasis patient coordinator team on 020 7830 2376 or 020 7794 0500 (extension 38134 or 33508) to arrange an appointment. The appointment may be in a telephone clinic or a face-to face appointment in the psoriasis clinic.
What is an ‘open appointment’?
The ‘open appointment’ system is available to all patients currently attending the psoriasis service and to patients who have been seen in the psoriasis service within the last two years. After two years of being seen you will need to ask your GP for a further referral as a new patient.
Why do I need blood tests and what are they?
Blood tests are for screening purposes. We will check the fats in your blood (cholesterol and triglycerides), sugar (glucose), vitamin D level, liver function tests and kidney function tests together with a full blood count which checks you are not anaemic. We also screen for hepatitis B and C, HIV and whether you’ve had chicken pox, just in case we start you on a tablet form of medication.
Do the blood tests have to be performed at the Royal Free Hospital?
At the moment we would like you to have your bloods taken at the Royal Free Hospital so the results are on our computer system. In the future it maybe possible to have them taken at an alternative site nearer to where you live.
Do I have to have bloods taken?
You don’t have to have your blood taken. It is very helpful for us to have these blood tests when you come to your clinic appointment, but not essential. Even if you do not have your bood taken for any reason, please still come to your appointment.
What does a fasting blood test mean?
We would like, if possible, that you do not eat before having your blood test taken as we will be checking the fats in your blood and glucose level. These can be artificially elevated if you have eaten recently. Fasting entails not eating or drinking anything except water, black tea or black coffee for nine hours before you have your blood test. Most people do this overnight and have their blood taken first thing in the morning.
What are the opening hours for blood tests and where do I go?
The blood testing service is located on the ground floor of the Royal Free Hospital near the main lifts. It is well sign posted within the hospital. Find out more about blood tests.
Do I need a blue form to have my blood taken?
No. Your blood tests will have been requested on the computer system. It is helpful to have the blue form and your MRN (hospital number) but not essential. Your blood test requests can also be accessed using your name and date of birth. Please come and have your blood tests taken even if you don’t have a blue form.
Why do I fill in questionnaires at each appointment?
Psoriasis can be associated with psoriatic arthritis, anxiety and depression and may have an impact on daily life. We therefore assess each of these areas using a questionnaire. We will ask you to fill in a DLQI, PEST and HADS questionnaire at each appointment in order to assist with monitoring your response to treatment. At times it will seem repetitive, but the HADS and PEST scores only need to be performed every six months.
DLQI (dermatology life quality index)
This questionnaire enquires about how your psoriasis affects the clothes you wear, activities of daily living, work and relationships. It is scored out of 30. A score above 10 indicates a major life impact.
PEST (psoriasis epidemiology screening tool)
This questionnaire assesses whether or not you have joint pain and swelling which could be psoriatic arthritis. It also asks about nail psoriasis which can be associated with psoriatic arthritis. A positive score (>/= 3) does not mean you have psoriatic arthritis, but we may refer to a rheumatologist for an assessment.
HADS (hospital anxiety and depression scale)
This questionnaire screens for anxiety and depression. A score above eight in either of the anxiety or depression questions indicates a possible anxiety or depressive disorder and a score above 11 is highly suggestive of anxiety or depression. If you have high anxiety or depression scores we may suggest you see your GP for advice or refer you to our psychodermatology service.
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