Chronic spontaneous urticaria is not one of the conditions currently included in the Pharmacy First Clinical pathway protocols. NHS England will continue to keep the clinical scope of the Pharmacy First service under review, including any future service expansion to include new conditions.

If patients do not qualify for the Pharmacy First service, they should still be able to access healthcare advice from their pharmacy. Support for self-care is an essential service that all pharmacies must provide. This can include the provision of healthcare advice, the sale of over-the-counter medicines and, where appropriate, pharmacies must signpost to other providers if the supply of a prescription-only medicine is required.

Modern service frameworks will define an aspirational, long-term outcome goal for a major condition and will then identify the best evidenced interventions and the support for delivery.

The Government will consider clinical specialities for future waves of modern service frameworks, including allergy, dermatology, which includes chronic spontaneous urticaria (CSU), and immunology. The criteria for determining other conditions for future modern service frameworks will be based on disease burden, care variation, economic impact, and where there is potential for rapid and significant improvements in the quality of care and productivity.

The Department recognises the potential benefits of virtual clinics in improving access to specialist care for conditions like CSU. A central part of our 10-Year Health Plan is moving care closer to home, and we recognise that we need to do this while retaining access to specialist support. Trusts should provide the infrastructure and resources to facilitate virtual consultations, but this should not replace face-to-face care where it is more appropriate, dependent on clinical need, or preferred by individual patients.

NHS England’s service specification for specialised dermatology services for adults and children is designed to reduce regional disparities in care for CSU by setting consistent national standards for diagnosis, treatment, and follow-up. The specification ensures that all patients, regardless of location, have access to evidence-based interventions and specialist expertise, including advanced therapies where clinically appropriate. The specification addresses historical variations in service provision and supports equitable access across integrated care systems. This approach helps to improve outcomes for patients with CSU and ensures a more uniform level of care throughout England.

Additionally, NHS England’s Getting It Right First Time programme is working to improve capacity and waiting times through its established Further Faster programme. This programme brings together hospital trust clinicians and operational teams with the challenge of collectively going ‘further and faster’ to transform patient pathways, reduce unnecessary follow-up outpatient appointments, and improve access and waiting times for patients.

A Further Faster handbook for dermatology has been produced, to share best practice and support National Health Service dermatology teams to reduce the number of Did Not Attend appointments, reduce unnecessary follow ups and, where appropriate, reduce the number of outpatient appointments by booking patients straight to tests, helping to free up capacity for patients in need of specialist dermatology services.

Modern service frameworks will define an aspirational, long-term outcome goal for a major condition and will then identify the best evidenced interventions and the support for delivery.

The Government will consider clinical specialities for future waves of modern service frameworks, including allergy, dermatology, which includes chronic spontaneous urticaria (CSU), and immunology. The criteria for determining other conditions for future modern service frameworks will be based on disease burden, care variation, economic impact, and where there is potential for rapid and significant improvements in the quality of care and productivity.

The Department recognises the potential benefits of virtual clinics in improving access to specialist care for conditions like CSU. A central part of our 10-Year Health Plan is moving care closer to home, and we recognise that we need to do this while retaining access to specialist support. Trusts should provide the infrastructure and resources to facilitate virtual consultations, but this should not replace face-to-face care where it is more appropriate, dependent on clinical need, or preferred by individual patients.

NHS England’s service specification for specialised dermatology services for adults and children is designed to reduce regional disparities in care for CSU by setting consistent national standards for diagnosis, treatment, and follow-up. The specification ensures that all patients, regardless of location, have access to evidence-based interventions and specialist expertise, including advanced therapies where clinically appropriate. The specification addresses historical variations in service provision and supports equitable access across integrated care systems. This approach helps to improve outcomes for patients with CSU and ensures a more uniform level of care throughout England.

Additionally, NHS England’s Getting It Right First Time programme is working to improve capacity and waiting times through its established Further Faster programme. This programme brings together hospital trust clinicians and operational teams with the challenge of collectively going ‘further and faster’ to transform patient pathways, reduce unnecessary follow-up outpatient appointments, and improve access and waiting times for patients.

A Further Faster handbook for dermatology has been produced, to share best practice and support National Health Service dermatology teams to reduce the number of Did Not Attend appointments, reduce unnecessary follow ups and, where appropriate, reduce the number of outpatient appointments by booking patients straight to tests, helping to free up capacity for patients in need of specialist dermatology services.

Modern service frameworks will define an aspirational, long-term outcome goal for a major condition and will then identify the best evidenced interventions and the support for delivery.

The Government will consider clinical specialities for future waves of modern service frameworks, including allergy, dermatology, which includes chronic spontaneous urticaria (CSU), and immunology. The criteria for determining other conditions for future modern service frameworks will be based on disease burden, care variation, economic impact, and where there is potential for rapid and significant improvements in the quality of care and productivity.

The Department recognises the potential benefits of virtual clinics in improving access to specialist care for conditions like CSU. A central part of our 10-Year Health Plan is moving care closer to home, and we recognise that we need to do this while retaining access to specialist support. Trusts should provide the infrastructure and resources to facilitate virtual consultations, but this should not replace face-to-face care where it is more appropriate, dependent on clinical need, or preferred by individual patients.

NHS England’s service specification for specialised dermatology services for adults and children is designed to reduce regional disparities in care for CSU by setting consistent national standards for diagnosis, treatment, and follow-up. The specification ensures that all patients, regardless of location, have access to evidence-based interventions and specialist expertise, including advanced therapies where clinically appropriate. The specification addresses historical variations in service provision and supports equitable access across integrated care systems. This approach helps to improve outcomes for patients with CSU and ensures a more uniform level of care throughout England.

Additionally, NHS England’s Getting It Right First Time programme is working to improve capacity and waiting times through its established Further Faster programme. This programme brings together hospital trust clinicians and operational teams with the challenge of collectively going ‘further and faster’ to transform patient pathways, reduce unnecessary follow-up outpatient appointments, and improve access and waiting times for patients.

A Further Faster handbook for dermatology has been produced, to share best practice and support National Health Service dermatology teams to reduce the number of Did Not Attend appointments, reduce unnecessary follow ups and, where appropriate, reduce the number of outpatient appointments by booking patients straight to tests, helping to free up capacity for patients in need of specialist dermatology services.

Each medical school in the England sets its own undergraduate curriculum which must meet the standards set by the General Medical Council (GMC) in its Outcomes for Graduates. The GMC would expect that, in fulfilling these standards, newly qualified doctors are able to identify, treat and manage any care needs a person has, including chronic spontaneous urticaria (CSU) and similar conditions. The training curricula for postgraduate trainee doctors is set by the relevant Royal College and must also meet the standards set by the GMC.

To support clinicians in the diagnosis, treatment, care and support of patients with CSU, the National Institute for Health and Care Excellence (NICE) has developed an online Clinical Knowledge Summary (CKS) for the management of the condition. Patients can usually be managed with either antihistamines or steroids, but the guidance also makes clear that patients with CSU should be considered for a referral to a dermatologist where symptoms are severe, persistent, or unresponsive to first-line treatments.

The NICE CKS and Technology Appraisal is on the NICE website in an online-only format.

Skin lesion analysis tools that use an artificial intelligence (AI)-based fixed algorithm are currently being trialled in several National Health Service trusts. These AI tools have the potential to free up dermatology capacity and reduce waiting times by effectively triaging patients with skin lesions where there is a suspicion of cancer. Data from trials in 2023/2024 suggests these tools could help with diagnosing and discharging around 30% of cases from the pathway. This will allow more patients to be seen and get a diagnosis in a timely manner.

NHS England’s Getting It Right First Time (GIRFT) programme addresses regional variations in healthcare by identifying areas of unwarranted variation and working with local teams to implement improvements and reduce differences. Through GIRFT’s Further Faster programme, hospital trust clinicians and operational teams are being brought together with the challenge of collectively going ‘further and faster’ to transform patient pathways, reduce unnecessary follow-up outpatient appointments, and improve access and waiting times for patients.

A Further Faster handbook for dermatology, which covers conditions like chronic spontaneous urticaria, has been produced, to share best practice and support National Health Service dermatology teams to reduce the number of Did Not Attend appointments, reduce unnecessary follow ups and, where appropriate, reduce the number of outpatient appointments by booking patients straight to tests, helping to free up capacity for patients in need of specialist dermatology services.

In addition, NHS England and the British Association of Dermatologists have established a specialist dermatology clinical reference group. Its objectives are to: measure and improve quality; improve value and reduce unwarranted variation; improve equity of service; and transform and provide advice and support to integrated care boards as they take on responsibility for specialised service commissioning.

Each medical school in the England sets its own undergraduate curriculum which must meet the standards set by the General Medical Council (GMC) in its Outcomes for Graduates. The GMC would expect that, in fulfilling these standards, newly qualified doctors are able to identify, treat and manage any care needs a person has, including chronic spontaneous urticaria and similar conditions. The training curricula for postgraduate trainee doctors is set by the relevant Royal College and must also meet the standards set by the GMC.

No assessment has been made.

No assessment has been made.

The National Institute for Health Research (NIHR) Clinical Research Network is recruiting patients to an international dose-finding study of QGE031 as add-on therapy to evaluate efficacy and safety in patients with chronic spontaneous urticaria.

The NIHR welcomes funding applications for research into any aspect of human health, including urticaria. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money and scientific quality.

Urticaria, more commonly referred as to as hives, is estimated to affect 1 in 6 people at some point in their lives, compared with 1 in 1,000 people for chronic urticaria. Many people will experience urticarial in response to a food or drug reaction or insect sting, and some find emotional stress can be a trigger. However some people experience more prolonged or chronic bouts of the condition. In such cases an autoimmune reaction is thought to be associated with a high number of cases without an identifiable cause. A range of information for the public on the conditions is available via NHS Choices.

The care of people with skin problems is a core competence of general practitioner training and people with urticaria can usually be managed through routine access to primary or second care services. To support clinicians in the diagnosis, treatment, care and support of patients with chronic spontaneous urticaria, the National Institute for Health and Care Excellence (NICE) has developed an online Clinical Knowledge Summary (CKS) for the management of the condition. Patients can usually be managed with either anti-histamines or steroids, but the guidance also makes clear that patients with chronic urticarial should be considered for a referral to a dermatologist. In addition, July 2015 NICE published the Technology Appraisal Omalizumab for previously treated chronic spontaneous urticarial, recommending the drug for patients in whom the conditions is identified as severe and standard treatments have not improved the symptoms. Both the NICE CKS and technology Appraisal can be found at the following links:

http://cks.nice.org.uk/urticaria

www.nice.org.uk/guidance/ta339/resources/omalizumab-for-previously-treated-chronic-spontaneous-urticaria-82602555773893

For those patients with the most serious forms of chronic spontaneous urticaria who cannot be managed through routine access treatments provided through primary or secondary care, a referral to a specialised dermatology service may be appropriate. NHS England commissions services for people with rare and complex skin conditions and has set out what providers must have in place in order to offer specialist dermatology care. These services may provide more intensive therapies with a involvement of a range of health and care professionals, subject to that patient’s needs. More information can be found at the following link:

www.england.nhs.uk/wp-content/uploads/2013/06/a12-spec-dermatology.pdf

Urticaria, more commonly referred as to as hives, is estimated to affect 1 in 6 people at some point in their lives, compared with 1 in 1,000 people for chronic urticaria. Many people will experience urticarial in response to a food or drug reaction or insect sting, and some find emotional stress can be a trigger. However some people experience more prolonged or chronic bouts of the condition. In such cases an autoimmune reaction is thought to be associated with a high number of cases without an identifiable cause. A range of information for the public on the conditions is available via NHS Choices.

The care of people with skin problems is a core competence of general practitioner training and people with urticaria can usually be managed through routine access to primary or second care services. To support clinicians in the diagnosis, treatment, care and support of patients with chronic spontaneous urticaria, the National Institute for Health and Care Excellence (NICE) has developed an online Clinical Knowledge Summary (CKS) for the management of the condition. Patients can usually be managed with either anti-histamines or steroids, but the guidance also makes clear that patients with chronic urticarial should be considered for a referral to a dermatologist. In addition, July 2015 NICE published the Technology Appraisal Omalizumab for previously treated chronic spontaneous urticarial, recommending the drug for patients in whom the conditions is identified as severe and standard treatments have not improved the symptoms. Both the NICE CKS and technology Appraisal can be found at the following links:

http://cks.nice.org.uk/urticaria

www.nice.org.uk/guidance/ta339/resources/omalizumab-for-previously-treated-chronic-spontaneous-urticaria-82602555773893

For those patients with the most serious forms of chronic spontaneous urticaria who cannot be managed through routine access treatments provided through primary or secondary care, a referral to a specialised dermatology service may be appropriate. NHS England commissions services for people with rare and complex skin conditions and has set out what providers must have in place in order to offer specialist dermatology care. These services may provide more intensive therapies with a involvement of a range of health and care professionals, subject to that patient’s needs. More information can be found at the following link:

www.england.nhs.uk/wp-content/uploads/2013/06/a12-spec-dermatology.pdf

Urticaria, more commonly referred as to as hives, is estimated to affect 1 in 6 people at some point in their lives, compared with 1 in 1,000 people for chronic urticaria. Many people will experience urticarial in response to a food or drug reaction or insect sting, and some find emotional stress can be a trigger. However some people experience more prolonged or chronic bouts of the condition. In such cases an autoimmune reaction is thought to be associated with a high number of cases without an identifiable cause. A range of information for the public on the conditions is available via NHS Choices.

The care of people with skin problems is a core competence of general practitioner training and people with urticaria can usually be managed through routine access to primary or second care services. To support clinicians in the diagnosis, treatment, care and support of patients with chronic spontaneous urticaria, the National Institute for Health and Care Excellence (NICE) has developed an online Clinical Knowledge Summary (CKS) for the management of the condition. Patients can usually be managed with either anti-histamines or steroids, but the guidance also makes clear that patients with chronic urticarial should be considered for a referral to a dermatologist. In addition, July 2015 NICE published the Technology Appraisal Omalizumab for previously treated chronic spontaneous urticarial, recommending the drug for patients in whom the conditions is identified as severe and standard treatments have not improved the symptoms. Both the NICE CKS and technology Appraisal can be found at the following links:

http://cks.nice.org.uk/urticaria

www.nice.org.uk/guidance/ta339/resources/omalizumab-for-previously-treated-chronic-spontaneous-urticaria-82602555773893

For those patients with the most serious forms of chronic spontaneous urticaria who cannot be managed through routine access treatments provided through primary or secondary care, a referral to a specialised dermatology service may be appropriate. NHS England commissions services for people with rare and complex skin conditions and has set out what providers must have in place in order to offer specialist dermatology care. These services may provide more intensive therapies with a involvement of a range of health and care professionals, subject to that patient’s needs. More information can be found at the following link:

www.england.nhs.uk/wp-content/uploads/2013/06/a12-spec-dermatology.pdf

Information concerning the number of people with chronic spontaneous urticaria (also known as hives, welts or nettle rash) in England is not collected. However, the National Institute for Health and Care Excellence estimates that approximately 15% of people in the United Kingdom experience urticaria at some time in their lives and the lifetime prevalence of chronic urticaria is 0.5–1%.

Information concerning the number of people with chronic spontaneous urticaria (also known as hives, welts or nettle rash) in England is not collected. However, the National Institute for Health and Care Excellence estimates that approximately 15% of people in the United Kingdom experience urticaria at some time in their lives and the lifetime prevalence of chronic urticaria is 0.5–1%.

The information requested is not held centrally and no assessment has been made.