Published guidance, policy, official data, or peer-reviewed evidence carries the claim.
Sources
Sources and evidence gaps
This page is the public source-and-gap register. It shows what the current source trail can support, where testimony begins and ends, which claims remain Citation required, and how FOI evidence gathering will be added safely.
PubMed probiotic references remain verification and evidence-gap references only. They do not support public treatment claims, product promotion, or prescribing recommendations.
Evidence key
The source trail uses three public labels.
This page shows which sources support claims, which areas are testimony, and which remain unresolved.
Lived experience shows how pathways can break down, but it is not treated as clinical proof.
Important claims remain clearly marked until the source trail is verified.
Sourced
Current source-backed principles.
These are the limited principles the current public source trail can support.
Sourced
Emollient choice and acceptability
The current source trail can support the principle that emollient choice, acceptability, and practical use matter in eczema care.
- Supports careful wording about choice and acceptability.
- Does not support claims that any named product is superior for everyone.
Sourced
Patient-facing guidance on different emollients suiting different people
Patient-facing eczema guidance can support cautious copy about tolerability, irritation, texture, fragrance sensitivity, and practical daily use.
- Supports the suitability principle.
- Does not turn individual product preferences into clinical recommendations.
Sourced
Prescribing restrictions and clinical judgement
NHS prescribing-policy context can be used to frame cost-conscious prescribing alongside clinical judgement and documented need.
- Supports the policy context.
- Does not prove the campaign's total-cost case without further data.
Patient testimony
Patient testimony boundaries.
Testimony can identify pathway problems and policy questions, but it is not clinical proof.
Patient testimony
Anonymised experience as a pathway signal
The campaign can say that one anonymised patient reported unsuitable or poorly tolerated prescribed options, local access constraints, and self-funded care.
- Use testimony to identify policy questions.
- Do not use testimony as clinical proof, population-level prevalence, or product endorsement.
Patient testimony
Future patient evidence remains governance-dependent
Any future patient evidence route must keep individual accounts labelled as testimony and must not collect health-related personal data until governance is ready.
- No live patient-submission form is part of the current public site.
- Aggregated patterns would still need cautious interpretation and source-backed claims.
Citation required
Citation-required evidence gaps.
These remain visible as research and source-work questions rather than settled public claims.
Citation required
Total system cost of unsuitable first-line prescribing
The campaign asks whether unit-cost savings are offset by repeat demand, escalation, referral pressure, or self-funded care, but the scale remains unproven.
Citation required
Dermatology waiting-time impact on primary-care eczema management
Current waiting-time data and its effect on interim eczema prescribing must be added before system-wide statements are made.
Citation required
Formulary variation and exception-route evidence
The campaign needs concrete formulary examples and route evidence before claiming the scale or consistency of local access constraints.
Citation required
Named products, ingredients, mechanisms, and probiotic strains
Product-specific, ingredient-specific, probiotic strain, and mechanism claims remain evidence gaps until verified from reliable primary sources.
Reference trail
Sources currently available in the repo.
These sources are linked so serious readers can check the footing and the limits.
Briefing routes
Source trail
- External source: NICE QS44: provision of emollientsQuality standard for emollient provision, choice, and eczema care.
- External source: NHS England OTC prescribing policy guidancePolicy context for routine prescribing restrictions and clinical judgement.
- External source: Eczema UK emollients guidancePatient-facing emollient guidance, product types, and irritant considerations.
- External source: PubMed: probiotic evidence verification sourceEvidence-gap source for verification only; not support for a public treatment claim.
- External source: PubMed: probiotic strain-name verification sourceUsed only to check unresolved strain naming; not support for public mechanism or effectiveness claims.
Open evidence gaps
- Current NHS dermatology waiting-time data.
- Cost evidence for repeat eczema appointments, flare management, infection, escalation, and referrals.
- Examples of formulary variation and documented exception routes.
- Patient evidence methodology and consent-led submission governance.
- Adjacent evidence questions, including probiotics or product-specific mechanisms, remain outside the launch argument unless independently verified from reliable primary sources.
FOI evidence gathering
FOI evidence-gathering items.
FOI requests can help test what public bodies hold, but pending requests are not findings.
FOI pendingFOI evidence gathering
Integrated Care Boards / formularies
Whether relevant formulary evidence, review records, criteria, or exception-route data are held and how documented need is considered.
- Formulary evidence base, clinical reviews, equality impact assessments, committee minutes, criteria, Individual Funding Request data, dermatology referral waiting times, and any review of probiotic interventions.
- Requested / awaiting response. Pending FOI requests are not findings.
FOI pendingFOI evidence gathering
NHS Trusts / dermatology access
Whether relevant access, waiting-time, cost, extractability, and non-formulary policy data are held in a form that can inform the campaign question.
- Urgent dermatology referral waiting times, 18-week performance, 52-week waits, atopic eczema extractability, first outpatient appointment costs, non-formulary emollient policy, and recording of urgent or emergency care while waiting.
- Requested / awaiting response. Pending FOI requests are not findings.
FOI pendingFOI evidence gathering
NHS Business Services Authority / prescribing data
Whether prescribing data can support careful analysis of volume and cost patterns without making unsupported effectiveness claims.
- Monthly prescribing and dispensing volumes and Net Ingredient Cost for emollient and barrier preparations, grouped by broad preparation type where data allows.
- Requested / awaiting response. Pending FOI requests are not findings.
FOI pendingFOI evidence gathering
MHRA / Yellow Card data
Whether aggregated Yellow Card data can inform safety or tolerability questions, with reporting limitations clearly stated.
- Aggregated Yellow Card reports for emollient and barrier preparations, including suspected adverse reactions, condition aggravated, drug ineffective, treatment failure, reporter type, severity, and product-level counts where available.
- Requested / awaiting response. Pending FOI requests are not findings.
Out of scope
Product, probiotic, and mechanism claims remain out of scope.
The current campaign does not promote products, rank treatments, or make probiotic treatment claims.
Out of scope
Product or routine recommendations
The public site must not tell patients to start, stop, switch, or prefer any named eczema product, supplement, ingredient, probiotic, or routine.
- The campaign is about prescribing policy and documented need.
- Individual care decisions belong with qualified clinicians.
Out of scope
Probiotic mechanism and strain claims
PubMed probiotic references are kept as verification and evidence-gap references only. They do not support public treatment claims on this site.
- The unresolved DSM 22775 strain-name issue remains citation required.
- No probiotic effectiveness, mechanism, or prescribing claim is being made.
Out of scope
Commercial product comparisons
The campaign does not rank emollients, claim that more expensive products are automatically better, or promote a product category as universally suitable.
Evidence hygiene
How new evidence should be added safely.
The site should only strengthen public claims when the source trail, limitations, and evidence label all support the wording.
Citation required
Add the source before strengthening the claim
A claim can move from Citation required to Sourced only when the public page can point to reliable evidence that actually supports that wording.
Evidence gathering
Keep limitations visible
FOI responses, official data, or papers should be added with limits, non-responses, refusals, extractability issues, and applicability caveats visible.
Patient testimony
Keep testimony separate from proof
Patient experience can shape research questions and advocacy, but clinical and policy claims still need published sources or a visible citation-required label.
Next step
Evidence gaps stay public until they are resolved.
Readers can use the sources page to check what is already supported, what is testimony, and what still needs citation before stronger claims are made.