Psoriasis remains one of the commonest conditions seen in dermatological practice, and its treatment is one of the greatest cost burdens for the UK NHS. Treatment of psoriasis is complex with numerous overlapping lines and modalities of therapy employed in combination. This complexity reflects the underlying pathophysiology of the disease as well as the heterogenous population which it affects. NICE guidance for the treatment of psoriasis has been available since 2013 and has been the subject of 3 national audits conducted by the British Association of Dermatologists (BAD). This report synthesises the results of the most recent of those exercises and places it in the context of NICE guidance and previous audits. It clearly shows the significant burden of disease, issues with provision of services and long waiting times as well as the marked shift in therapeutic modalities towards targeted biologic therapies.