New report demonstrates how dermatology teams can re-design their services to streamline the patient pathway and reduce wait times

November 29, 2021

The Dermatology Improvement Collaborative was a bespoke quality improvement programme designed and delivered by the Health Innovation Network, Kent, Surrey and Sussex AHSN and supported by the Industry Dermatology Initiative (IDI). The programme was fully funded by the IDI and they also supported with the development of activities and outputs. The collaborative worked to support local south London and Surrey dermatology services to streamline the patient pathway and clear their backlog.

Note: a full report looking at the work of the Collaborative was published in 2023.

Key stats

  • In south west London it was found that 17% of dermatology appointments were being cancelled by the provider, compared to 10% Nationally in 2020
  • Across the three trusts in South East London, dermatology services received an average of 6750 referrals per month in 2019/20
  • It was found in Leeds and York that by using high quality dermatoscopic images, 9.5-33% of cases avoided a face-to-face consultation

Pre-pandemic, the referral to appointment time (RTT) was 16 percent over the 18-week marker in south west London and 31 per cent over in south east London. Covid-19 dramatically worsened the situation as a result of Consultant Dermatologists and other operational staff being redeployed to deal with the pandemic response, therefore further increasing patient waiting times.

However, with funding from NHSX to accelerate the introduction of teledermatology in south east and south west London ICSs, the Dermatology Improvement Collaborative was able to support each ICS to implement new technology which aim to reduce wait times for patients.

The focus for south east London ICS was utilising their clinical resources more effectively, particularly in clinical triage and referral. A technology platform was implemented to manage clinical virtual review. A joint consultant rota was generated where consultants across the three NHS Trusts in south east London could review referrals before they are actioned, in order to streamline clinical triage.

In south west London ICS it was about reducing waiting times for dermatology appointments in secondary care. Educational videos were created to support patient and GP education of the treatment and management of skin conditions. As a result, GPs could make more informed decisions and therefore more appropriate referrals, which reduces wait times.

Ashford and St Peter’s NHS Foundation Trust sought solutions to address increasing service size and demand. For their two-week wait skin cancer referral pathway, they established teledermatology ‘photohubs’ across three north west Surrey locations. Employing healthcare assistants to take high quality images, which were uploaded securely to the Trust image database for review by the dermatology consultants. Next steps are to pilot the AI tool Skin Analytics in their services as part of the NHSX’s Artificial Intelligence in Health and Care Award.

“Like many across the country, Dermatology teams in south east and south west London were put under huge pressure during the pandemic, but by embracing new technology they saw the potential to improve their services. We hope the report into their success can help more dermatology services to transform their services through introduction of technology to help to reduce wait times for patients.”Lesley Soden, Programme Director of Innovation Theme, Health Innovation Network

A number of case studies were produced using the insights gathered and have now been translated into a report to share lessons learnt for all dermatology services wanting to implement teledermatology. These case studies will be being presented at the Conference: Govconnect – NHS Long Term Plan 2021 Meeting on 30th November 2021.

The IDI is a cross-industry collaboration to improve dermatology care and includes and is funded by the following member companies: Amgen, Eli Lilly and Company, LEO Pharma UK, Sanofi and UCB.

Date of preparation: September 2021                                 Document number: GB-NPS-0921-00004

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