‘The user interface is excellent – it’s not clunky and doesn’t feel outdated. I also love that I receive my photos as attachments to my NHS email afterwards. The best part is that it doesn’t take any time out of my schedule; if anything, it streamlines my workflow.’
Healthcare professionals in North Central London (NCL) ICB have access to a range of elective care specialties for Enhanced Advice & Guidance (A&G) provided by out-of-area NHS consultants on the National Consultant Network (NCN), including messaging advice services for dermatology lesions and dermatology advice. The NCN consultants support primary care clinicians by delivering A&G via telephone and messaging, which frees up already-busy local specialists. We spoke with Dr Fahad Iqbal, a GP trainee in Barnet, to discover why he finds Consultant Connect useful within primary care.
NCL Dermatology stats since project launch in 2020*:
More than 45,000 messages sent | Messages answered within 12 hours, on average | 74% of queries resulted in patients avoiding an unnecessary referral and being managed within the community
How and when did you start using Consultant Connect?
‘I started seeking A&G via Consultant Connect recently, following my GP trainer’s recommendation. I almost always use Consultant Connect via the app because I can attach my dermatoscope to my phone to take high-quality images. However, because Consultant Connect is a multi-platform service, I can log in on my desktop to add my activity to the patient’s notes. The user interface is excellent – it’s not clunky and doesn’t feel outdated. I also love that I receive my photos as attachments to my NHS email afterwards. The best part is that it doesn’t take any time out of my schedule; if anything, it streamlines my workflow.
‘How fast I receive responses to my messages is a game changer because that allows me to provide a solution to my patients, whilst allowing me to learn. This is especially true for a specialty like dermatology, where patients often present with multiple symptoms, and trialling different prescriptions hasn’t provided any benefit. There’s always the option of referring the patient to a dermatologist, with the caveat that they won’t receive an appointment for approximately 18 months. Alternatively, I could submit a teledermatology request via e-RS, which also delays processes, because it isn’t seamless, and the learnings take longer. Or I could take a photo via Consultant Connect to send to a consultant dermatologist, and probably have an answer by the end of the day. That’s brilliant for my learning and one of the main reasons I continue using the service.’
Why is dermatology such an essential specialty for you to have access to?
‘Dermatology has a lot of grey areas. Consultant dermatologists who review dermatoscopic images know exactly what they’re looking at straight away, but GPs aren’t dermatologists. We build up our experience over time, and when you’re more junior in your career, it’s not quite as easy to determine exactly how to treat a dermatological condition. As a result, having almost instant access to specialist dermatology advice feeds into my learning.
‘At the point of seeing my patients, most of them have not yet been referred to dermatology, so they don’t fully appreciate how much easier Consultant Connect has made this process for them. However, they’re much happier knowing a dermatologist has reviewed their images. So in a way, they’ve already been seen by a specialist, and I relay the management plan.’
Patient example
‘In addition to dermatology messaging, I use the calling functionality to speak with consultants in other specialties. Recently, I contacted a consultant neurologist on the NCN after seeing a patient with a recent diagnosis of secondary metastatic cancer to the brain. The patient has an unknown primary, but the secondary cancer was causing seizures. He’d already been seen in hospital and had commenced anti-epileptic medication, but since then had had another seizure, so I knew he needed an increased dosage of the medication. However, as these drugs are extremely specialist, it’s best to get advice first before prescribing them. I got through to the consultant neurologist in a few minutes. I had the entire conversation during the patient’s consultation without needing to go through any switchboards or wait on hold indefinitely. The consultant neurologist I spoke with gave me a perfect plan, including what to bridge the medication with. Consultant Connect made it easy for the patient and me to deal with his condition and keep him out of hospital.
‘His seizures are now far better controlled, which makes a huge difference to his quality of life. Taking the hard outcome of “is the patient better or not?” out of the equation, patient experience is everything in primary care. The question is, “Did the patient leave the surgery happier than when they first came through the door?”, and this patient definitely did.’
* correct as of June 2025
You can download a PDF of the case study, or if you have any questions about this service, please get in touch on 01865 261467 or at hello@consultantconnect.org.uk.
