Photo messaging advice aids faster answers for child with unusual birthmark

The launch of Enhanced Advice & Guidance (A&G) across NHS Greater Manchester has given clinicians in all 10 localities rapid access to a wide range of elective care specialties. Provided by out-of-area NHS consultants on the National Consultant Network (NCN), clinicians can speak directly on the telephone or use photo messaging to share clinical images and receive timely, specialist advice.

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A clear treatment plan for an unusual ear infection

Dr Sandhu values the ability to discuss individual cases directly with a consultant, which is particularly helpful when a patient’s presentation doesn’t fit neatly into a single definitive diagnosis.

One patient presented with outer ear pain, discharge, and discomfort. Dr Sandhu suspected a fungal ear infection, but as this wasn’t something she encountered frequently, she wanted to check the appropriate management.

‘I spoke with an ENT consultant via Consultant Connect, who advised on the typical treatment, but also recommended that the patient attend the local hospital for microsuction.

‘This was good learning for me and a better outcome for the patient. Additionally, the consultants are very friendly and supportive, and provide reasonable advice, with specific answers that are helpful for management plans.’

A faster answer for a child with an unusual birthmark

Photo messaging supports queries that are visual and difficult to describe over the phone. Dr Sandhu used photo messaging to safely send images of a child who presented with a large birthmark. Whilst many birthmarks are benign, Dr Sandhu wanted advice on whether the appearance warranted further assessment:

‘Sometimes birthmarks can be signifiers of disease, especially when they’re on the abdomen.

‘In this case, I was able to send photographs directly to a paediatric consultant and received a rapid response confirming that the patient should be referred.

‘Previously, I would have needed to contact the local paediatric team and ask to speak to the on-call doctor. I didn’t feel it was needed in this case because it wasn’t urgent, and I couldn’t show them a picture of the birthmark for review.

‘I got a reply so quickly that I didn’t even have time to check if a response had been received. The speed of the response also meant that the patient’s next steps could be established without a prolonged wait.’

Dermatology advice helps manage complex patient in the community

Kathleen has also used photo messaging to obtain specialist advice for a patient with a persistent skin problem who had sought help from multiple clinicians:

‘The patient had seen four different GPs, been to out-of-hours, and come to see me. He’d tried a variety of different medications, including some strong steroid treatment. And one of the out-of-hours doctors had told him he needed an urgent dermatology referral.’

Kathleen and the patient agreed that she would send some photographs to a dermatologist via Consultant Connect before proceeding with a referral.

‘I received the reply within 24 hours, and the consultant gave me a structured treatment regime and diagnosis, and that has been a really good outcome, because it will manage the patient’s expectations – the fact that a specialist has seen the photographs and taken his history into consideration, has resulted in a management plan instead of a referral.’

Although the patient wanted a dermatology referral following the appointment, Kathleen explained that this did not necessarily mean one was clinically indicated. Specialist advice provided her with a plan to manage the condition in the community, whilst reassuring the patient that his symptoms had been thoroughly assessed.