We are delighted to announce that our partnership Tele-Skin Two Week Wait Pathway project with County Durham and Darlington NHS Foundation Trust and local partner CCGs has been shortlisted for an HSJ Value Award in the category of Transformation and Acute Service Redesign Initiative. The local partner CCGs are; Durham Dales, Sedgefield & Easington CCG, Sunderland CCG, North Durham CCG, Darlington CCG and South Tyneside CCG.
The project, which covers a population of over one million people, focusses specifically on the two-week-wait (2ww) referral pathway. Instead of sending a traditional 2ww referral for an out-patient skin cancer appointment, GPs now send photos of the lesion with an e-RS referral. A consultant dermatologist views the images and the referral details within one working day and triages the patient into the appropriate service. The project has the full support of the local cancer network, the North East Cancer Alliance.
The re-design aims to reduce unnecessary 2ww demand, provide timely access to a specialist opinion, care in the best setting and provide faster re-assurance to patients who do not have cancer.
Dr Patrick Wright, Macmillan GP Cancer Lead for North Durham CCG commented:
“Thanks to excellent collaborative and planning, this safe and effective 2 week dermatology referral pathway is now a firmly embedded primary care cancer pathway.”
The project was launched in May 2019 and at the end of February 2020, across all participating CCGs, the results were as follows:
- 56% of referrals have been triaged into a 2ww dermatology appointment
- 14% were re-booked into a 2ww plastics appointment
- 9% were booked into a routine dermatology slot
- 13% were returned to the GP with advice on how to manage the patient in Primary Care
- 8% were unable to be triaged, either because there was no image or because the images were not clear enough to form the basis of a diagnosis.
Benefits for staff and patients
The re-designed pathway has had a significant benefits for staff and patients as evidenced by the testimonies from the Cancer Lead GP, Dr Wright, and the lead dermatology consultant below.
Dr Maneesha Vatve, Lead Dermatology consultant:
“This project benefits patients and consultants:
(1) Patients with benign lesions are reassured quickly.
(2) Those needing referral to plastics are redirected without having to attend a dermatology appointment first. This is more convenient and allows them to be seen by the right clinician more rapidly.
(3) Waiting times for cancer 2ww appointments have fallen, allowing us to convert unused slots into routine new slots so patients with inflammatory skin conditions are seen sooner.”
Dr Patrick Wright, Macmillan GP Cancer Lead for North Durham CCG:
“Audits reveal that the pathway has had an immediate impact in reducing unnecessary 2ww skin cancer outpatient appointments, saving many patients unnecessary trips to hospitals […] The scheme is highly regarded by primary and secondary care clinicians and is especially appreciated by patients presenting with suspicious skin lesions.”
Staff, particularly consultants, have also experienced significant benefits as testified by Dr Maneesha Vatve, Lead Dermatology consultant:
“There is less need to overbook clinics to accommodate 2ww patients. Consultants have not had to do a single extra ad-hoc clinic to avoid potential breaches.”
For patients a number of very significant benefits have been accrued:
- Patients whom a specialist determines do not have cancer receive confirmation rapidly instead of having to wait two weeks for a hospital appointment.
- Return of 13% of referrals to the GP:
- enables those patients to be treated in Primary Care without the patient having the inconvenience of attending hospital.
- Reserves 2-week wait appointments for patients who need them.
- Frees up consultant capacity for routine referral skin patients to be seen more rapidly than they otherwise would have been.
- Earlier access to specialist opinion not only reduces variation but also ensures all patients are managed in the right place and on a shorter pathway without the need for unnecessary hospital appointments.
To read more about the HSJ Value Award we have been shortlisted for (under Transformation and Acute Redesign Initiative), click here. Winners will be announced in September 2020.
If you are interested in reducing dermatology referrals in your area click here for more information on how our solutions work. Alternatively, please get in touch with us on 01865 261467 or email firstname.lastname@example.org.