Sheffield Teaching Hospitals NHS Foundation Trust has strengthened its urgent suspected cancer (USC) dermatology pathway by combining access to high-quality clinical imagery with rapid specialist review. Since December 2024, more than 13,000 USC referrals have been reviewed, helping to improve referral and waiting list performance.
The Challenge
The pathway faced two significant issues:
- Many referrals arrived with poor-quality or no imagery, limiting clinical decision-making.
- Limited consultant capacity made it difficult to review referrals quickly, contributing to growing waiting lists.
Together, these challenges delayed decision-making and increased pressure across primary and secondary care.
The Trust therefore looked at how referral information, combined with rapid access to additional consultant expertise, could support more effective triage and referral management.
The Solution
48-hour expert review
Every USC referral is now assessed within 48 hours, utilising the clinical expertise of remote NHS consultant dermatologists on the National Consultant Network (NCN). By providing additional specialist capacity remotely, the NCN enables referrals to be triaged quickly without increasing demands on the Trust’s existing workforce.
Imaging hubs support better referral management
GPs are encouraged to submit dermatoscopic photos with referrals, or can refer via imaging hubs, where trained HCAs capture the patient images.
The project’s analysis demonstrates the value of this approach. Overall, 28% of referrals received via imaging hubs were returned to GPs with clinical advice and management plans and removed from the waiting list, compared with 7% of referrals submitted directly by GPs.
This means referrals submitted via imaging hubs were four times as likely to be managed with specialist advice without needing a dermatology appointment.
Simple for GPs
The pathway uses existing e-RS processes, meaning no retraining and minimal change for primary care.
Impact
The optimised pathway is delivering measurable benefits for referral management and waiting list performance:
- More than 13,000 USC referrals reviewed since December 2024
- Every referral reviewed within 48 hours, supporting faster clinical decision-making
- 28% of referrals managed with advice when submitted via imaging hubs
- Additional consultant capacity provided through the NCN, freeing up local specialists to focus on direct patient care
- Improved referral information supporting more confident clinical decision-making, helping to ensure patients are directed to the most appropriate next step
The data captured through the project has also highlighted the importance of imaging hubs in supporting the wider pathway. By making appropriate imagery more readily available at the point of referral, imaging hubs can support more effective use of available resources. In supporting more appropriate referral management, the project contributes to improved waiting list performance whilst maintaining rapid access for patients who do require specialist assessment.
What’s next
- Encourage greater use of imaging hubs where referral images are absent or of poor quality
- Explore rollout to Plastics
- Use referral trends and captured data to target GP education and improve referral quality
- Continue to use imaging hubs alongside rapid access to consultant expertise to support the ongoing management of USC referrals
By combining rapid access to remote consultant expertise with higher-quality referral information, Sheffield has created a more resilient USC dermatology pathway. The NCN provides flexible specialist capacity where it’s needed most, helping to maintain rapid referral review whilst freeing up valuable time for local dermatology teams to focus on patient care.
If you have a question or would like to learn how Consultant Connect can support your NHS area, please contact us on 01865 951207 or email info@consultantconnect.org.uk.
