New GP led referral system to be rolled out for patients with suspected skin cancer

A GP led initiative to improve referrals for suspected skin cancer is to be rolled out across the north.
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Instead of referring a patient for a traditional hospital outpatient appointment, digital images are taken in the GP practice and sent directly to a Consultant Dermatologist in the Trust, who then decides whether the patient needs further assessment.

The ‘Dermatology Photo Triage Pathway’ initiative gives patients with suspected skin cancer access to a rapid, high quality Consultant Dermatologist assessment.

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“Photo Triage is a collaboration between all parts of the health care system. Working with primary and secondary care and our IT colleagues we have developed an app which allows the safe transfer of images across Health and Social Care organisations,” said Magherafelt-based GP, Dr John Diamond.

“It allows us to take images of suspicious skin lesions in primary care and have them very quickly assessed by our consultant colleagues. This greatly enhances patient care and allows them to be triaged to the appropriate service much more quickly. We have found many of our patients can be reassured when lesions are benign and therefore avoid a trip to the hospital.

“This also helps to free up hospital outpatient appointment slots to allow secondary care to deal with more complex cases.”

The project has been expanded following a pilot in the Mid Ulster and South Belfast areas which saw a 50% reduction in red flag referrals requiring assessment within secondary care.

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Every year there are over 54,000 referrals sent by GPs to hospital dermatology services across Northern Ireland and approximately half of these referrals are for the diagnosis and management of skin cancer.

Health Minister Robin Swann visited Dr Diamond’s practice to hear more about the roll-out of the scheme.

He said; “I commend the work of all those involved in the development of this innovative scheme, supporting better linkages between Primary and Secondary Care which is central to the successful transformation of health and social care.

“It also builds on the success of Primary Care Covid-19 Centres where shared resources and improved communications between Primary and Secondary Care delivered huge benefits and created a foundation for a more effective HSC going forward.

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“Through initiatives like the Dermatology Photo Triage pathway, Primary Care will continue to transform to meet growing patient demand, with cutting-edge technology and new ways of working.”

Dr David Alderdice, Consultant Dermatologist and Clinical Director for Cancer Services in South Eastern Health and Social Care Trust said; “This photo triage service is a real game changer.

“If you have a worrying spot on your skin – instead of waiting weeks or months – you can go to your GP and get an image taken and have it sent through to the hospital along with the clinical history.

“We, in the hospital, will then get back to the GP promptly with a plan. This speeds things up, helps education, and avoids unnecessary visits to the hospital and hopefully gets the patients who need to be seen, seen rapidly for treatment.

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“As we all know the health and social care system is generally under immense strain. In Northern Ireland it was struggling before the pandemic, and over the last two years waiting times have gone up, especially in dermatology.

“So we needed to innovate and change and this exciting service capitalises on recent technological and communication advances to provide a better, timely service for those we serve – the patients. I know doctors, commissioners and managers and most importantly patients will really love this service.”

The pilot service in Mid Ulster and South Belfast has already proven to be a success, limiting footfall in secondary care and proving instrumental in managing demand on dermatology services throughout the pandemic.

Roger Kennedy, Programme Director Health and Social Care Board said: “Photo Triage is a great example of how technology can be used to improve patient experience and clinical decision-making. During the pandemic patients have continued to be assessed and treated for skin issues away from secondary care which is vitally important in terms of infection control.”

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A plan has been agreed to roll out this service to all GP Federations by the end of April 2022. The Project Team are conducting an extensive training and engagement process ahead of the planned expansion.

Louise McMahon, Director of Integrated Care, Health and Social Care Board added; “This is a truly transformational project, one that embraces new technology and actively supports the Health Minister’s plans to address our waiting lists.”

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