NHS CCG Commissioner Information

Referrals of patients with skin lesions to secondary care under the urgent 2ww rule are increasing, incurring rising costs for CCGs and placing significant strain on hospital waiting times.

70% of those referrals could be avoided if GPs had access to a rapid diagnostic service for skin lesions.

TELEDerm® is an award-winning tele-dermatolgy service which provides GPs with a ‘next day’ diagnosis by a MOLE Clinic® specialist expert in dermoscopy.

The service helps GPs reduce avoidable referrals to secondary care.

It is recommended for use by GPs and practice nurses prior to referring any patient with a suspect skin lesion to secondary care under the urgent 2 week wait rule.

A GP or nurse uses a smartphone to access the secure, web-based TELEDerm® form to record relevant patient and lesion history. The user then attaches a dermatoscope to the smartphone to add clinical and dermoscopic images of the lesion to the form.

The form is then electronically and securely transferred via WIFI to MOLE Clinic® specialists for review.

Using TELEDerm® is simple and intuitive and no training is required.

A TELEDerm® consultation with a patient normally takes around 5 minutes.

Reports are issued in .pdf format for the GP or nurse to attach to the surgery’s electronic patient record or for onward transmission to secondary care if required.

The service is compliant with NICE Guideline [NG14], which recommends that all pigmented skin lesions that are referred for assessment should be assessed ‘using dermoscopy carried out by healthcare professionals trained in this technique.’

The service is also compliant with NHS Digital guidelines to provide assurance that we practise good data security and that personal information is handled correctly.

Reports are issued in .pdf format for the GP or nurse to attach to the surgery’s electronic patient record or for onward transmission to secondary care if required.

Because our service supplies GPs with Diagnostic Reports in .pdf format (to attach to a patient’s record) and not with ‘IT systems or technology’, we are exempt from NHS Digital’s requirement for integration with existing NHS IT systems.

Most TELEDerm® reports are issued to GPs on a next day basis, with a diagnosis and recommendation in line with UK clinical guidelines.

Approximately 75% of patients with a TELEDerm® report receive welcome reassurance that their mole or sore is not skin cancer and a hospital referral is not required.

Only 25% of patients still need to be referred to their local hospital as a precaution to rule out a skin cancer.

Reducing referrals to secondary care by 75% significantly reduces pressure on hospital waiting times and should help ensure patients referred under the 2ww scheme are seen within targeted timescales.