Picture perfect care
27 March 2017
Hundreds of patients with skin problems are being diagnosed more quickly thanks to a new virtual service which means they don’t have to attend hospital to be diagnosed.
A new ‘teledermatology’ service, developed by clinicians at the Royal Free London dermatology department, has only been up and running for four months but it’s already proving a hit with patients, the majority of whom can be treated outside of hospital.
Instead of being immediately referred by their GP to hospital if they have a skin lesion they are concerned about, such as a wart, mole or freckle, patients in Barnet and Enfield are now attending a clinic to have a photograph of the affected skin taken by a medical photographer. The pictures are then viewed by a consultant without the need for the patient to be present.
The results have been impressive as over half – 57 per cent of patients – have not needed to be referred to a consultant. Instead the consultant is able to advise the patient and their GP about the required treatment, often removing the need for a hospital appointment.
A further nine per cent are called in immediately for a biopsy and the rest come in for an appointment.
Helen Wark, operations manager for dermatology at the Royal Free London NHS Foundation Trust, said: “Having teledermatology in place is already helping us because it means we can see the most at risk patients – those with skin cancer – more quickly.”
The teledermatology service does not include those patients who GPs immediately suspect as having skin cancer. These patients are fast-tracked for a consultant appointment and from there to treatment if required.
The Royal Free is an early adopter of teledermatology in the country and one of the first trusts in London to use it. The service is currently the only one in the country using a medical photographer as opposed to a GP. The clinics are being held at Lincoln Road Practice, Green Lanes Practice, Edgware Community Hospital and Finchley Memorial Hospital.
“The picture is make or break for the consultant to be able to deliver the right diagnosis,” explains Ioulios Palamaras, consultant and service line lead for dermatology at the Royal Free. “That’s why we use a specialist professional photographer and we’re pleased to say there has been no need to go back and take additional pictures.”
The aim is now to expand the service to other areas and also start piloting teledermatology for inflammatory conditions such as eczema or psoriasis.
Helen adds: “Technology like this is the way forward. It helps us to reduce the number of hospital appointments needed and ensures the patients who most urgently need to see us get the prompt care they need. Patients have told us they feel comfortable with teledermatology and understand how it works.”
The Royal Free London NHS Foundation Trust currently has 27,000 dermatology referrals a year and is the largest skin cancer referral centre in London.