This leaflet answers common questions about the two week wait (2WW) teledermatology service. If you would like further information, or have any worries, please do not hesitate to speak one of our team. 

This leaflet answers common questions about the urgent suspected skin cancer teledermatology service (previously known as a 2 Week Wait or 2WW). If you would like further information, or have any worries, please do not hesitate to speak to one of our team.

What is teledermatology?

Teledermatology is the use of a specialist magnifying camera to take photographs of your skin. Your photographs will be reviewed by a consultant dermatologist and a decision made as to whether you will need to be seen in clinic at one of the Royal Free London sites.

This service is safe. It is already provided in many areas of the country and is an excellent way of helping patients be seen more quickly than at present without losing any quality in the care received.

Who can be referred and why you’re being referred to our service

Patients who have been seen by their GP where there is a concern about the possibility of skin cancer, and who are considered suitable for the service, can be offered the teledermatology service.

The clinic you have been booked into aims to provide a prompt diagnosis for patients with a new or changing skin lesion. Please remember that most skin cancers are not life threatening and can be easily treated, and that very few of our referred patients will be diagnosed with cancer.

The benefits of using this service

  • You may come to find out the cause of your skin condition sooner than a hospital appointment.
  • You will be directed to the correct clinic for a follow-up appointment, avoiding potential delays in your care.​​​​​​
  • Getting a teledermatology appointment

Your GP will have referred you to the Royal Free London on an urgent suspected skin cancer pathway. After your referral was received, a member of the dermatology team will have looked at the information the GP provided. They will have decided that this is the best service for you. This quick and safe service allows us to quickly assess your needs and support you in the best way possible.

You have been triaged into this service and accompanying this letter you will have received a letter with your appointment time and location. We aim to send patient letters via email and via the RFL patient portal, so you receive information as quickly as possible.

What happens at your appointment

When you arrive you will be booking in at reception who will give you a short patient questionnaire and consent form. These forms provide the dermatology team extra information to help to diagnose your skin condition. The consent form is to confirm you approve Royal Free London NHS Foundation Trust to take and store the relevant photographs of the affected area of your skin.

Next you will meet with a medical photographer who will explain what they are going to do. This includes collecting your signed consent and taking the relevant photographs of your skin. These photographs will be transferred electronically to a consultant dermatologist at the Royal Free London NHS Foundation Trust, along with the referral letter from your GP and your signed consent form. This is done through a secure NHS IT network

What happens after my appointment

The consultant dermatologist will carefully review your photographs and referral and assess whether you need to be seen again or not. They will be able to decide on the best treatment plan, in the same way as if you had been seen in a face-to-face hospital clinic.

For some patients, the doctor will be able to diagnose your problem, provide reassurance and discharge you back to your GP with a plan for looking after your condition. Sometimes, the consultant may decide that you do need to be seen in person or that you need a biopsy (a small piece of skin is taken and sent to a laboratory for diagnosis). If this is the case, you will be contacted and offered an appointment.

Sometimes, the consultant may decide that you need treatment for a potential skin cancer. If this is the case, you will be contacted and offered a fast-track appointment. The consultant who reviews your photographs will write to you and your GP with the management plan, so you are kept up to date with what is happening with your care. This will usually be within ten working days of seeing the medical photographer.

Service provider

This service is delivered by the Royal Free London dermatology department, which is part of The Royal Free London Skin Unit.

Identifying what might be wrong

The consultant dermatologist does not have to see my skin problem in person to identify what is wrong. The photographs are high quality and taken by professional medical photographers. However, if the consultant has any uncertainty about the diagnosis, they will ask to see you in a face-to-face consultation.

After your appointment

You will receive a copy of the consultant’s letter, which will explain what action, if any, you need to take next. The actions may include:

  1. If you need to be seen face to face, we will contact you to offer you an appointment.
  2. It may be that you don’t need to be seen in hospital but will be managed by your GP. If this is the case, it will be clearly written in the letter. It is important that if the letter says this, you call your GP practice and make the appointment. This is so that your treatment, if any, can be started.
  3. It could be that there is no further action needed. In which case you only need to go back and see your GP if you are worried about it.