Transformation Directorate

How NHSX’s £5m teledermatology investment will help transform care and improve diagnoses and treatment

Consultant dermatologist Carolyn Charman reflects on how the recent investment by NHSX will help drive efficiency in referrals between primary and secondary care.

Every year in England, around 900,000 people see their GPs for skin concerns, resulting in around 3 million consultations. The COVID-19 pandemic has led to increased pressure on dermatology services, with a backlog of patients seeking outpatient appointments and NHS services further impacted by the added constraints of COVID-19 infection control measures. Unfortunately, as we start to see improved access to dermatology outpatient services we also expect to see an increase in serious conditions such as skin cancer. Melanoma UK has undertaken a comparison with previous World Health Organization incidence rates, which suggests that over 3,700 early-stage melanomas were undiagnosed in the UK as a result of the pandemic.

Earlier this month (March), NHSX invested nearly £5 million to equip and train staff working in integrated dermatology services to use digital technology and specialist tools to improve referrals between primary and secondary care. This investment will empower systems with the knowledge, confidence and resources they need to implement NHS England and Improvement’s Teledermatology Roadmap, enhancing productivity and improving patient access to high quality care, diagnostics and treatments.

As part of the investment, 28 clinical commissioning groups and seven trusts received funding, covering licencing for secure image-sharing applications, dermatoscopes and other essential equipment, resourcing and training so that local areas can make the necessary changes at speed, and with confidence. Fundamentally, this investment will allow GPs to benefit from easy and quick access to specialist advice and guidance from hospital dermatologists, enabling patients to be referred more quickly and efficiently for treatment and diagnosis. It can also support the streamlining of two week wait skin cancer pathways. The impact of this investment will be monitored through 2021 to 2022 with regional teams reporting to NHSX on progress.

From a wider strategic perspective, the investment will not only support the case for mobilising secure image sharing and associated technology in dermatology, but also open up opportunities for the wider use of image sharing to improve patient care across a range of specialties, including wound care, diabetes, paediatrics, vascular surgery, plastic surgery and emergency care among others.

The British Association of Dermatologists has led the development of teledermatology over the last 10 years, developing guidance and sharing examples of good practice that has supported the implementation of teledermatology in health systems across the country, but there is now urgent need and significant potential to use teledermatology to further improve referral pathways. This is evidenced through NHSX’s dermatology digital playbook and Innovation Collaborative dermatology case studies. The implementation of NHS England and Improvement’s Teledermatology Roadmap 2020 to 2021 will ensure that patients are managed by the right person in the right place at the right time, with teledermatology being a pivotal part of this process.

I, together with my colleagues in dermatology and general practice, wholeheartedly welcome this investment by NHSX, but we can’t stop here. It is imperative that we continue to build on the digital progress made during COVID-19 to realise the full potential of teledermatology to make patient diagnosis, treatment and care the best and most efficient possible.