I want to streamline 2 week wait pathways in secondary care

Disclaimer

Any virtual teledermatology 2 week wait pathway will require:

• the use of high-quality macroscopic and dermoscopic images as the ‘reasonable diagnostics’ required to exclude cancer
• a triage outcome that permits the specialist clinician to request to see the patient face-to-face if required
• the facility to communicate directly with the patient and their GP

Outcomes from the virtual teledermatology 2 week wait pathway

The clock can be stopped in 2 ways:

• if the macroscopic and dermoscopic images are taken by a member of the specialist dermatology team (for example, a medical photographer or a nurse), this counts as ‘1st diagnostic test’ so the clock can be stopped at the time the image is taken
• if the images are taken by the primary care team or in a primary care-led community hub and then reviewed by the specialist, the clock stops when ‘an appropriate member of the specialist team’ contacts the patient by telephone, video or face-to-face consultation. Determining who is ‘an appropriate member of the specialist team’ is a decision for the specialist department who have the overall clinical accountability or responsibility for this part of the pathway

For more information, read the guidance: suspected skin cancer 2 week wait pathway optimisation on the Dermatology Future NHS site.

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