About the service
The NHS have developed a number of services to aid in the earlier diagnosis of all cancers. This service has been developed to carry out screening for patients who have concerns about skin lesion(s)
The Lancashire and South Cumbria Integrated Health Board (ICB) have introduced this service to allow patients with lesions to be rapidly assessed through the use of Teledermatology (the use of specialist cameras to image skin conditions which are reviewed remotely by specialist dermatology clinicians).
This service is provided by NM Health Innovation Ltd (a local GP practice group). Our Health Care team will take photographic medical images of your patient skin lesion(s), which will then be assessed by Clinical Specialists (Central Virtual Triage Team) working within the ICB Cancer Alliance to identify the nature of the lesions and also identify suspected skin cancers. If onward treatment or care is necessary, this will be arranged through this service. For lesions that do not require treatment or care, patients will be discharged back to your GP Practice.
Your Practice has been selected to be able to refer into this Service - following which your referred patients will be asked questions by the Skin Hub screening Team, to assess the patient suitability for Teledermatology.
Your Hub
Your Hub is located at Buckshaw Village Surgery: Buckshaw Village Health Centre (Buckshaw Village Surgery, Unity Place, Buckshaw Village, PR7 7HZ)
Email us for more info skinhub@nhs.net
Before the appointment
Patients will be sent an e-mail, SMS or letter with a link to a questionnaire to complete prior to their appointment. This will ask questions relating to their skin history and the lesions together with some medical questions.
What happens on the day
The Health Care Imager will firstly confirm patient consents for treatment and for the use of images. Further medical questions and questions about the lesion(s) may be asked to ensure information is available for the Clinical assessment and also if an onward referral is needed.
After this, a series of images will be taken, using a specialist medical device called a Dermatoscope (used to magnify and illuminate the skin lesion) which will be placed onto the patient’s skin and images captured using an iPhone. These images are instantly uploaded into a NHS assured software named PATHPOINT (eDerma). No images are stored on the iPhone. These images are then available for full clinical assessment by the Specialist Clinical Team.
What happens after the appointment?
Once the images have been taken they will be reviewed by the Integrated Care Board (ICB’s) Specialist Clinical Team. They will provide the following possible outcomes:
- If the Clinical Team assess the lesion as harmless/benign and not requiring any form of treatment, they will advise the patient of this outcome (by email or by letter) and will also send a copy of the outcome to your GP Practice, to include in the medical records. the patient will be advised if still concerned, or if their lesion gets worse (or new symptoms develop), to contact their GP Surgery for further advice.
- The Clinical Team may assess the lesion(s) as a condition that, although not serious / not cancer, still requires treatment. This treatment may be with your GP, or with the Community Dermatology provider (OMNES) or at your local Hospital. This outcome would include lesions identified as Rodent Ulcer’s (BCC), which is a form of cancer, but does not require urgent referral under the Urgent Suspected Skin Cancer Referral Pathways. Your patient will be advised by email or letter, and a copy of the outcome and patient letter sent to the GP Practice, to include in the patients medical records. OMNES or the hospital the patient is referred to for onward treatment will make contact with the patient to arrange an appointment. If the lesion gets worse or if new symptoms develop in the meantime, the patient is advised to contact their GP surgery for further advice.
- The Clinical Team may assess one or more of the patients lesion(s) as high risk, and a suspected skin cancer. NOTE THIS WILL BE A SUSPECTED DIAGNOSIS ONLY AT THIS STAGE. The patient will be referred to the preferred hospital they identified in their appointment with the Skin Hub under the Urgent Suspected Skin Cancer Referral Pathway for all the lesions photographed to be reviewed. The patient will be advised by e mail or letter - and a copy of the outcome and patient letter sent to your GP Practice. The Hospital team will make contact to arrange an appointment with the patient, where further tests and/or treatment will be carried out. On this pathway the patient should receive a confirmed diagnosis or have skin cancer ruled out within 28 days of referral.
When will you find out the outcome?
The patient will be notified of the outcome within 7 working days of their visit to the Community Skin Hub - with any onward referrals carried out within this time frame. All outcomes will be sent to the patient via e-mail or letter, therefore, please make sure we have the patients up to date email address and home address. Once the Hub have notified the patient and your GP Practice of the outcome of your assessment, the patient will be discharged from the Skin Hub service, with any further follow up being with either OMNES or the Hospital, if they have been referred for treatment.
Does an urgent referral mean you have cancer?
It is IMPORTANT TO NOTE that if even after the images have been assessed as Suspected Skin Cancer by the Specialist Clinicians YOU WILL NOT HAVE A CONFIRMED DIAGNOSIS OF SKIN CANCER AT THIS STAGE. You will be referred under the Urgent Suspected Skin Cancer Referral Pathway for further urgent assessment and treatment which will look to confirm or rule this out.