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New GP scheme to reduce waiting times for patients with suspected skin cancer

Dr John Diamond takes digital images of a suspected skin cancer and sends them to a consultant for advice
A new GP initiative which allows digital images to be taken of suspected skin cancer, using a specially created app and device. These are sent directly to a dermatologist, who decides whether the patient needs further assessment.

A new GP initiative to improve referrals for suspected skin cancer has been launched in Mid-Ulster and south Belfast.

Instead of referring a patient for an outpatient appointment, digital images are taken in the GP practice and sent directly to a dermatologist, who then decides whether the patient needs further assessment.

The initiative gives patients with suspected skin cancer access to a rapid, high quality consultant assessment.

Regarded as a world first, the SMARTderm app and device – designed by the HSC Primary Care Elective Transformation team – ensures that pictures are sent quickly and securely to the hospital. This is the first time on the island of Ireland that the SMARTderm app has been used to transfer images between primary and secondary care.

Approximately 12,000 patients in Northern Ireland are waiting over 9 weeks for their first dermatology outpatient appointment. The new service will free up appointments as it will reduce the number of patients needing to be referred for a hospital outpatient appointment.

The scheme is among a number of primary care initiatives aimed at transforming the way services are provided. It is being taken forward by GPs and Dermatologists, in partnership with the Health and Social Care Board and Public Health Agency.

The GP-led service will see family doctors and practice nurses trained to take digital photos with the SMARTderm app and device. Once taken, the images are attached to the GP’s referral letter and securely transferred to a dermatologist who will make the initial online assessment.

Magherafelt-based GP Dr John Diamond is among one of the first GPs to get involved in the initiative.

“This is a truly transformative scheme. Using our own specially designed equipment and the SMARTderm app, we can now take photos in our own practice and send them to our consultant colleagues so patients can be triaged in a more timely fashion and reduce the need for many of them to attend hospital.

“Within 72 hours the image will be examined, with a letter confirming the outcomes sent to the GP and patient. These include offering reassurance if there is no need for further assessment, booking an outpatient appointment, booking minor surgery or an onward referral to a plastic surgery specialist.

“It will avoid a potentially lengthy and anxious wait for a hospital appointment and also help free up appointments for other patients.

“We’re grateful to all those involved, including the commissioners, who have worked tirelessly to make this project a reality.”

Dr Diamond also highlighted the opportunities for other specialty areas which may benefit from photographic triage, such as dentistry and optometry.

An earlier pilot showed that, of 4,700 patients referred with a photograph, around 8 out of every 10 did not require to be seen at an outpatient clinic.

Roger Kennedy, from the Health and Social Care Board, said: “This pathway is a great example of how technology can be used to improve patient experience and clinical decision-making. Working in partnership with GPs, this pathway is one of a number of elective care initiatives that are truly transformational.”

A total of 34 GP practices in mid-Ulster and South Belfast have completed their training. The Mid-Ulster practices began sending images at the end of October, with South Belfast practices starting in November.

It is anticipated that the new service will be rolled out across Northern Ireland in 2019.

Watch Dr Diamond explain the new scheme