Dermatology - information for healthcare professionals

For all referral guidance, please see below:

Referral information - East

Routine and urgent referrals

Please refer non-2WW referrals through the ‘Advice and Referral’ Teledermatology service (accessed via the advice channel of the NHS e-Referral service). The enhanced digital functionality of the ‘Advice and Refer’ Teledermatology service enables the Dermatology team to provide advice and streamlined booking of patients to the correct service. Advice and Referral requests are processed within 1-5 days and include advice to support patient care in the community where appropriate.

Where possible please include skin photos to allow patients to benefit from quicker access to specialist advice, more accurate triage and booking into the right service. Including 2-3 images (or more if relevant) when sending clinical information can significantly benefit patient access to specialist dermatology care. Both high quality photos taken by patients, or photos taken by the GP team can have a very beneficial impact on patient care. Please include a localising and close up image, and a side view if the area or lesion is raised. Dermoscopic images are very helpful for skin lesions. The Consultant Connect® smartphone app can be used on personal devices to take images securely and transfer to clinical systems and e-RS referrals (see under teledermatology).

Urgent advice

Please call the on-call dermatologist for urgent advice relating to patients with severe skin disease. On-call dermatology patient referrals include severe widespread drug reactions, suspected toxic epidermal necrolysis, widespread blistering skin conditions, severe or unstable eczema or psoriasis and erythroderma.

2-week wait skin cancer referrals

Only patients with suspected melanoma and squamous cell carcinoma (SCC) should be referred via the two week wait. Patients with basal cell carcinomas should be managed as routine referrals, unless there is diagnostic doubt or rapidly growing lesions where delay may cause harm (eg close to important facial structures).

Please include digital photographs with referrals if possible to streamline triage (localising image, close up image, +/- dermoscopic image). The Consultant Connect® smartphone app can be used on personal devices to take images securely and transfer to clinical systems and e-RS referrals (see under teledermatology).

Skin surgery

Please ensure patients referred for skin surgery or to the see and treat skin cancer clinic have had an INR checked within 24 hours of their appointment. Patients requiring skin surgery will normally need to have an INR of 2.5 or under.

Teledermatology

Skin photos to allow patients to benefit from quicker access to specialist advice, and more accurate triage and booking into the right service. Including 2-3 images (or more if relevant) when sending clinical information can significantly benefit patient access to specialist dermatology care. Both high quality photos taken by patients, or photos taken by the GP team can have a very beneficial impact on patient care. Please include a localising and close up image, and a side view if the area or lesion is raised. Dermoscopic images are very helpful for skin lesions. The Consultant Connect® smartphone app can be used on personal devices to take images securely and transfer to clinical systems and e-RS referrals.

The department provides a Consultant-led teledermatology Advice and Referral Service (previously called Advice and Guidance) through the NHS e-Referral Service. This is the preferred route for all dermatology referrals except 2-week wait skin cancer referrals. Advice and Referral requests are responded to within 1-5 working days.

Joint formulary

The electronic edition of the Joint Formulary includes information on prescribing, referral guidelines, shared care guidelines and commissioning policies.

Other useful information

The British Association of Dermatologists provides a range of teledermatology resources: www.bad.org.uk/healthcare-professionals/teledermatology

The NHS Advice and Guidance toolkit supports clinical teams to provide Advice and Guidance services: digital.nhs.uk/services/e-referral-service/document-library/advice-and-guidance-toolkit

Last updated: November 16, 2022.

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