Community Dermatology

Overview of community dermatology:   

This service is a collaboration between IHL, Guy’s and St Thomas’ Foundation Trust (GSTT) and King’s College Hospital Foundation Trust (KCH). It involves dermatologists,  GPs with Extended Roles (GPSwERs) in dermatology and local GPs working together to deliver improved access to dermatology management advice, community clinic assessment and secondary care management where needed

The service is consultant led, includes six GPwERs and is based at two community clinic sites (Guy’s Hospital and Elm Lodge). The clinics work closely in partnership with local secondary care (GSTT and KCH).

 

What is the purpose of this service? 

  • To ensure that patients receive appropriate help to manage their dermatology problems within a clinically appropriate time frame. 
  • To support GPs to manage their patients as effectively as possible in primary care.
  • To ensure that patients are seen in the right place, first time by identifying where a patient would best be assessed. 
  • To increase GP confidence in diagnosing skin lesions that should be seen via the two week wait clinics.
  • To increase primary care dermatology knowledge and practical dermatology management.
  • To encourage prescribing in line with local guidelines.

What have we done so far?

  • We have collaborated with our partners to deliver better integrated care with local secondary and tertiary dermatology services.
  • We have established both clinics within EMIS (GP computer system), integrating access to pathology and prescribing services and allowing us, with consent from patients, to access patients GP records and the Local Care Record to enhance patient care. 
  • Patients can be seen at one of the clinics Monday to Friday – with daily clinics at Elm Lodge Surgery and twice weekly (Mondays and Wednesdays) at Guy’s Hospital.  We currently deliver 14 clinics per week. Consultant clinics are offered weekly at Guy’s Hospital and monthly at Elm lodge
  • We have recruited three new GPwERS and supported KCH in recruiting two GPwERs to their two week wait service.
  • We have reduced the waiting time for patients to receive assessment and advice.
  • We have increased access to dermatology education.  GPs, Advanced Nurse Practitioners (ANPs) and pharmacists have attended local clinical education sessions and community dermatology sessions.

What difference has this made?  

  • There have been 2,100 new patients that have been seen in our community clinics in the first 12 months.
  • We have triaged 3,468 referrals in first 12 months ensuring patients are seen in the right place, first time.
  • Patients are surveyed monthly and are overwhelmingly positive about the service and quality of care that they have received.

What are our plans for the future?

The model is being extended to other local CCGs (another community consultant has been appointed for Lambeth with its own community clinic and GPwERS to follow). We also aim to improve access to and use of local dermatology guidelines.