Black Country ICS: Transforming Dermatology Services with Teledermatology

The challenge

RCP guidance suggests a consultant dermatologist can see up to 12 new or 16 follow-up patients in a four-hour clinic; in practice, mixed templates are typically 12–14. Of a full-time consultant’s roughly 7.5 weekly clinical sessions, around four to six are outpatient clinics, with the remainder covering skin surgery and clinical admin. That equates to roughly 60–70 patients per working week, across about 42 working weeks a year.

For a service managing thousands of patients on a backlog, with demand still rising, that ceiling creates a problem that more clinics alone cannot solve.

Black Country ICS had concluded that its traditional "appointment first" approach was unsustainable. Patients were waiting an average of six months for intervention. Urgent suspected cancer patients were at risk of breaching NHS constitutional measures. And the mix of systems in use across the system made it difficult to manage demand in a joined-up way.

The ICS recognised that with the right information and images, a significant proportion of patients who would normally attend an outpatient appointment could be triaged remotely the clinician deciding the right next step without the patient needing to travel to a clinic. Teledermatology could also reduce anxiety for patients waiting with a suspected cancer, by getting an earlier clinical opinion in front of the right specialist.

Following a procurement process, the ICS selected Cinapsis to support the transformation.

How it works

GPs send structured referral information and images to Consultant Dermatologists, or when preferred, to clinical imaging teams for professional grade dermoscopic images to be captured.  The Consultant reviews the case remotely and either advises on management in primary care, provides a pre-appointment management plan, or books the patient directly into the clinic. A chat function allows consultants and GPs to discuss a case directly when needed, without reverting to phone or email. Cinapsis manages all of these pathways efficiently and integrates with eRS, GP systems and trust EPRs, so patients who do need a face-to-face appointment continue to flow through existing systems without any duplication of work.

Dr James Halpern, Consultant Dermatologist at Walsall Healthcare NHS Trust, explains:

“Our clinical photography team takes the pressure off GPs to capture images themselves. The images are consistently good enough for us to make a decision first time, which means far fewer cases going back and forth between primary and secondary care.”

The results

Routine dermatology wait time: from six months to six weeks

The impact extends beyond the headline wait time figure. Patients with inflammatory skin conditions can now receive pre-appointment reviews and early management advice while waiting for an outpatient appointment, which means treatment can begin earlier — without an additional clinic slot. For patients under the two-week-wait or Faster Diagnosis Standards for suspected cancer, faster triage means faster escalation when it is needed.

Dr Halpern on what the platform has made possible day to day:

"The biggest benefit of Cinapsis is that we can now manage more cases safely and quickly. I can review as many cases in one triage session as I previously would have seen in a week of outpatient clinics. The platform also allows me to educate and support GP colleagues with the rationale behind my diagnoses, and we have an option to enter a chat mode which greatly improves relationships with clinicians in primary care."

Roz Geary, Project Manager at NHS Black Country:

"The introduction of teledermatology using Cinapsis has improved waiting times for urgent suspected cancer patients, meaning that we can meet our NHS constitutional measures with greater confidence and improve patients' experience with better outcomes."

What made the difference

Two things drove the results in Black Country. The first was image and data quality. High quality images are captured by GPs and professional photography services along with structured templates to ensure that referrers capture the mandatory clinical information and images before submission, which means consultants have what they need to make a triage decision at first review. That reduces the rate of cases being returned to GPs for more information, and speeds up the pathway for every patient behind it.

The second was integration. Because Cinapsis connects with eRS, GP systems and trust EPRs, adopting teledermatology did not create a parallel system that consultants and administrators had to manage separately. Patients who need face-to-face appointments still flow through the existing pathway. The administrative burden on referring clinicians did not increase.

Carl Woodroffe, Head of Commercial Operations at Cinapsis:

"Some ICSs have told us that teledermatology has stopped their services closing because capacity limits were reached. Those that have adopted our solution, which integrates with all the local systems, can manage significantly more patients safely without creating additional administrative work. This ensures urgent cases receive prompt attention without overburdening clinicians. But it's not just a numbers game. We hear so many individual stories of the difference an early response, intervention, treatment plan or even just reassurance makes to a patient."

The educational dimension of the platform is also worth noting. When consultants explain their triage decisions back to the referring GP — something the chat function makes straightforward — that knowledge carries forward. GPs become more accurate at identifying which presentations need specialist input, which over time reduces inappropriate referral rates.

Read more about how Cinapsis supports teledermatology pathways. Or to discuss what this could look like in your ICB or trust, speak to us today. 

‍