Transforming Dermatology Services with Teledermatology

With recent levels of patients waiting longer for treatment, it’s clear that innovative solutions are needed to modernise care delivery.

Managing patients via outpatient appointments can be an inefficient way to manage a service that may not serve the patients best interests, particularly when alternative solutions are available.  In many Dermatology Services, a specialist’s session consists of reviewing 12-16 patients in a four-hour face-to-face clinic. Most clinicians run 5 clinics per week, meaning that only 60-80 patients can be assessed and accepted for treatment discharged back to the referrer.  

With most NHS Trusts reporting long backlogs of thousands of patients, record-low patient satisfaction and the Institute for Fiscal Studies stating that it’s unlikely that waiting lists will fall back to pre-pandemic levels until at least 2027, it’s been accepted that more effective ways of managing patients must be found.

Faced with these mounting pressures The NHS Black Country Integrated Care System (ICS) concluded that the existing myriad of systems and its traditional “appointment first” approach were unsustainable, especially given the increasing demand on their services.

A significant proportion of patients who would normally attend an outpatient appointment with the correct information and accompanying images could be triaged by clinicians to inform on further clinical interactions and options. It was recognised that by implementing a teledermatology process many patients could be reviewed and advised without the need to visit a hospital setting for a face-to-face appointment, thus potentially reducing anxiety for suspected cancers.

The Black Country ICB in collaboration with the system’s dermatology services  embarked on a procurement process to appoint a suitable technology provider to support reliable and safe teledermatology that would expand and improve the quality of requests and referrals being sent to their service so more cases can be managed digitally.

Dr James Halpern, Consultant Dermatologist at Walsall Healthcare NHS Trust told us:  “Teledermatology is not about reducing the number of patients that we see it’s about ensuring we see the right cases sooner.  We see far less ‘worried well’ and thanks to the improved quality of cases, we no longer have to send as many requests back to GPs for clarification or additional information.”

“The NHS Black Country ICS selected Cinapsis to support their teledermatology transformation.  This enables them to manage Advice & Guidance cases far more efficiently than is possible on other systems and integrates with eRS, GP Systems and Trust EPRs so patients who need to be seen in a face-to-face setting can still be work flowed through existing systems.”

Dr. Halpern highlights the impact of the new approach: “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.”

The impact of this transformation is already evident. Before teledermatology, patients faced an average six-month wait for intervention. Today, that wait time has been reduced to just six weeks. 

The benefits extend beyond urgent cases handled under the 2 Week Wait or Faster Diagnosis Standards for suspected cancerous conditions. Patients with inflammatory skin conditions can now receive pre-appointment reviews and early management advice whilst waiting for an outpatient appointment, significantly expediting treatment timelines for a wide range of skin conditions.

Carl Woodroffe, Head of Commercial Operations at Cinapsis said: “Some ICS’s have told us that the introduction of Teledermatology has avoided their services being closed due to capacity limits being reached. Those ICBs that have adopted and implemented our solution that integrates with all the local systems can manage significantly more patients safely, without creating additional administrative workloads.  This ensures urgent cases receive prompt attention without overburdening referring clinicians. However, it’s not just a numbers game.  We hear so many individual stories of the difference that an early response, intervention, treatment plan or even just reassurance means to a patient.”  

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Roz Geary, Project Manager at NHS Black Country, shares her perspective: “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.”

The success of Black Country ICS’s teledermatology transformation highlights the potential for other NHS Trusts to implement similar solutions. With increasing pressure on healthcare systems, modernising referral and triage processes has become a necessity. By leveraging platforms like Cinapsis, NHS teams can improve efficiency, reduce waiting times, and ultimately enhance patient care.