Retaining dermatology patients in primary care through dialogue with secondary care providers: A service evaluation

Brainard, Julii, Crawford, Amy, Wright, Beth, Lim, Mark and Everden, Paul (2024) Retaining dermatology patients in primary care through dialogue with secondary care providers: A service evaluation. Annales de Dermatologie et de Vénéréologie, 151 (2). ISSN 0151-9638

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Background: There are long patient waiting lists for specialist care. A dermatology dialogue service between primary and secondary care (DDPS) was developed in eastern England. Primary care referrers uploaded patient images of skin conditions for review by and dialogue with consultant dermatologists in an attempt to retain patients in primary care rather than refer them to secondary care. Methods: Evaluation of service performance against specific targets, including reduction in secondary care waiting list growth over the period April 2021–March 2022 inclusive. Service activity was summarized in terms of speed of resolution, case numbers, and dispositions. Clinician and patient satisfaction were assessed using structured questionnaires. Actual numbers of new referrals were compared to projections based on historical data. Waiting list growth was compared to other specialties and other commissioning areas. Waiting times to initial treatment were monitored. Results: Over 3300 patients were enrolled and > 90% of dialogues were resolved within 36 hours. Clinician and patient satisfaction were high. Frequently asked questions and conditions were highlighted by dermatologists to design and deliver an educational event for primary care clinicians that was well received. Waiting list growth for dermatology patients in the commissioning area was smaller than for other major specialties, and generally smaller than growth for dermatology waiting lists commissioned by other NHS commissioners. There was no negative impact on the urgent priority (cancer pathway) waiting list. Conclusion: The DDPS was satisfactory for clinicians and patients and coincided with lower growth in dermatology waiting lists than might otherwise have been expected.

Item Type: Article
Additional Information: Funding information: This evaluation was funded by the UEA Health and Social Care Partnership (UEAH&SCP). UEAH&SCP were not involved in the data collection, analysis and manuscript preparation. JB is affiliated to the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response at King’s College London in partnership with the UK Health Security Agency (UK HSA) and collaboration with the University of East Anglia. The views expressed are those of the author(s) and not necessarily those of the UEAH&SCP, NHS, NIHR, UEA, UK Department of Health, UKHSA, any funder, private company or NHS organisations involved with service delivery.
Uncontrolled Keywords: pathway management,health services,primary care,referrals,dermatoscope,health services,referrals,dermoscopy,primary care,dermatology,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2708
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health
Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023)
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Depositing User: LivePure Connector
Date Deposited: 12 Jul 2023 14:31
Last Modified: 03 Apr 2024 10:31
DOI: 10.1016/j.annder.2024.103248


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