Frimley ICB Case Study
Cutting dermatology demand for secondary care services through virtual services.
Frimley ICB approached Xyla Elective Care (XEC) when the wait times for routine dermatology at the local trust were in excess of 80 weeks. They were keen to explore alternative solutions as they had heard of teledermatology being an innovative solution and expressed an interest to implement it in the area.
XEC was able to provide a bespoke service where GPs could refer to a referral platform either with or without dermatoscopic images. A medical photography clinic is provided up to four days per week across the geography, allowing access to photos within 48 hours for 2-week waits, to 10 days for routine patients.
Once the photographs have been uploaded, XEC Consultant Teledermatologists remotely review the images along with the referral, at which point they have a number of options. They can onward refer to the acute trust if they feel it is required, refer to Community Clinics where it’s appropriate to do so, or write to the GP with a Primary Care Management Plan.
The aim of teledermatology is to reduce demand on the acute trusts, to treat patients in the community where possible, and to eliminate the need for any face-to-face appointments if a management plan can be sent to the GP by the specialist.
XEC provides a fully consultant-led and consultant-delivered service. Our Dermatology Consultants hold substantive posts within the NHS, meaning they are on the receiving end of referrals that could be safely managed outside of secondary care, and in a much quicker timeframe.
The performance summary for the first four months has shown:
- 40% reduction in 2-week wait referrals being sent to secondary care
- Prompt teledermatology services allowing clinicians to confidently confirm which patients are true 2-week waits, and which can be managed on alternative pathways
- 40% of overall referrals are managed outside of secondary care
- Diverting to community clinics, or furnishing the GP with a management plan that does not need secondary care intervention
XEC are proud to be able to deliver such a high standard of Consultant Dermatologists with specialist interests in teledermatology and skin cancer, who can respond to referrals within 48 hours of receipt.
“The seamless integration with Primary Care means I can rapidly reassure patients with benign skin lesions or enable swift access to specific skin cancer services. Rashes receive optimum initial therapies within hours, rather than waiting months for appointments. It also fosters education and learning for GPs with immediate feedback on proposed diagnoses and management plans.”
Rob added: “Over time this model will reduce the number of patients requiring hospital appointments; resulting in shorter waits for patients and ongoing support for their specialist care teams.
“Personally, I feel able to provide better quality care, to more patients than ever before in my career.”
Sarah Piper, Head of Community Services, said: “In four months, XEC has been able to facilitate service re-design in collaboration with the ICB, Acute Trust, Primary Care and the Cancer Alliance.
“Our passion to improve access for patients sets XEC apart from other providers, and as Head of Community Services, I am proud to have such a driven team supporting this exciting pathway development.”
In some cases, GP practices are keen to take the photographs themselves or have HCAs trained to do so, but this is no longer a restricting factor.
The management team at XEC is highly experienced in NHS management, Dermatology pathway management, and service redesign, and is on hand to guide clients through the setup process. The team takes a huge amount of pride in being able to reduce wait times so dramatically, improving access for all patients in the locality.
Xyla Elective Care has a proven track record in creating capacity solutions to decompress pressures in dermatology through our teledermatology services, directing cases away from secondary care and significantly reducing wait times.