North Norfolk Primary Care (NNPC) Case Study

Delivering High Impact Interventions at scale: Tele-dermatology

The Challenge

There was a significant challenge in recruiting qualified clinicians to Norfolk as it can be perceived as an area to complete, rather than commence a career. This coupled with a marked increase in dermatology referrals meant that patients were waiting well over 18 weeks for a routine dermatology appointment.


Xyla Elective Care was called upon by North Norfolk Primary Care (NNPC), to support the transformation of the services and offer an alternative and innovative pathway that:

  • Provides a capacity solution to ‘decompress’ current pressures in dermatology
    across the Norfolk & Waveney System.
  • Develops and operates, in partnership with ‘new’ Primary Care organisations
    (e.g. PCN’s) and existing Acute Hospital Services, a dermatology pathway that is highly accessible and appropriately rooted in Primary Care.
  • Enables local services to sustainably deliver the revised pathway beyond
    the pilot phase.

Over several months, our senior managers and lead clinician worked very closely with the NNPC, Norfolk & Waveney CCG and key stakeholders from the acute hospitals in Norfolk to design the service. As the chosen delivery partner to the NNPC for this innovative service, we produced key documents that were required to ensure the success of the service. These included tele-dermatology guides for primary care referrers and patients, dermoscopy guidelines, tele-dermatology consent form and many other learning resources.

Demand management
Our clinicians provide an enhanced advice and guidance service by producing a detailed management plan to each GP.

Since January 2021 to mid-April 2021, we have used this model to re-direct 81% of cases away from secondary care.
KPI: >60% reduction in the number of patients requiring onward referrals to secondary care

Shorter waiting times
Our clinicians receive referral and images within the technology platform that is interoperable with all Primary Care patient management systems. Referral and images are reviewed, and a detailed patient letter is produced for the GP for all patient outcomes.
KPI: 100% achieved in reviewing and completing Advice and Guidance referrals within 24 hours

“We were super excited to use it for the first time and brilliant to already have a quick response.”
Practice Manager, Norfolk

“I had a response back from the consultant in 49mins. Outcome was ‘Harmless Lesion. Discharged back to GP.’ The patient avoided the waiting list.”
Referring clinician, Norfolk