The BMJ Awards 2018: Dermatology Team of the YearBMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k1338 (Published 26 March 2018) Cite this as: BMJ 2018;360:k1338
- Nigel Hawkes, freelance journalist
- London, UK
Skin lesion teledermatology
Urgent referrals by GPs for suspected cancer under the two week wait route was devised with the best of intentions but has drawbacks, as the dermatology team at Barnet and Chase Farm Hospitals NHS Trust discovered in 2015-16 during an audit of referrals. Basal cell carcinomas (BCC) are not meant to be referred urgently unless they meet certain criteria, but 76% of BCCs referred to the hospital nevertheless came through this route.
A survey of GPs found that more than half referred urgently, even when they were “almost certain” the cancer was benign. “GPs didn’t want their patients waiting three months to be seen, so they were referring them as urgent cases,” says Ioulios Palamaras, consultant dermatologist and head of department. “We devised an alternative pathway, using teledermatology to solve the problem.”
Medical photographers were employed to take images at regular clinics to which GPs could refer patients. “The quality of the picture makes or breaks …