Virgin Care North and North East Lincolnshire Dermatology Service Presentation
Welcome and introductions Todays presentation is delivered by: David Pratt – Regional Business Analyst/Project Manager Heather Morris – Senior Operations Manager 2 Virgin Care private and confidential www.virgincare.co.uk
We’d like to tell you about • Who we are • What the community dermatology Service is commissioned to deliver • What is changing from April 2017 • Teledermatology • Patient Involvement 3 Virgin Care private and confidential www.virgincare.co.uk
What we do Virgin Care have been chosen by NHS North Lincolnshire Clinical Commissioning Group (CCG) and NHS North East Lincolnshire CCG as the provider of North and North East Lincolnshire Dermatology services as from 1 st April 2017. We have been providing the Community Dermatology Service in North Lincolnshire on behalf of NHS North Lincolnshire CCG since 2012, and will be contracted to provide the Community Dermatology provision in North East Lincolnshire from the 1 st April 2017. Our service is delivered in the community closer to home by: • Consultants • GP’s with Special Interests in Dermatology • Nurses • Minor surgery doctors • Heath Care Assistants • Administrators 4 Virgin Care private and confidential www.virgincare.co.uk
What type of conditions we treat What we do: Teledermatology Skin Cancer The following, where not responding to primary care treatment: Actinic solar keratosis Troublesome acne Moderate/severe psoriasis which may need light therapy. Moderate/severe eczema which may need light or systemic therapy Allergic contact dermatitis or other moderate inflammatory dermatoses Minor surgery Hyperhidrosis not responding to primary care management 5 Virgin Care private and confidential www.virgincare.co.uk
What type of conditions we don’t treat What we don’t do : Patients with suspected low risk BCC - Basal cell carcinomas (BCCs) are slow-growing, locally invasive malignant epidermal skin tumours which are thought to arise from hair follicles. The tumour infiltrates local tissues through the slow irregular growth of subclinical finger-like outgrowths and morbidity results from local tissue invasion and destruction, especially on areas of chronic sun exposure, such as the face, head and neck . These patients will be managed within GPwSI/ Community Skin Cancer Clinician service(NEL) Referrals for lesions with high suspicion of cancer which are on the extended T Zone face should be referred onwards from the dermatology service directly to a maxillofacial surgeon at a local tertiary centre. The criteria for referral will be agreed between the service provider and the tertiary service. 6 Virgin Care private and confidential www.virgincare.co.uk
What we will be delivering • Free NHS Dermatology Services • Referrals in to the service are made via your GP • Care closer to home in the community • For routine appointments, the referral to treatment time will be 4 weeks. • For Urgent appointments you will be seen within 2 weeks • Single point of access • Teledermatology Am I getting the same level of clinical care as I would have had if I went to the hospital? Yes you are, the Dermatology service is just delivered in the community in order to deliver care closer to home, for those accessing the service. You will still be treated and supported by a fully trained clinical time including Consultants, GPs, Specialist Doctors, Nurses and Health Care Assistants in a health care setting. 7 Virgin Care private and confidential www.virgincare.co.uk
Locations Stirling Medical Centre, Striling Street, Grimsby , North East Lincolnshire, Lincolnshire, DN31 3AE The Roxton Practice, Pelham Rd, Immingham DN40 1JW Weelsby View Health Centre, Ladysmith Road , Grimsby, Lincolnshire, DN32 9SW Cromwell Road, Grimsby, Grimsby , North East Lincolnshire, DN31 2BH 8 Virgin Care private and confidential www.virgincare.co.uk
Teledermatology This will mean that for some skin conditions, your GP and our service will work together using high quality digital imagery to allow your GP to oversee your treatment and ongoing care. This will save you time, and ensure you only need make appointments at the dermatology service if these are necessary. 9 Virgin Care private and confidential www.virgincare.co.uk
If your GP thinks you have a dermatological condition and queries whether your condition could be managed in your own GP Practice setting or if you need to attend a more specialist service in the community, they will send a teledermatology referral directly to us. Teledermatology allows specialists quickly to examine and triage cases from photographic images, recommending referrals to the specialist community service or secondary care where appropriate, but otherwise triaging cases back to the community with a suitable management plan. 10 Virgin Care private and confidential www.virgincare.co.uk
2. Exploring Teledermatology and our technology needs How does Telederm work? 3. Telederm 2. Primary Care 4. Appropriate care 1. Patient need Triage Hub setting • • Patient referred by GP / • • Steps Patient looks for self- Patient sent a letter with Telederm consultants nurse for Telederm help information online results and either given review images and send • using VC provided Patient attends GP all clear, given care back diagnosis within camera and software appointment advise or referred to VC 48 hours along with any Derm service in person care notes for GP or secondary care • • • How will we ensure people Which clinician will take the • Key questions How will the patient How many consultants do are seeing the right pictures? access self help we ideally need to review • clinician first time? How will we market to and information before our patient numbers? • How will we ensure select GP practices? • appointment? Can we share this • • patients get the letter with Which patients will be eligible How will they know resource nationally? the appropriate action? for Telederm? what to do? • • System for sharing • Quality camera/ dermatoscope Follow up letter to be • Good website with self information back with that is CE marked and meets produced and sent to help information referring clinician / Technology minimum standards for picture patient advising them of practice. Clinician will then requirements quality. £50-300 price range. next steps • copy directly into own Screens to view pictures in big patient record system enough size • • GPs ideally emailed by System for referring clinicians to system to say results register an account and upload available images securely 11 Virgin Care private and confidential www.virgincare.co.uk
Who will use T elederm? Conditions suitable for teledermatology Conditions not suitable for teledermatology referral referral • Benign skin lesions, for diagnosis, to exclude • Significant suspicion of high risk skin cancer possibility of malignancy, or for advice as to (SCC, melanoma etc). These must be referred whether treatment is available. on the 2 week wait pathway. • Potentially malignant lesions, includes BCC but • No rash present or minimal, e.g. urticaria, others only if low suspicion of malignancy (can excoriation due to pruritus. • Severe rashes with extensive involvement of the be triaged directly to surgical treatment if necessary) skin, or highly symptomatic e.g. severe eczema • Rashes with unknown diagnosis, or to confirm or psoriasis, likely to require complex suspected diagnosis management. • Rashes with known or strongly suspected • Children with significant eczema (requires diagnosis, where management advice is sought explanation to and discussion with parents) • Genital Images 12 Virgin Care private and confidential www.virgincare.co.uk
Meet John… …a 43 year old male living in Oldham. He has always had good health. He has recently found a rash on his arm that is red, itchy and bumpy under the skin.. 13 Virgin Care private and confidential www.virgincare.co.uk
John’s care journey Rashes Acne “I have started getting a strange rash on “I google „bumpy rash on arm‟ and my “I visit my GP who asks me about my my arms…I‟m going to google it.” local Dermatology website comes up. medical history and takes a photo of my They advise me to book an appointment rash using a digital camera. He told me with my GP because it‟s red and itchy.‟ the Oldham Total Skin service will get back to me‟ “I am sent a letter with an appointment to “I attend the Skin Clinic and am prescribed see the Skin Clinic with time and a number a cream for my rash. After the to call if I want to rearrange. I also receive appointment, I can call back to arrange a text message reminder 48 hours before” another visit within 6 months if I need to ” Virgin Care private and confidential www.virgincare.co.uk
Virgin Care private and confidential www.virgincare.co.uk
Virgin Care private and confidential www.virgincare.co.uk
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