Dermatology

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Care closer to home

Specialist services in minor surgery, dermatology and ophthalmology provided in a community setting

Cumbria Medical Services

Community Based Dermatology Service

Service Quality Performance Report

April 2017 – March 2018


Introduction

The service is led by Dr Fayyaz Chaudhri, GP with special interest in dermatology (GPwSI) with support and mentorship provided by Professor Philip Harrison, consultant dermatologist.

Dr Nicola Cawley, Dr Richard Sloan and Dr Maria Martin, GPwSIs, also provide regular clinics for the service. Dr Raluca Rotar and Dr Kate Milne run clinics alongside Dr Chaudhri whilst studying for their dermatology diploma.

Sister Jackie Shearer, our dermatology nurse specialist, provides vital support for psoriasis and eczema patients giving them the confidence, skills and knowledge to manage their condition better and be in more control of their lives.  

This NHS service is provided from London Road Community Clinic and Arnside House Surgery in Carlisle, Cleator Moor Health Centre, Orchard House Surgery in Workington, Cockermouth Hospital, Penrith Hospital and Temple Sowerby Medical Practice and is available to book via Choose and Book following a referral from the patient’s GP surgery.

Dr Martin White, GPwSI in minor surgery, performs the skin operations for the dermatology patients needing treatment, with support from Mr Graham Putnam, maxillofacial surgeon, Dr Christy Chou, plastic surgeon and Dr Jo Grove, GPwSI in minor surgery.

The average waiting time from referral to appointment is 4 weeks with all patients treated within 18 weeks of referral.

Referrals are triaged by the administration team and passed to Dr Chaudhri if unsure whether they meet evidence based referral criteria.

Verruca, skin tags, seborrheic keratosis are rejected if they don’t meet the requirements for NHS treatment.

Patients are advised they can phone in for advice following their consultation.

GPs also phone for advice on a variety of problems which helps cut down on the number of referrals.

Education

A series of dermatology education events have taken place over the past year in afternoons and evenings which have proved very popular with GPs and nurses.

Several GPs have also taken the opportunity to sit in on clinics to learn more about dermatology.

Activity

Between April 2017 and March 2018, 9687 consultations were carried out.

On average 3 clinics a week are held by two or three doctors and a dermatology nurse specialist, with a consultant dermatologist available a minimum of once a week.

The ratio of new patient appointment to follow up appointment is 1:1

A breakdown of the appointments provided is shown in the table below:

 Derm chart 20

Locality Activity Referrals

We receive a high proportion of referrals from Allerdale but have seen a steady increase in referrals from Carlisle over the past year.

 Derm chart activity 2018

The service provides a lesion screening service for patients, as well advice and management for a range of skin problems.

 Derm chart main conditions 18

 derm chart main cond pie

Onward Referral

  • 72      patients were referred on by 2WW to CIC
  • 5        patients were referred to Changing Faces
  • 47      patients to CIC dermatology
  • 3        for wig vouchers
  • 97      patientss were referred to other specialities such as urology, ophthalmology, plastics, gastroenterology, respiratory,            rheumatology, endocrinology, genetics and orthopaedics
  • 1519 patients were referred for skin surgery in a community setting
  • 7        patients were referred for UVB therapy
  • 15      patients were referred on for patch testing
  • 6        patients were referred to Newcastle for Mohs surgery

Patient Satisfaction

At each episode of care the referring GP is notified by letter within 5 days of the consultation.  A copy of this letter is also sent, or given at the time of the appointment, to the patient.  

The friends and family test form is available at clinics for the patients to fill in, with boxes available in the waiting room for return of the survey.

Patients are also given the opportunity to give feedback on ‘iwantgreatcare’ and through our website www.cumbriamedicalservices.co.uk

Over 30% patients have given feedback with 99% of patients saying they would recommend the service to their family and friends. 

Patient comments include

April – September 2017

  • All staff polite and with a human empathetic approach. Dr Cawley is the best dermatologist I’ve seen, she really listens to my concerns and gives time to ask questions and discuss worries.
  • Dr Cawley immediately struck the right note when after assessing the area requiring treatment she simply said 'let’s make a plan' The plan was made and the plan worked. The doctor is a valuable member of the team
  • Dr Cawley has seen me four times – on each occasion she has been very professional and has given me the right amount of information. Thank you”
  • “Excellent treatment, Doctor Cawley explained everything – was given the opportunity to ask questions
  • Professor Harrison is an excellent specialist doctor and Amanda is a lovely and efficient assistant
  • Everything about this clinic is very well organised, from receiving appointments to meeting the doctor
  • I saw my GP on 19/07/17 and had the dermatology appointment on 21/07/17 – excellent service – thank you.
  • The service my sister received on the last two appointments with Dr Chaudhri were excellent – lovely man
  • Following my review appointment with Doctor Fayyaz Chaudhri regarding the removal of a rather large seborrhoeic growth on my back l received an appointment within one week to have it removed by Doctor Groves. My experience of Cumbria Medical Services is one of total satisfaction. All staff involved were friendly and totally professional.
  • The medical professional care of doctors and nurses quite outstanding. In addition it is worth noting that patients generally may be suffering some degree of anxiety and the efficient process of arranging an appointment is very important. The appointments staff and reception staff were more than obliging and accepted requests to notify availability of cancelled appointments. It makes the process all the more user friendly when the staff gave their name on the telephone - it becomes a more personal service Cumbria Medical Services can be proud of their overall standard of care

 October 2017 – March 2018

  • Very flexible in terms of changing location to make appointment closer to home.  Very happy with the service.  Thank you very much
  • Throughout the whole treatment I have been very satisfied with the care and information given.  Very impressed with the staff and the efficiency and consideration shown
  • Great service with a smile, always on time.  The treatment and advice was always spot on.  Thanks very much
  • Very informative - was kind enough to give me feedback and talk through my test results exploring what each field refers to
  • Prior to being prescribed methotrexate I was advised to research the drug and decide for myself if I was willing to use as a treatment.  This was brilliant advise by the Doctor as it allowed me to weigh up the pros and cons of taking this drug
  • I think that the ladies who dealt with me were lovely, they listened and helped me understand.  That's why I like this clinic because all the people are lovely
  • Having suffered for many years with facial acne rosacea I am delighted that I am now almost clear.  The service and consultations have been very informative.  Jackie has been very helpful.
  • The Dr & Nurses were very kind and I didn't feel as if i was bothering them and wasting their time
  • I am so pleased I was referred here.  After four months of suffering I feel 95% mended.  I am touching wood, crossing my fingers and hoping that my improvement continues.  Thank you very much
  • The team is probably the best team in Cumbria.  I am most grateful for the attention and care that I experienced.  Well done.

For more information on this report or the dermatology service please contact Pauline Stuart at paulinestuart@nhs.net