Community Based Dermatology Service
Service Quality Performance Report
April 2022 – March 2023

Introduction

The service is led by Dr Fayyaz Chaudhri, Speciality Doctor in dermatology.

Our team of 8 GP specialists have considerable knowledge and experience and regularly attend courses and seminars to keep abreast of any developments in dermatology. There is also two Consultant Dermatologist who works closely with the GP team and runs clinics on a monthly basis providing clinical input for the patients presenting with more complex conditions.

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 over the last twelve months has been delivered from Arnside House Surgery in Carlisle, Westcroft House Surgery in Egremont, Victoria Cottage Hospital in Maryport, 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.

This NHS service over the last twelve months has been delivered from Arnside House, Carlisle, Cockermouth Hospital, and more recently Carlisle Healthcare South (moved from Arnside House) and is available to book via Choose and Book following a referral from the patient’s GP surgery.

Dr Martin White, GPER 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, Dr David Brigham and Deborah Bradley Advanced Operating Department Practitioner.

The average waiting time from referral to first appointment for an assessment is 4 – 6 weeks with all patients treated within 18 weeks of referral.

Referrals are triaged by the admin team and passed back to the GP surgery if they don’t meet the requirements for NHS treatment. Lesions of a benign nature such as skin tags, warts etc. will not be treated unless they meet evidence based criteria such as subject to trauma, increasing in size, irregular pattern, uncertainty of diagnosis. Any benign lesions that meet the criteria for treatment have a Prior Approval Ticket (PAT).

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

The service has held regular teaching sessions for local GPs and nurses to improve knowledge of dermatology in primary care.

We are hoping to re-introduce Education events again that would usually take place in afternoons and evenings and have in the past proved very popular with GPs and nurses.

As part of the CMS education programme several GPs and trainees have in the past also taken the opportunity to sit in on clinics to learn more about dermatology. This input has more recently started again with a small number of local GPs.

During this year there have been 15 GPs/Nurses sitting in for a Dermatology clinic and one group teaching session.

Activity

Between April 2022 – March 2023 13,035 consultations were carried out 5,467 new patients were seen and there were 7,051 follow up consultations.

On average 20 clinics a week are held with four doctors and a dermatology nurse specialist. A consultant dermatologist is available twice a month.

Included in some of those appointments:    

The Dermatology service had a total of 517 DNAs over the twelve month period.

Patients are reminded by text message 2 days before their appointment to help cut down on non-attendance.

The community Dermatology Service treated a wide variety of different conditions during the year, including:

Onward Referrals   

The Community Dermatology Service has referred on a total of 401 patients in this reporting period:

*Such as urology, ophthalmology, plastics, gastroenterology, respiratory, rheumatology, endocrinology, genetics and orthopaedics

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.  

On a quarterly basis a sample of patients are sent a text message which includes a link to survey monkey asking them to complete a satisfaction survey.

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

126 patients completed and returned survey forms. Results demonstrate that the following patients would recommend CMS to friends and family:

  • 93%of patients felt the right amount of information was given to them about their condition or treatment.
  • 96% of patients thought they were involved as much as they wanted to be in decisions about their care and treatment.

Patient comments included

  • ‘The service was great, the dermatologist was very understanding and the treatment worked well’
  • ‘All good service doctor was a nice guy’
  • ‘Grateful that the problem seems to be settling down. Extremely helpful and professional care. Admin staff are also extremely welcoming and professional. Thank you.’
  • ‘Friendly and knowleable’
  • ‘I found the service to be extremely welcoming and friendly. The facilities at Cockermouth are immaculate. Directions to the service and department were detailed exactly. I found the receptionist very welcoming and approachable. The doctor was very thorough and spoke to me as a person and not just a patient’
  • ‘I felt comfortable with both Doctors seen, everything was explained and I was re-assured about treatment necessary’
  • ‘Very professional service. Very patient focused’
  • ‘The building was bright, clean and welcoming. The Doctor that I saw was very pleasant and helpful, following up with results as promised. Overall, one of the most pleasant NHS experiences that I have received in recent years. I felt that the Dr actually listened and acted accordingly’
  • ‘Very professional friendly staff, appointment waiting time good, no complaints at all’
  • ‘I think the way the service comes to more remote parts of the county is excellent. Hospitals like Cockermouth feel underused in my opinion, and the fact that we didn’t need to travel to Carlisle, Whitehaven or further afield with young children was a godsend. It is the same when attending appointments with an elderly or disabled relative – incredibly difficult, stressful and exhausting. To give you a comparison, when referred to maxiofacial surgery for a tongue tie revision of my newborn baby, I had to travel to Newcastle or Lancaster, five days postpartum. Nowhere in Cumbria could this simple procedure be carried out. There is no reason I can see why such a service couldn’t be done in the same way as this dermatology service’
  • ‘Felt really comfortable from walking into reception very polite receptionist, and doctor Denham very professional and made me feel at ease’
  • ‘Not having been to the doctors for some time I found the service and how I was dealt with and treated extremely professional and caring , I cannot thank the people involved enough from start to finish’
  • ‘All the staff were helpful and treatment options explained clearly’
  •  ‘Dr Chaudhri is an extremely helpful doctor and has always treat me with the utmost courtesy. His staff are also very pleasant’
  • ‘I was a bit nervous going in but the person I saw was friendly, competent and efficient’
  • ‘Pleased to see and speak to a professional Dermatologist at last. Confident that a solution to my problem is finally achievable’
  •  ‘The staff at Arnside House surgery were very efficient and kind. Dr Chaudhri was kind too. He printed a note of explanation after my examination which I’m very grateful for. It’s so easy to forget what you’ve been told when you’re in examination’
  •  ‘Relieved a lot of anxiety following a “not important” attitude from doctors. High praise though for Louise, the nurse practitioner who took an interest and raised a referral’
  • ‘The doctor was willing to discuss treatments with me and make a combined decision. I hate being told what I am taking without explanation
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