Community Based Dermatology Service
Service Quality Performance Report
April 2020 – March 2021

Introduction

The service is led by Dr Fayyaz Chaudhri, GP with extended role in dermatology (GPER) with support and mentorship provided by Dr Bea Bakos, consultant dermatologist.

Our team of 7 GP specialists have considerable knowledge and experience and regularly attend courses and seminars to keep abreast of any developments in dermatology.

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 Arnside House Surgery in Carlisle, Westcroft House Surgery in Egremont, 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. Clinics historically delivered at Orchard House in Workington were suspended during the year during due to COVID and were moved to Victoria Cottage Hospital, Maryport.

Dr Martin White, GPSI 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 David Brigham, GPER in minor surgery.

The average waiting time from referral to assessment is 4 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 would usually hold regular teaching sessions for local GPs and nurses to improve knowledge of dermatology in primary care, but due to COVID over the last year this has not been possible. It is hoped to re-start these sessions as soon as it is safe to do so.

Education events 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. Again this will be offered to local GPs and nurses as soon as it is safe to do so.

Activity

Between April 2020 and March 2021, 11,255 consultations were carried out and 3,887 new patients seen.

In the first few months of the year the majority of first appointments were managed over the phone as a telephone consultation due to COVID. The assessment over the phone would then often lead to a face to face appointment particularly in the instance of a skin lesion. Over more recent months however all lesions are now provided with a face to face appointment in the first instance.

On average 23 clinics a week are held with doctors and a dermatology nurse specialist. A consultant dermatologist is available once a fortnight and by phone/email contact at all times. The ratio of new patient to follow up is 35% new patient to 65% follow up.

Included in those appointments:    

The Dermatology service had a total of 431 DNA’s for the year.  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 242 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.  

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

Patients attending clinic during the first week in each quarter are asked to complete an online survey. 360 surveys were returned. Analysis of the feedback provided shows 98% of patients saying they were extremely likely or likely to recommend the service to their family and friends.

  • 99% patients were involved as much as they wanted to be in decisions about their care and treatment.
  • 98% patients felt the explanation given by the health professional was clear and easy to understand.
  • 98% patients felt they were given the right amount of information about their condition or treatment.

Patient comments included

  • Dr Chaudhri is very knowledgeable and made me feel 100% confident in his diagnosis. I would like to add my thanks for how I was treated.
  • The doctors have been excellent and supportive.
  • Everything went as I hoped and I got treatment which seems to be working so far.
  • Dr Smith came across as kind and interested in helping me which was appreciated.
  • Dr Rotar is excellent by any measure. I have every confidence in her.
  • Every time I phone up to change an appointment the person who answers is very polite and helpful. Also when the consultant rings for the telephone appointment she too is very polite and always goes through everything with me asking how I am and if I have any problems or concerns also making sure I have enough meds and creams even though she knows I can request my own. First class service.
  • I have never had a bad experience with my dermatologist Dr Cawley and the services and information I receive from Cumbria Medical Services is amazing. Nothing is too much effort for the staff and they are always so lovely and friendly. Thank you for looking after me so well over the years.
  • I was seen by the consultant initially and then by the dermatology nurse (Jackie). A very caring nurse, kind and sympathetic. I am very lucky to have been in her care! Thank you Jackie and everyone in the dermatology department. My skin is so much better.
  • All very good – happy with advice and the service provided.
  • Happy. Thank you.
  • Very good and reassuring.
  • I felt the doctor really cared about me.
  • Excellent, efficient service.
  • Very good thanks! Good parking, friendly staff and clean facilities.
  • Lovely service and informative.
  • Dr Smith was lovely and caring – such a nice doctor. Thank you.
  • Wonderful service and cannot thank staff enough!
  • I was very happy with the level of service and care I have received.
  • From access for appointment to treatment and results all were caring and efficient – also convenience of closer to home welcome.
  • All good – thank you. Doctors and staff very kind and very reassuring.
  • Very clear on what will happen with future treatment. Very happy with overall appointment.
  • I was really pleased with the service and care I was given in my appointments.
  • What a difference to my skin within two weeks. Thank you.
  • Thorough and courteous consultation. Administration also good. An efficient clinic.
  • Excellent service, informative and courteous throughout. Opportunity for questions and all very well explained.
  • Excellent service. Quick and efficient. Treated with dignity and respect.
  • Very professional and easy to understand the problem and how to solve it.
  • Dr Cawley is very warm and friendly which makes such a difference and she knows her stuff!
  • Excellent care by Dr Chaudhri. Always helpful and understanding.
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