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Skin

Skin. Veronique Bataille Consultant Dermatologist, WHHT NSSG Chair. Key Features of Service. Dermatology services at West Herts, Luton and East and North with critical mass of consultants dermatologists especially in West of the patch

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Skin

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  1. Skin Veronique Bataille Consultant Dermatologist, WHHT NSSG Chair

  2. Key Features of Service Dermatology services at West Herts, Luton and East and North with critical mass of consultants dermatologists especially in West of the patch Surgical services from plastic surgery hub at the Lister. Sentinel node service starting locally. Royal Free providing surgery clinics at Watford Oncology at MVCN with one of the most active department in the country for melanoma trials Radiotherapy access for SCCs and BCCs improved dramatically with appointment of Dr Corner Community services with accredited Gpwsi for low risk BCCs and pre-cancerous skin lesions

  3. 2 ww Most 2 ww seen by dermatologists in Herts. Many 2 ww are not suspected SCCs and MMs Workload is significant with over 3300 referrals in Herts per year Bottle neck for surgery with breaches Access to MVCC for radiotherapy is difficult for elderly patients

  4. Key Achievements • Centralised surgical services at Lister in Dec.2009 and agreed local pathways • Merged the 2 MDTs at West Herts • Produced Skin Film for GP education and resource kit in development • Carried out regular audits in Melanoma and SCC • New immuno-compromised clinic started at the Lister • Radiotherapy services more accessible at MVCC • National Patient Survivorship Project- Questionnaire has been piloted on a small number of SCC and MM patients

  5. Key Achievements (2) • Successful tele-dermatology pilot in West Herts: 50% of 2 ww teledermatology referrals not suitable for 2 ww. • Patient Information Prescriptions (PIP) have been implemented across the network. • Agreement of a network wide pathology MDS and standardised path. reporting across MVCN but support by Trusts for collection of data during MDT still needed • Oncology at MVCN offering entry into major melanoma therapeutic trials with gene therapy and immunotherapy

  6. Skin

  7. Some Challenges • Dermatology and plastics provision not provided evenly across Network • Maintaining minimum Lymph node dissections for both plastic surgeons • Some lymphadenectomies being carried out at Royal Free following SNB rather than repatriated • Historical RF Plastics clinic at MVCC

  8. Other Challenges • Data collection for COSD • Cross site working for CNS (WHHT) • Oncology cover at WHHT and L&D • L&D dermatology capacity for 2WW referrals and decreased capacity for plastic surgery procedures.

  9. Priorities for the Future • Network wide teledermatology service • Set up local Sentinel Node Biopsy service • Explore local B cell and T cell lymphoma service with Dr Corner • Complete data collection of the COSD • Implement outcomes of review of network wide dermatology/plastics provision

  10. Finally…. • Overall major progress considering the piece meal delivery of skin cancer services in Herts in mid 2000s • MDTs and SSMDTs running well • CNS presence very valued • Advanced melanoma patients receive top treatment with multi-disciplinary approach

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