One in four people in England and Wales (13.2m) see their GP about a dermatological condition every year, with 3.5m outpatient or day surgery attendances every year.

In addition, around half of all cancers in England and Wales are skin cancer – and this is increasing by 8% annually.

The GIRFT national report for dermatology makes recommendations to help recruit and retain skilled clinicians specialising in dermatology, to make greater use of new technology and to offer equal opportunities for early access to diagnoses and treatment across England.

GIRFT also recommends supporting diagnosis and treatment for skin cancer within dermatology settings by setting out clear and consistent delineations between day case and outpatient skin cancer activity.

Professor Nick Levell MD FRCP MBA

Clinical Lead for Dermatology

Nick has been a consultant dermatologist at the Norfolk and Norwich University Hospital for 30 years, where he is the senior dermatologist. He is particularly interested in diagnosis and treatment of complex skin disorders such as vasculitis and also has research in health economics and skin cancer epidemiology. 

As speciality lead for the NIHR, his team supports more than 50 clinical studies in over 200 centres across the UK.  He is past president of the British Association of Dermatologists and of the British Society for Medical Dermatology.  He chairs the national dermatology therapy and guidelines committee, which produces national guidelines and gives advice to national bodies including NICE.

Useful information

  • Simplification of skin cancer two-week wait clock stop for images received from primary care: New cancer waiting times monitoring dataset guidance enables more efficient virtual triage of two-week wait skin cancer referrals.

    Now the ‘clock stop’ for two-week wait teledermatology referrals from primary care is when the image is reviewed by the specialist. Previously the ‘clock stopped’ when the patient was notified of the outcome by a member of the specialist team, either by phone or video.

    The 28 day Faster Diagnostic Standard clock stop, published in October 2022, has not changed and is the date the patient is informed of the outcome of the teledermatology interaction, by phone or letter.

    Further information is available in the full guidance (section 6.10.1, page 73) and in a simple flow diagram.

  • Redesigning dermatology pathways: Guidance to support the process of redesigning dermatology pathways – ensuring systems and services consider the potential for widening health inequality locally, using pathway redesign as an opportunity to reduce existing inequalities – has been published by the Outpatient Transformation and Recovery programme. Ensuring equity of access to care when redesigning dermatology pathways is available on the NHS England website. More resources to support the transformation of outpatient services are available on the Outpatient Recovery and Transformation workspace on Future NHS.
GIRFT recommendations address dermatology workforce shortages and call for wider use of technology

Making greater use of remote and digital technology will support more patients presenting and living with conditions such as skin cancer, eczema, psoriasis and acne according to GIRFT’s new dermatology report.

Alongside enhancing the dermatology workforce, digital innovations across dermatology – from screening to treatment – will help to ensure patients receive the best treatment available.

The report also recommends improving the training and function of the whole multidisciplinary team to improve patient care and reduce locum costs, with suggested measures including training dermatology nurses as specialist nurses and nurse consultants, as well as better training opportunities for GPs and pharmacists, who are often the first point of contact for patients. 

In August 2021, GIRFT published its national speciality report for Dermatology:

Click above to view the pdf report

Watch the video about the Dermatology report…

Click above to play the Dermatology national report video

Dermatology Academy Resources