Background
Kent and Medway ICB have commissioned a GP with Extended Role (formerly GPwSI) Community Dermatology Service supported by a consultant for the people registered with East Kent. This service is designed to provide a local, more accessible and cost-effective service to patients in line with the 5-year forward view. Outpatient and surgical services are offered as part of the community dermatology service.
Service Objectives
The overarching aim of the service is to provide an innovative, high-quality, consultant-supported GPwER Dermatology Service to the patients registered within Kent & Medway ICB area.
The service aims to deliver an accessible, efficient service managing the majority of diagnostics and outpatient activity within primary care settings. This will entail working closely with Consultants, GPs, GPwERs undertaking minor surgery, Acute Specialist Service Departments, and Specialist Skin Cancer services as well as other secondary care specialties such as plastic surgery, rheumatology, and diabetes.
The clinical aims of the service are to:
Provide assessment, investigation, and treatment of patients suffering with skin disease, including a full diagnostic service including phlebotomy, biopsy, and swab taking and reporting of results.
Provide a high-quality, accessible, multi-disciplinary based service with consultant oversight which delivers excellent outcomes meeting the needs of patients in line with NICE guidance and best practice.
Operate a one-stop-shop as far as possible, where patients are assessed and receive treatment in the same appointment by a GPwER or a joint appointment with a GPwER and a consultant.
Be involved in the clinical triage for all referrals to the dermatology pathway.
Manage cases appropriately and adhere to the local referral pathways.
Refer to hospital only tier 4 cases which cannot be seen in the community, including acutely unwell patients, those with diagnostic uncertainty, and those needing hospital supervised treatments such as biologic therapy, or services such as patch testing/light therapy.
Provide clinical opinions and treatment plans for the referring clinicians; the aim is to diagnose and refer back to the GP with a detailed management plan, and follow up only as appropriate.
Support patients around the management of skin disease. Provide information and support about self-care, prevention of skin disease, and ongoing management of long-term skin conditions.
Develop integrated pathways and good communication across all tiers of care; bridging primary and secondary care services.
Deliver care outside the acute setting and closer to home for patients with the aim of reducing all acute referrals.
Maximise the clinical care delivered to patients with associated conditions (such as rheumatology and diabetes) through effective joint working with other key clinical specialties.
Description of Key Services
Undertake annual peer supervision. Audit all clinical lesions removed.
Be in receipt of feedback on performance. Maintain competency as appropriate with your qualification. Attend quarterly clinical governance meetings. Provide evidence of competency in teaching and training healthcare professionals and a commitment to cascading knowledge and skills.
Maintain professional links with local clinicians and local acute specialist providers.
Reporting and Performance
Any issues or concerns relating to the performance of this service will be escalated and managed through the Community Dermatology performance management process. Any significant events that occur will follow our significant event procedures. This investigation will be managed by our Patient Safety and Quality Manager.
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