{"id":6141,"date":"2023-05-04T10:53:45","date_gmt":"2023-05-04T09:53:45","guid":{"rendered":"https:\/\/northerncanceralliance.nhs.uk\/?page_id=6141"},"modified":"2023-10-19T18:03:42","modified_gmt":"2023-10-19T17:03:42","slug":"qi-digital-dermatology","status":"publish","type":"page","link":"https:\/\/northerncanceralliance.nhs.uk\/primary-care\/dermatology-primary-care\/qi-digital-dermatology\/","title":{"rendered":"QI: Digital Dermatology"},"content":{"rendered":"<p class=\"lead\">Cancer Referral Quality Improvement: Digital Dermatology example<\/p>\n<p>This will be coordinated by PCN but likely PCN GP practices will have different issues.<\/p>\n<ul>\n<li><span style=\"color: #000000;\">Appoint <strong>PCN lead<\/strong> for the project to coordinate<\/span><\/li>\n<li><span style=\"color: #000000;\">Ensure that each practice has a <strong>Clinical Champion<\/strong> and <strong>Non-Clinical champion.<\/strong><\/span><\/li>\n<li><span style=\"color: #000000;\">Suggest review <strong>20 to 30<\/strong>, Fast Track Suspected Cancer referrals skin referrals in each practice within the PCN.<\/span><\/li>\n<\/ul>\n<p>On review of the referrals, could consider:<\/p>\n<ul>\n<li><span style=\"color: #000000;\">Does referral<strong> contain Digital Images<\/strong> (Three appropriate images OR appropriate reason why missing)<\/span><\/li>\n<li><span style=\"color: #000000;\">Check <strong>Image Quality for acceptability<\/strong> &#8211; ie Images in Focus, Correct views.<\/span><\/li>\n<li><span style=\"color: #000000;\">Is there <strong>appropriate narrative<\/strong> describing the history of the lesion (CLINICAL REVIEW)<\/span><\/li>\n<li><strong><span style=\"color: #000000;\">Record Staff Role of Referrer <\/span><\/strong><span style=\"color: #000000;\">to help identify any training needs within staff groups (i.e. GP \/ GP trainee \/ F2 \/ Clinical Practitioner Role (Non Medical).<\/span><\/li>\n<li><span style=\"color: #000000;\">Did the patient have the <strong>Fast Track Suspected Cancer referrals\u00a0Patient information leaflet<\/strong> (READ CODE)<\/span><\/li>\n<li><span style=\"color: #000000;\">Was any referral <strong>safety netting<\/strong> in place (<span style=\"text-decoration: underline;\">READ CODE<\/span>)<\/span><\/li>\n<li><span style=\"color: #000000;\">Was the <strong>referral accepted<\/strong><\/span><\/li>\n<li><span style=\"color: #000000;\">Was there a <strong>Skin Cancer Diagnosis outcome<\/strong><\/span><\/li>\n<li><span style=\"color: #000000;\">Was <strong>Cancer Care review process<\/strong> instigated appropriately<\/span><\/li>\n<\/ul>\n<p>Could then look at individual practices <strong>processes for Digital Dermatoscope equipment:<\/strong><\/p>\n<ul>\n<li><span style=\"color: #000000;\"><strong>Practice survey<\/strong> to assess<strong> knowledge<\/strong>, <strong>competence<\/strong> and <strong>training needs<\/strong>.<\/span>\n<ul>\n<li><span style=\"color: #000000;\">Does everyone know what they should be doing and how to do it?<\/span><\/li>\n<\/ul>\n<\/li>\n<li><span style=\"color: #000000;\"><strong>Practice systems<\/strong> or specific practice issues.<\/span>\n<ul>\n<li><span style=\"color: #000000;\">e.g. Wifi or Mobile Signal, access to dermatoscope etc<\/span><\/li>\n<\/ul>\n<\/li>\n<li><span style=\"color: #000000;\">Then GP practices meet to <strong>review<\/strong>, <strong>generate themes<\/strong> and <strong>create an improvement plan<\/strong> for practices to implement.<\/span><span style=\"color: #000000;\">This maybe <strong>shared best practice<\/strong> from other GP practices within the PCN that are doing well. This could include:<\/span>\n<ul>\n<li><span style=\"color: #000000;\"><strong>Clinician training on Fast Track Suspected Cancer referrals &amp; equipment<\/strong><\/span>\n<ul>\n<li><span style=\"color: #000000;\"><strong>NCA Skin Lesion Training Session <span style=\"text-decoration: underline;\">recommended for all Cancer Skin Referrers<\/span>:<\/strong><\/span><\/li>\n<li><b>NCA Educational Dermatology Webinar:<\/b><\/li>\n<li><span style=\"text-decoration: underline;\">Differentiating Benign from Malignant Skin Lesions in Primary Care.\u00a0<\/span><\/li>\n<li>Thursday 23rd November, 12:30-14:00hrs.<\/li>\n<li>This session will be hosted by the Northern Cancer Alliance and presented by Dr Tim Cunliffe, GPwER Dermatology and Skin Surgery, &amp;Joint lead for Skin Cancer &amp; Skin Surgery, South Tees.<\/li>\n<li>This is intended for all clinicians involved in dermatological referrals for skin lesions within NENC ICB.<\/li>\n<li>Eventbrite: <a href=\"https:\/\/www.eventbrite.co.uk\/e\/differentiating-benign-from-malignant-skin-lesions-in-primary-care-tickets-712977152857?aff=oddtdtcreator\">Register by Clicking Here<\/a><\/li>\n<li><em><span style=\"color: #000000;\">Recording of Webinar will be posted here after event.\u00a0<\/span><\/em><\/li>\n<li><span style=\"color: #000000;\"><em><strong>Specific practice level training<\/strong><\/em><\/span>\n<ul>\n<li><span style=\"color: #000000;\">Using the specific type of local equipment<\/span><\/li>\n<li><span style=\"color: #000000;\">Using the local systems for transfer of images eg accurx or email etc<\/span><\/li>\n<li><span style=\"color: #000000;\">Using local safety netting and readcoding policies<\/span><\/li>\n<li><span style=\"color: #000000;\">How do new clinicians, trainees &amp; Locums know how to do this?<\/span><\/li>\n<\/ul>\n<\/li>\n<li><span style=\"color: #000000;\"><em><strong>Gateway C &#8211; <\/strong><\/em><\/span><span style=\"color: #000000;\">Skin Cancer Module: <span style=\"color: #003edb;\"><a style=\"color: #003edb;\" href=\"https:\/\/www.gatewayc.org.uk\/courses\/skin-cancer-early-diagnosis\/\">https:\/\/www.gatewayc.org.uk\/courses\/skin-cancer-early-diagnosis\/<\/a><\/span><\/span><\/li>\n<li><span style=\"color: #000000;\"><em><strong>Dermoscopy features video<\/strong><\/em>: <span style=\"color: #003edb;\"><a style=\"color: #003edb;\" href=\"https:\/\/egplearning.co.uk\/introduction-to-dermoscopy-for-gps\/\">https:\/\/egplearning.co.uk\/introduction-to-dermoscopy-for-gps\/<\/a><\/span><\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li><span style=\"color: #000000;\">Improve <strong>Readcode adoption<\/strong> for Fast Track Suspected Cancer Referrals Patient leaflets \u2013 use of templates etc<\/span><\/li>\n<li><span style=\"color: #000000;\">Improve <strong>Safety net processes<\/strong> \u2013 Consideration of use of Cancer Care Coordinator role?<\/span><\/li>\n<li><span style=\"color: #000000;\">Improved <a href=\"https:\/\/northerncanceralliance.nhs.uk\/primary-care\/dermatology-primary-care\/\"><strong>Equipment process<\/strong><\/a> (Dermatoscope and iPhone) e.g.<\/span>\n<ul>\n<li><span style=\"color: #000000;\"><strong>Sign in \/ out register<\/strong> for Dermatoscope<\/span><\/li>\n<li><span style=\"color: #000000;\">Administrator <strong>guardian of the Equipment<\/strong><\/span><\/li>\n<li><span style=\"color: #000000;\">Administrator <strong>Equipment<\/strong><strong>\u00a0&#8220;runner&#8221;<\/strong> to bring the equipment to the Clinician.<\/span><\/li>\n<li><span style=\"color: #000000;\">Arrangements for <strong>Images to be taken by other staff<\/strong> \/ other clinics<\/span><\/li>\n<li><span style=\"color: #000000;\">Case\/Box to <strong>protect Equipment<\/strong><\/span><\/li>\n<li><span style=\"color: #000000;\">Equipment <strong>charging check list<\/strong><\/span><\/li>\n<li><span style=\"color: #000000;\"><strong>Portable battery<\/strong> to ensure that charge throughout the day.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Then <strong>Re-audit after 6 months<\/strong> to <strong>assess impact<\/strong> of changes in all practices.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Cancer Referral Quality Improvement: Digital Dermatology example This will be coordinated by PCN but likely PCN GP practices will have different issues. Appoint PCN lead for the project to coordinate Ensure that each practice has a Clinical Champion and Non-Clinical champion. Suggest review 20 to 30, Fast Track Suspected Cancer referrals skin referrals in each [&hellip;]<\/p>\n","protected":false},"author":12,"featured_media":0,"parent":6128,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/northerncanceralliance.nhs.uk\/wp-json\/wp\/v2\/pages\/6141"}],"collection":[{"href":"https:\/\/northerncanceralliance.nhs.uk\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/northerncanceralliance.nhs.uk\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/northerncanceralliance.nhs.uk\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/northerncanceralliance.nhs.uk\/wp-json\/wp\/v2\/comments?post=6141"}],"version-history":[{"count":7,"href":"https:\/\/northerncanceralliance.nhs.uk\/wp-json\/wp\/v2\/pages\/6141\/revisions"}],"predecessor-version":[{"id":6512,"href":"https:\/\/northerncanceralliance.nhs.uk\/wp-json\/wp\/v2\/pages\/6141\/revisions\/6512"}],"up":[{"embeddable":true,"href":"https:\/\/northerncanceralliance.nhs.uk\/wp-json\/wp\/v2\/pages\/6128"}],"wp:attachment":[{"href":"https:\/\/northerncanceralliance.nhs.uk\/wp-json\/wp\/v2\/media?parent=6141"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}