Skin Conditions Campaign Scotland

NHS 24 Tele-Dermatology User Forum November 2012

Dr Stewart Douglas, SCCS Director

Skin Conditions Campaign Scotland is a Company Limited by Guarantee Registered in Scotland No. SC290012 and Scottish Charity No. SC036783

SCCS Aims

SCCS is an umbrella group that campaigns on behalf of patients in Scotland to improve provision of care for people who suffer from skin disease.

We are a patient-focused organisation

•To work for improvement in care for people affected by skin conditions•To educate and inform the public, the media and relevant professional bodies about skin conditions and their treatment

Skin Conditions Campaign Scotland is a Company Limited by Guarantee Registered in Scotland No. SC290012 and Scottish Charity No. SC036783

The need for patient power - bureaucratisation & politicisation of the NHS

• 1980s-1990s: Internal Market; Trusts & Fundholding; Patient Charter; cultural change– Problem solving replaced by problem

management– Beds replaced by bed managers– Increase in waiting times generates increase in

waiting times managers– Continuing care replaced by “patient episode”

Skin Conditions Campaign Scotland is a Company Limited by Guarantee Registered

in Scotland No. SC290012 and Scottish Charity No. SC036783

First joint meeting of PSGs:6th April 1994

Skin Conditions Campaign Scotland is a Company Limited by Guarantee Registered

in Scotland No. SC290012 and Scottish Charity No. SC036783

Skin Care Campaign

• Recognition of combined strength: Tina Funnell (NES) first chair of SCC

• All-Party Parliamentary Group on Skin established jointly with BAD

• Reports on adequacy of training, staffing, treatment.

Skin Conditions Campaign Scotland is a Company Limited by Guarantee Registered

in Scotland No. SC290012 and Scottish Charity No. SC036783

APPGS report prompted RCGP Curriculum Statement 2007

Skin Conditions Campaign Scotland is a Company Limited by Guarantee Registered

in Scotland No. SC290012 and Scottish Charity No. SC036783

Skin Care Campaign

• Peter Lapsley persuades BMJ to publish “Patient Journey” series

Skin Conditions Campaign Scotland is a Company Limited by Guarantee Registered

in Scotland No. SC290012 and Scottish Charity No. SC036783

Skin Conditions Campaign Scotland (formerly Skin Care Campaign Scotland )

• Response by SCC and DCS to devolution of parliament and (parts of) the NHS

• An umbrella group representing common interests of people in Scotland who have skin diseases and conditions

• Members include 14 disease-specific support groups

Skin Conditions Campaign Scotland is a Company Limited by Guarantee Registered in Scotland No. SC290012 and Scottish Charity No. SC036783

SCCS Work has included:• The patient voice on Dermatology Council for

Scotland• Steering Groups:• Skin Action Scotland • Foundation Course in Dermatology (University of

Stirling)• Lobbying for sunbed control, changes in wig

provision, development and implementation of SIGN guidelines

Skin Conditions Campaign Scotland is a Company Limited by Guarantee Registered in Scotland No. SC290012 and Scottish Charity No. SC036783

SCCS Work has included:

• Involvement in Parliamentary briefings and CPGs: psoriasis, cancer, health inequalities

• NHS Board consultations

• SMC submissionsSkin Conditions Campaign Scotland is a

Company Limited by Guarantee Registered in Scotland

No. SC290012 and Scottish Charity No. SC036783

SCCS Funding

• Core Funding from affiliate membership fees– Open to pharmaceutical companies, professional

organisations, individuals

• Fees are unrestricted donations • Project Funding from other bodies

Skin Conditions Campaign Scotland is a Company Limited by Guarantee Registered in Scotland No. SC290012 and Scottish Charity No. SC036783

SCCS Long Term Objectives• RESTORE training in skin diseases for GPs and practice nurses

• IMPROVE access to specialist care for patients with skin conditions

• IMPROVE access and reduce delays in treating skin cancer

• ELIMINATE discrimination and bullying of people with skin disease

• IMPROVE Health Education to prevent skin diseases and reduce cancer deaths

• ENSURE that guidelines for skin disease are used across Scotland

Skin Conditions Campaign Scotland is a Company Limited by Guarantee Registered in Scotland No. SC290012 and Scottish Charity No. SC036783

Improved Access for Patients

• From 2007 the Scottish NHS has funded examinations for patients with eye problems by specialist optometrists

• Several NHS Boards provide self-referral community physiotherapy for people with musculoskeletal problems

• When will the NHS do something similar for people with skin disease?

Skin Conditions Campaign Scotland is a Company Limited by Guarantee Registered in Scotland No. SC290012 and Scottish Charity No. SC036783

Improved Access for Patients

• How can patients consult a knowledgeable HCP at first point of contact?• Office/Community dermatologists?• PCDS members: how can they be increased?• Community nurses – can we transform services

using the leg ulcer care model?• What contribution can teledermatology

make?• Could NHS24 have a major role?

Skin Conditions Campaign Scotland is a Company Limited by Guarantee Registered in Scotland No. SC290012 and Scottish Charity No. SC036783

Triage of Skin Cancer

Diagnosis of skin cancer :•Structured history•Clinical appearance including dermoscopy

Primary Care has deficiencies: •GPs refer almost all suspected cancer (>50,000 pa)•Quality of history and clinical findings highly variable•1-2% use dermatoscopes•Use of Fast-track pathways is variable

Skin Conditions Campaign Scotland is a Company Limited by Guarantee Registered in Scotland No. SC290012 and Scottish Charity No. SC036783

What might NHS 24 do for patients with skin disease ?

• Patients have direct access to NHS24• NHS24 has enormous experience of triage in

emergency care• NHS24 has responsibility for telemedicine• Teledermatology with photodermoscopy

triage reduces delays in treatment• Could NHS24 take on skin cancer triage?

Skin Conditions Campaign Scotland is a Company Limited by Guarantee Registered in Scotland No. SC290012 and Scottish Charity No. SC036783

info@skinconditionscampaignscotland.org

Skin Conditions Campaign Scotland, C/O The ALLIANCE, Venlaw Building,

349 Street, Glasgow G2 4AA

Skin Conditions Campaign Scotland is a Company Limited by Guarantee Registered in Scotland No. SC290012 and Scottish Charity No. SC036783

www.skinconditionscampignscotland.org