Launching Agile Insourcing’s Spotlight Series
Agile Insourcing unveils our groundbreaking spotlight series. We partner with leading clinicians to bring you real insights from the front line in NHS healthcare.
This collaboration with leading clinicians takes you behind the scenes of NHS healthcare. You'll hear from thought leaders with decades of medical experience. They understand the challenges of healthcare in the UK today.
In the first article of the spotlight series, renowned consultant dermatologist Dr Arif Aslam writes for us. Dr Arif Aslam is an experienced consultant dermatologist. He is a double fellowship-trained Mohs micrographic surgeon and a member of the prestigious American College of Mohs Surgery (ACMS).
Dr Aslam writes about the need for speed in skin cancer diagnoses. He unravels the challenges and solutions in dermatology. Discover how real-life challenges meet cutting-edge solutions.
The importance of rapid diagnosis
Skin cancer is not just a national but a global public health concern. It is more commonly diagnosed than all other malignancies. Cases of both melanoma and non-melanoma skin cancer are rising dramatically worldwide.
And there is growing concern in the UK. Rates of skin cancer are increasing faster than any other cancer in the UK, with figures doubling every 10 to 20 years. In the UK, one in four men and one in five women will develop a form of skin cancer at least once in their lifetime.
Over 250,000 cases of non-melanoma skin cancer are diagnosed annually in the UK, with rates predicted to reach almost 400,000 per year in 2025. Approximately 3,500 people die from skin cancer each year in the UK and the estimated costs of skin cancer treatment for the NHS are more than £500 million.
The challenge
An ageing population compounds rising cases of skin cancer which is more common in the elderly population. And like other areas, there is the COVID-19 pandemic backlog. Many patients were reticent about coming forward at the time of the pandemic. Added to this, there is a national shortage of dermatologists in the UK. The dermatology shortage of workers and increasing rates of skin cancer are both extremely challenging problems, for which there needs to be a long-term fix.
Time is of the essence
The truth is that over 90% of all skin cancers are curable if detected, diagnosed, and treated early. The reality is also that many cases are preventable. Dermatology services receive more urgent referrals for suspected cancer than any other speciality. About half of the one million dermatology referrals yearly are suspected skin cancer two-week wait referrals.
The process
In the UK NHS service, patients with suspected malignant melanoma (MM), or squamous cell carcinoma (SCC) are referred from general practitioners to secondary care dermatology services using an urgent suspected skin cancer referral pathways within two weeks. Patients with suspected basal cell carcinomas (BCCs) are also referred under this pathway if they are changing rapidly, are in a high-risk location, or are large.
The need for speed
Innovative approaches to support the early diagnosis of skin cancer are part of the COVID-19 recovery plan including Teledermatology.
UK studies have shown that as many as one in three melanomas is diagnosed incidentally by a total body skin examination, which implies a face-to-face consultation. A total body skin check remains one of the most important clinical encounters for the detection of skin cancer.
Whilst local trusts can step up skin cancer detection activity, too often they are simply transferring the workload downstream. Out-patient clinic wait times are transferred to delays for surgical appointments and then pathology.
The solution
Agile Insourcing provides a full team of dermatologists to NHS Trusts to help reduce wait times and patient backlogs. We can also supply surgical teams and pathology services.
A complete, one-stop skin cancer service is vital. One where patients are seen face-to-face by a Consultant Dermatologist and treated is commenced the same day, either with a diagnostic skin biopsy, a therapeutic procedure (excision) or plastic surgery.
Agile clinical leaders also join the local skin cancer MDT to ensure all the patients are discussed and the outcomes recorded. If there is a concern about the burden on local MDTs. Agile can provide additional support to create a safe, workable solution.
Insourcing is the short- to medium-term solution to the need for extra clinical capacity through medical, clinical, and nursing insourcing that allows trusts to ensure patients are seen and treated within their local environment.
