Teledermatology refers to the use of digital images to triage, diagnose, monitor or assess skin conditions without the patient being physically present.
Teledermatology use in primary care has seen rapid expansion, with clinicians using Advice and Guidance (A&G) services to obtain specialist advice and guidance on the management of patients. These services are provided by community and secondary care providers via NHS e-RS (Dermatology A&G FAQs) and other commercial platforms and apps. Advice and Guidance requests in e-RS can be directly converted to a routine, urgent or rapid skin cancer referral/appointment by the Dermatology team if clinically indicated. Many services now use A&G as an ‘Advice and Referral’ service, allowing optional two-way dialogue with the referrer, and interim advice to optimise primary care management while the patient waits for their dermatology appointment. Advice and Guidance / Advice and Referral services are recommended at the point that an outpatient referral would otherwise be considered, in line with Dermatology Referral Guidance.
Teledermatology can provide a rapid diagnostic pathway to support early diagnosis of skin cancer. The use of macroscopic and dermoscopic images taken in primary, community, or secondary care can help clinicians determine those patients who can be discharged back to the GP and those patients who require further review or triage to a surgical appointment.
The Community Diagnostic Centre (CDC) Programme is supporting the establishment of teledermoscopy use in over 30 CDCs over the next two years. In England the Skin Cancer Faster Diagnosis Standard supports the use of teledermatology and teledermoscopy to inform patients of a non-cancer diagnosis by letter or telephone and streamline patients requiring review to clinic or skin surgery.
Teledermatology brings new ways of working and its activity needs to be resourced appropriately and included in dermatology clinicians job plans. Any clinician undertaking dermatology work should be up to date in this area of practice. The British College of Dermatology (BCD) is also supporting the expansion of teledermoscopy courses for a wide range of health care professionals. This includes working collaboratively with the Institute of Medical Illustrators on their eLearning photography courses for Healthcare Professionals.
The BAD continues to support safe expansion of integrated teledermatology services with our stakeholder organisations. This includes advising on a number of guidance and resources which are outlined in the table below.
The national Teledermatology Roadmap has been updated to support the implementation of safe and effective teledermatology triage pathways and processes in England, and many of the principles are transferable across the UK.
Also in this section
NHS e-Referral Service
All GP practices in England are required to use the NHS e-Referral Service (e-RS) to refer into consultant-led new out-patient appointments. If commercial A&G platforms are used pre-referral, then any A&G requests converted to referral are required to be received through e-RS by the provider organisation.
NHS England Guidelines and Resources relevant to Teledermatology Clinical Pathways
NHS England have collaborated with the BAD to produce resources to support clinicians, commissioners, and service managers to optimise Teledermatology pathways to improve patient access to specialist care.
Teledermatology Events and Educational Resources
The BAD Teledermatology subcommittee members provide and contribute to regular educational events and meetings.