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. SC 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. SC 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. SC and Scottish Charity No. SC036783

First joint meeting of PSGs: 6 th April 1994 Skin Conditions Campaign Scotland is a Company Limited by Guarantee Registered in Scotland No. SC 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. SC 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. SC 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. SC 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. SC 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. SC and Scottish Charity No. SC036783

SCCS Work has included: Involvement in Parliamentary briefings and CPGs: psoriasis, cancer, health inequalities NHS Board consultations SMC submissions Skin Conditions Campaign Scotland is a Company Limited by Guarantee Registered in Scotland No. SC 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. SC 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. SC 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. SC 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. SC 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. SC 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. SC and Scottish Charity No. SC036783

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. SC and Scottish Charity No. SC