1. VERONICA WILKIE GP CORBETT MEDICAL PRACTICE ACADEMIC AND LEARNING LEAD SWCCG RETIRED GPWSI DERMATOLOGY Dermatology Audit

2. Highlights and Numbers Total Number of records reviewed 608 4.7% no diagnosis (>95% had a stab..) 48% ? Cancer had cancer 9.5% Eczema and dermatitis 7.24 % Acne 2.3 % referred for solar keratoses (many more in consultant diagnosis)

4. Clinician and Numbers percentages Locum 50 No Info 3 Nurse Practitioner 4 Partner 404 Registrar 33 Salaried 114 Total 608 8.2% <1% 66% 5.4% 19% Referral Source

5. Change in Consultant diagnosis 112 Completely different diagnoses made 23 could only be made by excision 3 referred on We are not very good at; Seborrheic and actinic keratoses Granuloma annulare

11. Diagnosis in GP letter of BCC – often correct Diagnosis “unsure” – often seb k Eczema and psoriasis – can be difficult

12. GP diagnosis Consultant diagnosis Itch Chronic pruritus Fleshy lesion on chest Itch Itchy Bump Disease Fleshy Lesion on chest ???

14. Could anything else have been done in the practice to avoid referral? No 447 Yes 134 Unsure/Not completed 27 22% could have intervention to reduce referral

15. Treatments after hospital diagnosis Steroid creams emollients and more steroids…………..

16. Treatments after hospital diagnosis Oral antibiotics 45 Referred on 3 Rest as per diagnosis

17. Answer and numbers Percentage Yes171 Possibly48 Y+P219 No389 28% 8% 36% 64% Would extra expertise have helped?

18. Points for discussion Experience and availability of GPwSI Greater prevalence of GPs with Diploma in Practical Dermatology In practice referral screening service Dermatology Road Shows