This paper provides the Committee with an update on the North Kent Dermatology service following the contract award to DMC Healthcare in April 2019. This includes an overview of current performance and the next steps.
DMC Healthcare had taken on the contract for the North Kent Dermatology service during a period when the service had been struggling. In relation to the cancer pathway, performance against the two week wait target had been particularly poor during the final two months that Medway Foundation Trust had been the provider. DMC had inherited a significant backlog of patients waiting for appointments. The vast majority of this backlog had now been seen and the patients who had not yet been seen had been contacted. Work had been undertaken to make the dermatology service less fragile with review meetings between NHS Medway CCG and DMC Healthcare taking place monthly. Overall waiting times for non-urgent patients had been reduced and the number of complaints had reduced to minimal levels.
The volume of phone calls from patients had reduced and the two week wait target for urgent referrals was now being met. Full data reporting was now in place and tele-dermatology clinics were being provided. This enabled patients to receive a diagnosis from images and therefore to be diagnosed within 3 days, quicker than would otherwise be possible. 600 patients had gone through tele-diagnosis with 65% of these having been diagnosed from photos and discharged back to their GP.
Members of the Committee made comments and asked questions as follows:
Tele-diagnosis - A personal experience of the service, where it had not been possible for a tele diagnosis to be made, was highlighted and concern raised about the length of time it had then taken to see a consultant. DMC representatives said that there had been initial difficulties with quality of photos and that these had been addressed. There was a national shortage of dermatologists. Work continued to reduce the number of patients waiting. Reducing waits was challenging in the context of the high number of referrals received since DMC had taken on the Dermatology Service. Over the next few months it was anticipated that patient waiting times for appointments would be reduced.
Appointment Waiting Times – In response to a question about how waiting figures were calculated, it was reiterated that the two week wait performance had improved. Data for November 2019 showed that 95.8% of these referrals were seen within two weeks. 14 patients were not seen within 14 days. All of these patients had been offered an appointment within the 14 day timeframe but had been unable to attend. These patients were rebooked for the next available slot.
Patient Engagement – Feedback was requested on the DMC Healthcare facilitated patient engagement event held on 3 December. The event had taken place in Gillingham with eight attendees. This was disappointing given that the event had taken place in the evening and had been promoted. A presentation had been given on the issues facing the Dermatology Service and how these had been overcome. More engaging methods of obtaining patient feedback were being established.
Referral Statistics – The report stated that the service had received over 10,500 new referrals since April 2019 with 83% of patients waiting less than 18 weeks and 50% of all patients referred having had an appointment. It was questioned what had happened to the patients not seen. The Committee was advised that DMC had focused on ensuring that the cancer pathway was working effectively. It had faced administrative difficulties as it had been provided no data in relation to some of the patients transferred and it had not been known whether patients had previously been sent an appointment by Medway Foundation Trust. A review had been undertaken of all the transferred patients with two thirds of the backlog having been resolved. The remaining patients now had a plan in place. These were all routine rather than urgent cases.
The Committee noted and commented on the report and agreed that an update on the Dermatology Service be added to the Work Programme for consideration at a future meeting.