Challenge

Outpatient services were impacted heavily by the pandemic, with patients themselves delaying making GP appointments. As restrictions began to lift and appointments increase, the Ipswich Hospital Dermatology Service was experiencing significant pressure on the 2WW pathway due to the sheer volume of cases.

Of the 10,000 urgent referrals reviewed by consultants in person, only 40% were subsequently kept on the 2WW pathway. The remaining 60% were reduced in severity to routine referrals. Finding a way to separate these groups ahead of hospital attendance would therefore help to identify the more urgent cases.

They asked the Vantage team to develop a robust solution that would enable earlier triage, keep the final referral decision with the GP and stay compliant with the Cancer Waiting Times Guidance.

Solution

To ensure the solution met the national requirements for triaging 2WW cases, the team worked in close collaboration with the CCG’s Teledermatology Steering Group, including a GP, a lead consultant dermatologist, operational and IT staff and transformation lead to develop a new triage process, enabled by the integration of Rego with eRS:

• GPs making 2WW referrals on the eRS system can now upload high-quality images of lesions for review by consultant dermatologists using Rego;
• Once reviewed, any suggestion to downgrade a case to a routine referral instantly alerts the relevant GP, who can then decide to accept or reject the advice;
• Cases which are triaged for a 2WW appointment are automatically booked in to the next available appointment at ESNEFT. If no response is received by the GP within 7 days, the patient would remain on the 2WW pathway.