Teledermatology Rapid Access Clinic -Chelsea and Westminster

What do I need to do?

Before you attend you will receive a text message with a link for you to click. Here you will be asked to add some personal details (name, date of birth and hospital/NHS number) for identification purposes and answer some questions about your medical history. As part of this you will be informed that photographs of your skin will be taken and used for your clinical care. Separately you can also consent for your images and data to be used for other reasons such as service improvement, research, teaching or commercial purposes. You may withdraw your consent at any time by contacting the dermatology department without it affecting your treatment or future care. Clinical images which have been used to make a clinical decision cannot be deleted as they form part of your medical record. This process should take less than 15 minutes. If you have difficulty completing the information, please don’t worry as the photographer can help you when you attend the appointment.

What happens next?

When you attend your appointment a specially trained medical photographer will take photographs of the skin lesion identified by your GP with a professional digital camera and a camera phone. They will photograph a general locating view of the area, a close-up view and then attach a specialist ‘dermatoscope’ lens that is placed lightly on the skin to provide a highly detailed image of the lesion. If you have any questions about the photography, please do not hesitate to ask. Please ensure that the lesion is not covered with any make-up. Depending on where the lesion is you might be asked to remove jewellery or certain items of clothing to gain a better view and you can request a chaperone if this makes you feel more comfortable.

At your appointment, a computer programme called DERM (created by Skin Analytics) will be used. DERM works by electronically assessing a detailed image of your lesion that is taken with a special lens called a dermatoscope. DERM then provides a suspected diagnosis and what the most appropriate next steps should be for your care. If DERM determines that all of the lesions imaged are benign (harmless) and it is unlikely that you have skin cancer you will be discharged and sent a letter confirming the outcome of your appointment with further details. In all other cases, the images and medical history will be reviewed by a Chelsea and Westminster NHS Foundation Trust dermatologist (a specialist skin doctor) who will decide on the next steps for your care. You can find out more about DERM here https://skin-analytics.com/derm/patients/ (please copy and paste the link into your browser if it does not work).

Once complete this information is securely transferred and stored in your electronic medical record.

Please note: you will not have a face to face appointment with a doctor at this appointment & we will only assess the specific lesion identified by your GP. If you are concerned about other lesions or skin problems please seek advice from your GP.

What happens after my photographs have been reviewed? 

You may be:

• Offered reassurance that no further tests or treatment are required (discharged)
• Booked for a routine follow-up appointment (usually within 3-6 months), this may be for repeat photographs or face-to-face in clinic.
• Booked for a biopsy (skin sample) or removal of the skin lesion
• Booked for an urgent face-to-face appointment with a dermatologist or other specialist

If you require non-urgent treatment we may contact your GP to ask them to arrange this.

Does an urgent follow up appointment mean I have cancer?

We could ask you to come back urgently for a number of reasons. Urgent appointments will generally be seen within a few weeks and so there should not be a long wait.

What happens if the photograph isn’t conclusive?

Not all lesions are suitable for teledermatology or DERM assessment, if there is any uncertainty you will be called back urgently for a Dermatologist review.

How will I find out the outcome?

You should receive a letter (electronically or by post) within three weeks of your appointment. If you don’t receive this please contact the teledermatology team on:

T: 0207 3153061

E: chelwest.tdadmin@nhs.net

How is my data used?

• Your data and images will be processed by both Chelsea and Westminster Hospital NHS Foundation Trust and Skin Analytics Ltd in order to assess your skin lesion(s). Chelsea and Westminster Hospital NHS Foundation Trust will be the data controllers and Skin Analytics the processors acting on the Trust’s instructions.
• Your data and images, as well as the final diagnoses for your lesions, may be reviewed by Chelsea and Westminster Hospital NHS Foundation Trust and Skin Analytics Ltd for other limited purposes e.g. to confirm the service is performing as expected. For this use, both Chelsea and Westminster Hospital NHS Foundation Trust and Skin Analytics Ltd will be independent controllers.
• Please refer to https://www.chelwest.nhs.uk/about-us/organisation/our-way-of-working/how-we-use-your-information, and https://skin-analytics.com/privacy-policy/

Is it safe?

No person or computer is completely accurate and skin problems can change over time. However, Chelsea and Westminster Hospital has been using DERM for over 2 years and assessed over 10,000 patients. DERM has demonstrated a performance at least as good as that of face-to-face dermatologist assessments. Eight out of ten patients would recommend the service to their friends and family.

If your GP has referred more than 3 skin lesions, the lesion is on genital skin or you are unable to consent to treatment for example due to learning difficulties or dementia, please inform the urgent appointments team on:

T: 0203 315 4043

E: chelwest.cw2ww-referrals@nhs.net