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GPs told to take pictures of suspicious moles on their PHONES before sending patients for referrals

  • Scheme applies to GPs working in four local areas in North East England
  • Specialists will review photos and offer a urgent or routine appointment
  • Brains behind the project claim they receive 150 urgent referrals a week 

GPs have been told to take pictures of suspicious moles on their phones before referring patients to a skin-cancer specialist.

Under new plans, general practitioners working across four areas in North East England will have to take three photographs on their mobiles, which then get sent to a consultant for review.

The specialist may then offer the patient an urgent or routine appointment, or decide there is no cause for concern.

The new system comes after the clinical commissioning groups behind the project claimed they received around 150 urgent referrals every week, with most of the patients not having cancer.

GPs have been told to take pictures of moles on their phones before referring patients to a specialist. The scheme has been rolled out in four areas of North East England (stock)

Melanoma is the most deadly form of skin cancer due to it being the most likely to spread to other organs. 

The most common sign of the disease is the appearance of a new mole or a change to an existing blemish, such as it growing, becoming irregular in shape or bleeding. 

In 2015, 15,906 new cases of melanoma were diagnosed in the UK, Cancer Research UK statistics show.

And in the US, around 96,480 new cases are expected to be diagnosed this year, according to the American Cancer Society.  

The new scheme is said to help specialists rank patients according to severity, with those more in need being given an appointment sooner. 

It should also stop patients being seen unnecessarily. GPs can still request patients see a specialist even if a consultant has given them the ‘all clear’. 

NHS North Durham CCG; NHS Durham Dales; NHS Easington and Sedgefield CCG; and Darlington NHS Foundation Trust are leading the project.

But the scheme is not without its critics.

One GP told Pulse: ‘Our CCG has decided to further increase our workload with this additional step before an urgent skin cancer referral can be made.

‘As well as adding to the workload of already overstretched GPs, I have concerns that it may potentially delay skin cancer diagnoses by making the referral process unnecessarily bureaucratic. 

‘For instance, we have been told that if a photo is not uploaded within 24 hours of a referral having been made then it may well be rejected.’

However, Dr George Rae – chief executive of Newcastle and North Tyneside LMC – supports the move, providing there are no technological glitches.

He believes the process will speed up patient diagnoses, with those most at need getting seen sooner. 

Although Dr Rae admits mobile-phone images may not be clear enough to draw any accurate conclusions, the scheme requires doctors take the photo alongside a dermatoscope.

This is a handheld instrument that magnifies an area by up to ten times. Doctors routinely use dermatoscopes to examine the skin closely.   

NHS South Tyneside CCG is also thought to be considering the scheme, according to Pulse.

However, it is thought to have concerns the scheme will lead to longer GP appointments. And no funding is in place to support this extra workload. 

This issue is said to have been raised with the Local Medical Committees. 

A spokesperson for the CCGs said: ’Digital technology is used increasingly across the NHS and evidence indicates it improves patient experience. 

‘This particular technology is already being used successfully in other trusts.

’We have training and other support in place to help with the initial implementation and will be monitoring the programme. 

‘Our priority is to ensure patients receive the care they need in the most appropriate place and as soon as possible.’

WHAT IS MELANOMA AND HOW CAN YOU PREVENT IT?

Melanoma is the most dangerous form of skin cancer. It happens after the DNA in skin cells is damaged (typically due to harmful UV rays) and then not repaired so it triggers mutations that can form malignant tumors. 

The American Cancer Society estimates that more than 91,000 people will be diagnosed with melanoma in the US in 2018 and more than 9,000 are expected to die from it.

Around 15,900 new cases occur every year in the UK, with 2,285 Britons dying from the disease in 2016, according to Cancer Research UK statistics. 

Causes

  • Sun exposure: UV and UVB rays from the sun and tanning beds are harmful to the skin
  • Moles: The more moles you have, the greater the risk for getting melanoma 
  • Skin type: Fairer skin has a higher risk for getting melanoma
  • Hair color: Red heads are more at risk than others
  • Personal history: If you’ve had melanoma once, then you are more likely to get it again
  • Family history: If previous relatives have been diagnosed, then that increases your risk

Treatment 

  • Removal of the melanoma:

This can be done by removing the entire section of the tumor or by the surgeon removing the skin layer by layer. When a surgeon removes it layer by layer, this helps them figure out exactly where the cancer stops so they don’t have to remove more skin than is necessary. 

  • Skin grafting: 

The patient can decide to use a skin graft if the surgery has left behind discoloration or an indent. 

  • Immunotherapy, radiation treatment or chemotherapy: 

This is needed if the cancer reaches stage III or IV. That means that the cancerous cells have spread to the lymph nodes or other organs in the body. 

Prevention

  • Use sunscreen and do not burn
  • Avoid tanning outside and in beds 
  • Apply sunscreen 30 minutes before going outside
  • Keep newborns out of the sun
  • Examine your skin every month
  • See your physician every year for a skin exam 

 Source: Skin Cancer Foundation and American Cancer Society

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