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Lead GP slams plan for GP photo referrals for skin cancer

Scheme ‘implies doubt’ over GPs’ clinical judgement

Jo Carlowe

Wednesday, 10 April 2019

Senior GPs have lambasted plans that require GPs to photograph skin lesion before cancer referrals.

Under the scheme, clinical commissioning groups (CCGs) in the North East of England will require GPs to take three photographs using their mobile phone and a dermatoscope and submit these with skin referrals.


The consultant would then use the images to determine whether to offer an urgent appointment, routine appointment, or an alternative treatment plan.

However, the Royal College of General Practitioners, says the scheme “implies doubt” over GPs’ clinical judgement, and could cause delays.

Professor Helen Stokes-Lampard, RCGP chair, said: "Deaths from malignant melanoma, the most serious form of skin cancer, are increasing more than any other cancer, so identifying skin cancer at the most timely stage possible leads to better health outcomes and, potentially, saves lives.

"However, introducing this extra step to the process of urgent referrals implies doubt about GPs' clinical judgment and risks adding substantial delays to the process.

"It is vital that all new initiatives are piloted carefully and appropriately funded before roll-out to ensure patient safety and prevent significant adverse impact on GP workload.

"Unlike many other cancers, skin cancer is often visible, and better access to diagnostic tools like dermatoscopes in our practices, along with the training to use them, is welcome. GPs are already doing a good job of appropriately referring patients we suspect of having cancer, but we need proper resources if we are to continue to deliver the best possible care to all our patients, both now and in the future.”

The CCGs leading the project, NHS North Durham CCG; NHS Durham Dales, NHS Easington and Sedgefield CCG; and Darlington NHS Foundation Trust, told Pulse magazine that the move was a response to receiving about 150 referrals for urgent dermatology outpatient appointments every week, most of whom do not have cancer.

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