Lincolnshire Skin Cancer Services Improvement and Innovation Programme
by United Lincolnshire Hospitals NHS Trust
Lincolnshire is a rural county, with a population of around 800,000. It has one of the largest numbers of people with skin cancer in the East Midlands. The diagnosis and management of people with suspected cancer had become increasingly challenging for two main reasons. One was the difficulty in providing capacity for the year-on-year increase in the number of suspected skin cancer two week wait referrals without impacting on access to care for people with other skin problems, such as psoriasis and eczema. The second issue was a lack of any specialist nursing support for patients diagnosed with skin cancer. This was highlighted by the Getting It Right First Time (GIRFT) review in 2018, and by the East Midlands Cancer Alliance in 2019. Innovative community and hospital clinics were developed to address these challenges. These Spot and Rapid Access clinics focused on the initial review of people with suspected skin cancer, providing a more efficient service to patients with suspicious skin lesions. Alongside the clinics, a new model of care was introduced to support patients diagnosed with skin cancer. This Skin-XL project incorporated a mix of site-based skin cancer support nurses, specialist skin cancer nurses and nurse surgeons.
"The judges felt that the multi-professional teamworking demonstrated by United Lincolnshire Hospitals NHS Trust’s project meant it warranted its place as category winner. The expected improvements in care delivery will affect a large patient population as well as reflecting the national imperatives for role development."
Holistically Transforming the Management of Delusional Infestation in Our Psychodermatology MDT Service
by Bart’s Health London
The Psychodermatology service at Bart’s Health has transformed the way in which patients with Delusional Infestation (DI) are managed. DI is a rare, primary psychiatric condition, that presents primarily to dermatologists because of its cutaneous nature. Patients believe they have living organisms, or non-living objects, emanating from their skin. There is a high disease burden and low social functioning, making this a very debilitating condition with which to live. Screening blood and urine tests were introduced to investigate the primary and secondary causes of DI. A serum prolactin monitoring system was used to ascertain and monitor treatment adherence. In addition, a patient information leaflet was developed for people with DI. This is being refined based on patient feedback, which has been positive to date. A database of over 1000 patients has been compiled, which has enabled Bart’s Health to evaluate the outcomes of the patients seen and conduct further research into this cohort of patients. Guidelines for managing DI, led by Dr Ahmed, were published as a Cochrane review in 2019.
"Bart’s Health London’s project was awarded a high commendation in recognition of the pioneering work described in the application in caring for people with delusional parasitosis."