Dermatology Audit VERONICA WILKIE GP CORBETT MEDICAL PRACTICE

Dermatology Audit VERONICA WILKIE GP CORBETT MEDICAL PRACTICE ACADEMIC AND LEARNING LEAD SWCCG RETIRED GPWSI DERMATOLOGY

Highlights and Numbers Total Number of records reviewed 608 4. 7% no diagnosis (>95% had a stab. . ) 48% ? Cancer had cancer 9. 5% Eczema and dermatitis 7. 24 % Acne � 2. 3 % referred for solar keratoses (many more in consultant diagnosis)

Referral Source Clinician and Numbers percentages �Locum 50 � 8. 2% �No Info 3 �<1% �Nurse Practitioner 4 �Partner 404 �Registrar 33 �Salaried 114 �Total 608 �<1% � 66% � 5. 4% � 19%

Change in Consultant diagnosis � 112 Completely different �We are not very good at; diagnoses made �Seborrheic and actinic � 23 could only be made by keratoses excision �Granuloma annulare � 3 referred on

�Diagnosis in GP letter of BCC – often correct �Diagnosis “unsure” – often seb k �Eczema and psoriasis – can be difficult

? ? ? GP diagnosis Consultant diagnosis �Itch �Chronic pruritus �Itchy Bump Disease �Fleshy lesion on chest �Fleshy Lesion on chest

Could anything else have been done in the practice to avoid referral? �No 447 �Yes 134 �Unsure/Not completed 27 � 22% could have intervention to reduce referral

Treatments after hospital diagnosis �Steroid creams emollients and more steroids…………. .

Treatments after hospital diagnosis �Oral antibiotics 45 �Referred on 3 �Rest as per diagnosis

Would extra expertise have helped? Answer and numbers Percentage �Yes 171 � 28% �Possibly 48 � 8% �Y+P 219 � 36% �No 389 � 64%

Points for discussion �Experience and availability of GPw. SI �Greater prevalence of GPs with Diploma in Practical Dermatology �In practice referral screening service �Dermatology Road Shows