Dermatology

Each year one in four of the population consults a GP with a skin condition. On average a GP will have 630 consultations per year that relate to a skin condition which makes skin conditions the commonest reason for patients to visit GPs with a new problem.

Dermatology Referral and Management Pathways

The Dermatology Referral and Management Pathways have been developed for the most common skin disorders presenting in Primary Care. These pathways cover over 95% of skin problems seen in General Practice as well as those frequently referred to Secondary Care. GPs that have used these guidelines have found them helpful and they can provide an excellent teaching resource for GP Registrars. The pathways can also offer a useful source of information for patients, however, it should be noted that the pathways provided here are not intended to provide a comprehensive overview of all treatments used in Secondary Care.

These pathways were originally published in 2005 by the Dermatology Pathways Development Group for the Centre for Change and Innovation (CCI) and have been updated by the Dermatology Task and Finish Group for 18 Weeks Referral to Treatment.

Pathways

Slide Set

All of the above pathways are contained within a powerpoint slide set which can be downloaded as a training resource:
Dermatology Referral and Management Pathways [PPT - 16Mb][Added 22 August 2011]

Management of Skin Disorders

Much of the management of chronic skin disorders can be undertaken in a Primary Care setting. A range of the members of the Primary Care team may be involved in the delivery and monitoring of care. Patients can also mange their own care, with the support of patient education material. Where there are difficulties with diagnosis, a specialist referral to Secondary Care will be needed before an appropriate management plan can be made.

In a small proportion of cases, treatment is best delivered in Secondary Care. This includes hospital-based treatments such as phototherapy, treatment of acute dermatoses which requires specialised dressing techniques and the management of skin cancers.

Formulary Choices

The drug choices in the Dermatology pathways are generic however a few extemporaneous preparations are listed. The pathways should be followed in conjunction with local formularies and guidance on extemporaneous preparations.

Development of Dermatology Patient Pathways

Dermatology Patient Pathways were originally developed in 2005 by the Centre for Change and Innovation (CCI) and updated in 2009. In 2010, under the auspices of the Dermatology Task and Finish Group, the pathways were reviewed and redesigned. This review was carried out by multidisciplinary group drawn from across Scotland.

The group, which included staff from Primary and Secondary care, developed these pathways to make certain that patients receive the most appropriate treatment for their condition. Following these pathways helps to ensure that the optimum treatment is delivered in Primary Care before a referral to Secondary Care is considered. By doing so we can help ensure that we are providing the quickest possible service for all patients with a skin condition.

SIGN Guidelines

The Scottish Intercollegiate Guidelines Network (SIGN) develops evidence based clinical practice guidelines for NHSScotland. SIGN guidelines are derived from a systematic review of the scientific literature and are designed as a vehicle for accelerating the translation of new knowledge into action to meet our aim of reducing variations in practice, and improving patient-important outcomes. The SIGN guidelines for skin conditions should be read in conjunction with the Dermatology pathways: www.sign.ac.uk/guidelines/published/index.html

Updated 22 August 2011.