North Norfolk Primary Care (NNPC) Case Study

Delivering high impact interventions at scale: Teledermatology

The Challenge

There was a significant challenge in recruiting qualified clinicians to Norfolk as it can be perceived as an area to complete, rather than commence a career. This coupled with a marked increase in dermatology referrals meant that patients were waiting well over 18 weeks for a routine dermatology appointment.

The Solution

Xyla was called upon by North Norfolk Primary Care (NNPC), to support the transformation of the services and offer an alternative and innovative pathway that:

• Provides a capacity solution to ‘decompress’ current pressures in dermatology across the Norfolk & Waveney System.
• Develops and operates, in partnership with ‘new’ Primary Care organisations (e.g. PCNs) and existing Acute Hospital Services, a dermatology pathway that is highly accessible and appropriately rooted in Primary Care.
• Enables local services to sustainably deliver the revised pathway beyond the pilot phase.

Over several months, our senior managers and lead clinician worked very closely with the NNPC, Norfolk & Waveney CCG and key stakeholders from the acute hospitals in Norfolk to design the service. As the chosen delivery partner to the NNPC for this innovative service, we produced key documents that were required to ensure the success of the service. These included teledermatology guides for primary care referrers and patients, dermoscopy guidelines, teledermatology consent forms and many other learning resources.

The Outcomes

Demand management

Our clinicians provide enhanced advice and guidance service by producing a detailed management plan for each GP.

• From January 2021 to mid-April 2021, we used this model to re-direct 81% of cases away from secondary care.
• KPI: >60% reduction in the number of patients requiring onward referrals to secondary care

Shorter waiting times

Our clinicians receive referrals and images within the technology platform that is interoperable with all Primary Care patient management systems. Referrals and images are reviewed, and a detailed patient letter is produced for the GP for all patient outcomes.

• KPI: 100% achieved in reviewing and completing Advice and Guidance referrals within 24 hours

GP Feedback

“we were super excited to use it for the first time and brilliant to already have a quick response.”

Practice manager, Norfolk

I had a response back form the consultation in 49mins. Outcome was ‘Harmless Lesion. Discharged back to GP.’ The patient avoided the waiting list.”

Referring clinician, Norfolk