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Skin care concerns

Referral management centres are delaying diagnosis and treatment of complex skin diseases and causing patients to be seen by doctors lacking necessary training.

That is the view of Peter Lapsley, chief executive of the Skin Care Campaign, which promotes care for patients with skin diseases.

He said referral management schemes were mainly geared towards saving money by retaining patients in primary care instead of sending them to hospitals for expert advice.

'The schemes are also insulting to GPs, second-guessing their decisions,' Mr Lapsley wrote in the BMJ (20 January).'

They undermine the viability of secondary care dermatology and they remove any incentive for secondary care specialists to support or develop the role of the GP with a special interest in dermatology.'Mr Lapsley continued:

'But what is more alarming is that some PCTs are deliberately delaying outpatient appointments, refusing to fund routine paper referrals seen within eight weeks of the date of the referral letter.'

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