Asking GPs to take pictures of lesions before skin cancer referrals ‘implies doubt’ in their clinical judgement, the RCGP has warned.
Under the new system, GPs will have to take three photographs with their mobile phones and a dermatoscope and submit those with the referral. A consultant will then review the pictures and offer either an urgent or routine appointment, or an alternative treatment plan.
GPs have expressed concerns about the proposal, saying it could result in longer GP appointments as well as making GPs liable should dermatology decline to see these patients.
RCGP chair Professor Helen Stokes-Lampard said the requirement for GPs to submit photographs in addition to the existing steps ‘implies doubt’ about the GP’s clinical judgement and could substantially delay the process.
She said: ‘Deaths from malignant melanoma, the most serious form of skin cancer, are increasing more than any other cancer, so identifying skin cancer at the most timely stage possible leads to better health outcomes and, potentially, saves lives.
‘However, introducing this extra step to the process of urgent referrals implies doubt about GPs’ clinical judgment and risks adding substantial delays to the process.
‘It is vital that all new initiatives are piloted carefully and appropriately funded before roll-out to ensure patient safety and prevent significant adverse impact on GP workload.’
Dr Stokes-Lampard added that skin cancer differs from other cancers as it is ‘often visible’.
She said: ‘Unlike many other cancers, skin cancer is often visible, and better access to diagnostic tools like dermatoscopes in our practices, along with the training to use them, is welcome.
‘GPs are already doing a good job of appropriately referring patients we suspect of having cancer, but we need proper resources if we are to continue to deliver the best possible care to all our patients, both now and in the future.’
