Description of specialty
There are over 2,000 recognised skin disorders, and according to the Office for National Statistics mortality data, approximately 4,700 deaths occurred in England and Wales from skin diseases in 2015, including 2,876 deaths from malignant melanoma and neoplasm of the skin. Dermatology services are predominantly provided in an outpatient setting, with outpatient referrals rising steadily year on year. According to HSCIC hospital outpatient activity, 2014/15 saw an increase of 175,238 outpatient attendances totalling 3,196,398 (979,296 first attendances and 2,206,911 follow‑up attendances). NHS England cancer waiting times for 2015/16 show that there were 332,272 patients referred with suspected skin cancer, with 93.9% of them seen at 14 days.
Secondary and tertiary consultant-led services provide routine, urgent, 2-week wait and admitted care. Both tiers of service provide care to skin cancer, adult and paediatric patients, with support from outpatient and admitted care services.
Care is carried out most efficiently using a hospital-based multidisciplinary team, with associate specialists and specialty grade doctors led by a consultant dermatologist. Dermatologists are the only experienced, trained and accredited specialists in the diagnosis and management of skin, hair and nail diseases in adults and children. Trained dermatology nurses, clinical nurse specialists and cancer nurse specialists are also integral to dermatology services, providing treatment, assistance and advice to patients and clinicians. The service also works across other specialties, with dermatologists providing treatment and additional input into patient care.