Dr Keith Freeman, consultant dermatologist, explains how the Sunderland dermatology and minor surgery service diagnoses and manages patients with a range of skin conditions whose treatment does not require a hospital setting.
The service is run by South Tyneside NHS Foundation Trust and is delivered in a purpose-built primary care centre co-owned by Sunderland CCG and Sunderland City Council.
Services include: general dermatology, rapid access and nurse-led clinics, minor skin surgery, and a telephone advice line. An innovative feature is that professionals within the service are supported by the consultant dermatologist and nurse practitioner to work to the limits of their training and skills.
One of the biggest challenges to the service has been the fragmented nature of the NHS management structure, with too many middle-level managers who have ability to stop things but don't have the ability to progress things.
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