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Care closer to home: Nurse-led dermatology clinic, Oakham

Posted on April 19, 2019

Lucy England is a Skin Cancer Nurse Specialist based at Leicester Royal Infirmary (LRI), but one afternoon a week she works from Rutland Memorial Hospital in Oakham, assessing and treating patients with suspected skin cancer.

“I see new patients referred on a routine basis (not a two week wait) where the GP suspects basal cell carcinoma – a low-grade, slow-growing skin cancer. In my clinic I assess and, where possible, give treatment. I also see patients for follow-up appointments, who’ve already had treatment at LRI. 

“This is so much more convenient for patients than going to the LRI, as they would have done previously. Many of my patients are quite elderly, so it’s really good that they don’t have to travel into Leicester and can avoid a much busier hospital environment. It’s a much easier experience for them and provides a service that’s much needed, closer to home.”

The referrals come directly to Lucy from GPs and, although she is only in Rutland one afternoon each week, she sees between 12 and 14 patients in that time. 

Lucy is currently the only Skin Cancer Nurse Specialist in LLR who offers this kind of community-based clinic. 

The Alliance would like to make it possible for more patients to be seen in the community, who don’t necessarily need to be seen by a consultant. Previously Dr Burd, Consultant Dermatologist, would have seen all of these patients and the waiting list would have been longer. Issues that can be safely managed out in the community allows more capacity in hospital clinics for patients on a two week wait, or with more complex cases which really require that level of expertise. 

Lucy added: “We have a busy clinic, with really good patient feedback - they feel reassured that I have clinical back-up from a doctor if it’s needed. As well as being more convenient, some of the patients need extra time that a doctor would not be able to offer, and this is something that patients really appreciate too.”

Rob Burd, Consultant Dermatologist, said: “Having the help and support of a skin cancer nurse for the Oakham service has been invaluable.  For the patients, from Rutland, East Leicestershire and Lincolnshire, to be able to access this specialist care closer to home has many advantages not least the fact that it is provided  in a calmer more friendly environment. Sr England is a very experienced nurse who is highly valued for the compassionate, holistic and pragmatic care that she provides.

“Ideally we would like to extend this service to more of our peripheral sites, particularly because skin cancer is predominantly a disease of the elderly who may find the travel into Leicester more arduous. Unfortunately the workload for the Leicester skin cancer team is growing at an alarming rate and we just do not have the staff to serve more sites at present. There has been recognition both locally and nationally that the dermatology service in particular does need to be resourced to meet this increasing demand, this, together with exploring new ways in working, may allow us to fulfil this vision of more locally provided services.”