North London Partners in health and care

NCL suspected skin cancer 2WW teledermatology referral


During the pandemic, we have established a new 2WW teledermatology pathway for suspected skin cancer referrals across NCL. This is already an established pathway for routine teledermatology referrals being used by some practices within NCL.

The new pathway will help ensure face-to-face dermatology and GP consultations are only offered to those patients that need to be seen in person, to minimise the risk to patients and staff. It will also facilitate assessment of patients with possible skin cancer, many of whom are in shielded groups, or those who do not want to come to their practice to be examined for a suspicious skin lesion.

The pathway allows GPs to refer patients via e-RS (electronic record services) with a digital image/s of the suspicious skin lesion taken with a dermoscope, a smartphone or other camera. This is currently only available at Royal Free London and Whittington Health hospitals. 

A Royal Free or Whittington Health dermatologist will triage the referral using the information received on e-RS. They will then either send a management plan back to the referring GP which will to be delivered in primary care, or arrange to see the patient at a face-to-face appointment.

As part of the triaging process and to help make a decision the dermatologist may contact the patient via a telephone consultation or in the case of the Royal Free for video consultation.

There is also guidance available to support GPs to identify and triage patients with potential skin cancer by telephone, including using photographic images that are emailed by patients.

If it is not possible to obtain and send an electronic image of reasonable quality, and there are significant concerns about the suspicious skin lesion, GPs may still refer via the regular 2WW pathway.