COVID-19 led to drastic reductions in non-urgent medical visits and cancer care. Some institutions saw 15% of pre-pandemic cutaneous malignancy patient numbers1. In the UK, skin cancer patients may be sent to Dermatology or Plastic Surgery. The COVID patient backlog means that new strategies are required to decrease wait times and administrative costs but increase patient outcomes. We reviewed if combined speciality Plastic Surgery and Dermatology 2 week-wait clinics can reduce wait times and overall attendances to hospital when compared to the single speciality 2 week-wait skin cancer clinics and assess the cost implications of this. A retrospective analysis comparing individual speciality Plastic surgery (PS) and Dermatology (DM) 2 week-wait skin cancer against combined Dermatology and Plastic surgery (DP) clinics across the same 3-month period in 2018 and 2019 at a single UK tertiary centre. 283 patients were reviewed in same 3-month period in 2018 and 2019 (PS n=53, DM n=158, PD n=72). PD clinics reviewed the greatest number of patients per clinic (Averages: PD n=18.0, PS n=8.8, DM n=12.1). Average trips to hospital decreased from 1.84 to 1.51. Patients booked for surgical procedures decreased from 48.3% to 41.6%. Those needing excisional biopsies 42.9% underwent the procedure on the same day as initial assessment in PD clinics compared to 18.0% in PS/DM clinics. Referral to surgery time decreased from 67.7days to 50.4 days, and tertiary assessment to surgery from 49.5days to 36.9days. Of note, referral to surgery time for possible squamous cell carcinoma or melanoma decreased from 37.8 to 29.9 days and tertiary assessment to surgery from 21.6days to 16.4days
Combined Dermatology and Plastic Surgery clinics reduce trips to hospital, time from referral to review and surgery, and reduce numbers of patients requiring operations. This has significant cost saving implications and optimising cancer care.

ESDRLB019 - In the COVID aftermath, using a collaborative approach to improve waiting times for skin cancer patients

50th Annual Meeting of the European Society for Dermatological Research. VIRTUAL MEETING