Skin cancers and NHS waiting lists: An alternative model of service delivery.

Abstract

Title Skin cancers and NHS waiting lists: an alternative model of service delivery. Background The incidence of skin cancer (SC) is on an upward trajectory, leading to an increase in referral rates for assessment. The NHS is struggling to meet waiting time directives for SC and physician shortages have resulted in dermatology services relying heavily on the contribution of nurses. This doctoral study is based in a hospital offering traditional doctor-led clinics and seeks to scale the service offering through nurse-led clinics. Objective To evaluate what nurse-led models of service delivery for SC detection are in existence, whether they are effective, offer ‘Value Added’ care and provide assessment, treatment and/or education comparative to physician-led care. Methods The systematic review protocol was developed collaboratively with the British Dermatological Nursing Group president, a representative from patient and public involvement with lived experience of Melanoma SC, academic experts in dermatology nursing, and specialised dermatology clinicians. A comprehensive literature search was performed to locate both published and unpublished studies. MEDLINE complete, PubMed, Embase, CINAHL complete, Scopus, British Nursing Index, Latin American and Caribbean Health Sciences Literature, PsycINFO, Trip Medical Database, Cochrane, Web of Science, Google Scholar, and the website, Getting It Right First Time was searched. Grey literature was requested from international dermatology nursing organisations. Results We have identified at total of 5,245 papers of which 53 are currently undergoing full text review. Most papers appear of low quality and consist of service evaluations, audits and observational studies. Conclusion The outcomes from the systematic review will influence the co-creation of a nurse-led model of care for SC detection.