Summary

Lancashire and South Cumbria Cancer Alliance (LSCCA) conducted research with stakeholders to identify opportunities to enhance referral practices for skin cancer and identify areas for improvement. This led to the development of short, GP educational videos focusing on dermatology conditions and skin cancer recognition. These have increased confidence in diagnosing dermatology conditions and skin cancer, resulting in a reduction in urgent suspected skin cancer referrals.

Method

In response to over 23,000 urgent suspected cancer (USC) referrals during 2022/23, LSCCA collaborated with Sanofi to reassess the USC skin pathway. The process began with a comprehensive analysis of the current referral practices and identification of key areas where GPs felt less confident in diagnosing skin conditions. Stakeholder engagement included surveys and interviews with primary care professionals to gather insights and identify specific educational needs. Based on this feedback, LSCCA developed four short educational videos covering critical topics: Skin Cancer Recognition, Identification of Seborrheic Dermatitis, Understanding Atopic Eczema – The Itch That Rashes, plus Identification of Actinic Keratosis. The videos were designed to be concise yet informative, providing clear visual aids and practical tips for GPs to enhance their diagnostic skills. To ensure maximum reach and engagement, the initiative included regional workshops and webinars where GPs could discuss the content with specialists and ask questions. These sessions were supplemented by follow-up materials and quizzes to reinforce learning. Additionally, an online platform was established to host the videos, allowing GPs to access the content at their convenience and participate in discussion forums to share experiences and solutions. The educational materials were disseminated through multiple channels, including email newsletters, professional networks and social media, to ensure widespread awareness and participation. Regular feedback was collected through surveys and informal discussions to continuously improve the content and delivery methods.

Results

Although difficult to attribute changes in referral outcomes for patients and early diagnosis impact directly to educational videos, a related audit where primary care had improved skin lesion recognition showed a reduction in USC referrals by 22% between October 2023 and January 2024 compared to the expected trajectory. Future audits will look at patient referral destinations (are these in line with NHSE 24/25 expectations?), community dermatology pathways impact (an increase in referrals expected), patient conversion rates to cancer (expected to increase as fewer low-risk referrals to USC pathways), diagnosis stage at presentation (has early diagnosis improved?) and overall patient outcomes two years after treatment.

Sustainability and Spread

The project was funded through a Sanofi Pharmaceuticals grant, minimising NHS costs. The educational videos have been shared widely within Lancashire and South Cumbria primary care and are available through Gateway C for national dissemination. Initial feedback has been positive, with GPs appreciating the clear guidance on identifying symptoms and differential diagnoses. More broadly, this project’s learning outcomes have been/will be shared locally to LSCCA integrated care board primary care networks and local medical councils via the LSCCA Skin Transformation Steering Group and LSCCA Skin Clinical Reference Group. In the North-West they will be shared with NHSE Regional Cancer Alliances and nationally via the NHSE cancer team quarterly reporting of successes and pathway improvement work.