Getting under the skin of Melanoma follow-up; can resources be optimised?
whitepaper
The incidence of cancer has generally been on the rise throughout the world, due in part to the lifestyle of some populations as well as other contributing factors. As a result of the Covid-19 pandemic, we have observed an increased delay between initial diagnosis and treatment for many cancers.
Melanoma skin cancer is the 5th1 most frequently diagnosed cancer in the United Kingdom, and the 6th 1 and 5th1 most common for men and women respectively. Pre-pandemic, it was reported in 2019/20 that 25,219 finished consultant episodes for malignant melanoma were treated in secondary care, as either a day case or inpatient in that 12-month period. This figure had grown by 43%2 since 2015/16. Despite the increased trend in melanoma cases, the observed 40% reduction in GP capacity and hospital outpatient attendances created by Covid-19 resulted in fewer referrals in 2019-2020 than in the past. We now predict that the number of referrals will spike once the Covid-19 situation is brought under control, making the resource problem in dermatology even more unsustainable.
Currently, the NHS backlog of elective activity is 6.13 million, the highest since records began in August 2007. The reduction in capacity and the significant resource demands has left services stretched to breaking point. Innovative ideas leading to proven solutions are desperately needed to help achieve the recovery of the NHS and bring it back on track. As reported before the pandemic, the Royal College of Pathologists stated that 3%4 of the NHS Trusts felt they did not have enough resource to support the demand on pathology, triggering an increased need to outsource services. Our research showed that 22% of the NHS Trusts questioned said they are already outsourcing pathology services to third parties. In the last 12 months, the NHS declared a peak of 89,0005 job vacancies, the highest level since 2020/21. This represents 7% of the total employed population of the NHS and will only become more of an issue, as the full impact of Covid-19 on the health system here in England, is realised.
To fully understand the problem, it is essential to evaluate the current procedures and treatments offered by the NHS for patients with non-ulcerated melanoma skin cancers, in order to improve both the patient experience and the utilisation of NHS resources.
Efficiency in the system is crucial to releasing capacity and providing assurance regarding changes to clinical pathways. The NHS now has more motive and opportunity than ever before to make a change. Optimising its workforce and adopting innovative ways of operating to redesign pathways or incorporating new innovative technologies could help to accomplish this. The reader only has to think about the shift to tele-consultations, which went up from 850k to 5.2m3 (+513%) during the pandemic as an example of how implementing new technologies to create efficiencies led to changes in practice to benefit clinicians and patients.
The time has come to implement changes to support the NHS in this time of extreme need. Some changes may not be cost-savings or even cost-neutral, but will allow the NHS to fully optimise and enable optimal recovery. Changes need not be massive as many small changes will result in overall efficiencies. Ultimately there could be light at the end of the tunnel where change results in better medical care where it is needed and a reduction in resource wastage where it is not.
Download our White paper and see how the NHS could benefit from other ways of working in relation to Melanoma skin cancer.
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