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Skin. Veronique Bataille Consultant Dermatologist, WHHT NSSG Chair. Key Features of Service. Dermatology services at West Herts, Luton and East and North with critical mass of consultants dermatologists especially in West of the patch

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Veronique Bataille

Consultant Dermatologist, WHHT

NSSG Chair

Key features of service
Key Features of Service

Dermatology services at West Herts, Luton and East and North with critical mass of consultants dermatologists especially in West of the patch

Surgical services from plastic surgery hub at the Lister. Sentinel node service starting locally. Royal Free providing surgery clinics at Watford

Oncology at MVCN with one of the most active department in the country for melanoma trials

Radiotherapy access for SCCs and BCCs improved dramatically with appointment of Dr Corner

Community services with accredited Gpwsi for low risk BCCs and pre-cancerous skin lesions

2 ww

Most 2 ww seen by dermatologists in Herts.

Many 2 ww are not suspected SCCs and MMs

Workload is significant with over 3300 referrals in Herts per year

Bottle neck for surgery with breaches

Access to MVCC for radiotherapy is difficult for elderly patients

Key achievements
Key Achievements

  • Centralised surgical services at Lister in Dec.2009 and agreed local pathways

  • Merged the 2 MDTs at West Herts

  • Produced Skin Film for GP education and resource kit in development

  • Carried out regular audits in Melanoma and SCC

  • New immuno-compromised clinic started at the Lister

  • Radiotherapy services more accessible at MVCC

  • National Patient Survivorship Project- Questionnaire has been piloted on a small number of SCC and MM patients

Key achievements 2
Key Achievements (2)

  • Successful tele-dermatology pilot in West Herts: 50% of 2 ww teledermatology referrals not suitable for 2 ww.

  • Patient Information Prescriptions (PIP) have been implemented across the network.

  • Agreement of a network wide pathology MDS and standardised path. reporting across MVCN but support by Trusts for collection of data during MDT still needed

  • Oncology at MVCN offering entry into major melanoma therapeutic trials with gene therapy and immunotherapy

Some challenges
Some Challenges

  • Dermatology and plastics provision not provided evenly across Network

  • Maintaining minimum Lymph node dissections for both plastic surgeons

  • Some lymphadenectomies being carried out at Royal Free following SNB rather than repatriated

  • Historical RF Plastics clinic at MVCC

Other challenges
Other Challenges

  • Data collection for COSD

  • Cross site working for CNS (WHHT)

  • Oncology cover at WHHT and L&D

  • L&D dermatology capacity for 2WW referrals and decreased capacity for plastic surgery procedures.

Priorities for the future
Priorities for the Future

  • Network wide teledermatology service

  • Set up local Sentinel Node Biopsy service

  • Explore local B cell and T cell lymphoma service with Dr Corner

  • Complete data collection of the COSD

  • Implement outcomes of review of network wide dermatology/plastics provision


  • Overall major progress considering the piece meal delivery of skin cancer services in Herts in mid 2000s

  • MDTs and SSMDTs running well

  • CNS presence very valued

  • Advanced melanoma patients receive top treatment with multi-disciplinary approach