Chamber and committees

A clinical refresh of the Scottish Referral Guidelines for Suspected Cancer has been completed with revised guidance published in January 2019. The Guidelines support primary care clinicians in ensuring those with symptoms suspicious of cancer are put on the right pathway at the right time, including possible skin cancers.

In December 2021, the Scottish Government published a refreshed Framework for Effective Cancer Management. This Framework provides NHS Cancer Teams with the tools to effectively manage USC patients from the point of referral to first treatment to improve patient experience and cancer waiting times. Tailored support will be provided to all NHS Boards to ensure the eight key elements are embedded, where relevant, across cancer pathways and specialties, including dermatology.

The Centre for Sustainable Delivery (CfSD) is working with a number of Health Boards to implement the Digital Dermatology app, which allows patients to interact with a clinician at a time convenient to them, without having to attend hospital. This will support dermatology teams in conducting more virtual appointments. CfSD also supports a Dermatology Pathways app and website which provides clinically validated pathway information to GPs and other health professionals for many of the most common skin conditions, with the aim of supporting access for patients who most need treatment in the most appropriate care setting. As part of this, CfSD is working with the British Association of Dermatologists to increase the number of pathways covered by this approach.

In Scotland, NHS Forth Valley is hosting a national project to support early diagnosis of skin cancer supported by digitalisation, the use of high-quality images, and machine learning. The project is called 25 by 25 - diagnosing cancer within 25 minutes by 2025. Industry, academics, and NHS are collaborating to rapidly innovate to create AI solutions in skin cancer.

This work is supported through the Scottish Health Industry Partnership and linked to the Health and Social Care and Wellbeing Programme. It takes the form of a number of challenges where partners innovate to find solutions to preparing images, creating AI learning environments, and real world Test Beds to try out new approaches in primary care with Consultant Dermatologist support.

The Scottish Government has invested in the Detect Cancer Early programme in this area, has committed to investing in an AI Hub, and has prioritised the 25 by 25 programme for innovation investment in 2022.

This will enable AI innovation in the form of AI enabled triage, diagnostics, and treatment decision making support for Clinicians.

It is for individual NHS Boards to decide which services they make available based on national and local priorities and the needs of their resident populations.

There are no plans to introduce protected learning time at present. It is a decision for employers to allow staff time to study for additional qualifications.

To support delivery of the Community Pharmacy First Plus service, Community Pharmacist contractors receive backfill (up to £5750) to release community pharmacists to undertake their IP qualification (5 days face to face teaching + 12 days Period of Learning in Practice), clinical skills training (4 days) and also access to a maximum of 3 sessions at a CCC Teach and Treat Training Hub (backfill up to £750).

The Centre for Sustainable Delivery (CfSD) (and prior to this the Modernising Patient Pathways Programme within Scottish Government), have supported the rollout of the Digital Dermatology Appointment (DDA) system. This platform allows patients to interact with dermatologists by answering a series of questions and uploading images of their skin condition for the clinician to review. This system is used for both new and return patients. The system was offered for rollout to all Health Boards during COVID and to date is live in five Health Boards, with over 4000 patients having appointments this way.

In addition, the CfSD is actively promoting Active Clinical Referral Triage in Dermatology and encouraging the use of images to support this where this can be done safely. We are currently engaged in a piece of work to understand the use of images in referral pathways across all Scottish Health Boards and the output of this will support key work in 2022 to increase the use of images to support timely access to Dermatology care.

The Scottish Government has embraced artificial intelligence (AI) as a transformational technology for public good. We were the first UK country to establish an AI Strategy which set out our ambition for Scotland to become a global exemplar in the ethical and innovative deployment of AI.

As part of the Recovery Plans for the NHS, social care and the economy, the Government will support innovation in health care delivery and the adoption of AI solutions into use. Accelerating the adoption of new technologies that support improved access to healthcare, such as the use of artificial intelligence, will be integral to the recovery of NHS services, and there are a range of partner organisations that are central to this work, including the new national Centre for Sustainable Delivery.

All NHS Boards across Scotland have the option of referring patients to the NHS Centre for Integrative Care (CIC) for services not available locally.

It is for individual NHS Boards to decide what complementary and alternative medicines/therapies they make available based on the needs of their resident populations and in line with national guidance.

The CIC is a facility owned and operated by NHS Greater Glasgow and Clyde (NHS GGC), offering people with long term conditions a range of services, including complementary, holistic and homeopathic treatments. It is the responsibility of NHS GGC to manage access to their services.

Our NHS workforce, across all specialties and care settings, have been remarkable throughout the pandemic. We are deeply grateful for their continued courage, commitment and professionalism.

This year we have made £12 million available to support the wellbeing of our workforce including across primary and social care services.

We are continuing to develop the National Wellbeing Hub, a 24/7 National Wellbeing Helpline, confidential mental health treatment through the Workforce Specialist Service and funding for additional local psychological support. We are also providing further support for practical measures to aid rest and recuperation alongside additional resources including Coaching for Wellbeing and grief and bereavement support.

The Centre for Sustainable Delivery (CfSD) is working with a number of Health Boards to implement the Digital Dermatology app, which allows patients to interact with a clinician at a time convenient to them, without having to attend hospital. This will support dermatology teams in conducting more virtual appointments.

The Centre for Sustainable Delivery (CfSD) is working collaboratively with the Dermatology AI Consortium championing Community Local Image Centres (CLICs) to improving the capture of images as part of the dermatology pathway. The idea is relatively new and the CLIC model is still in development. The consortium will be developing the operating model and evidence base to show their benefit. CfSD awaits the outcome of this with interest.

It should be noted that the Consortium is also considering other approaches to image acquisition to support dermatology referral – most notably increasing the ease and quality of image acquisition in Primary Care. It is unlikely that a one-size-fits all will suit the varied geography of NHS Boards and therefore CfSD is working to understand the current pathway arrangements in all Boards to support image acquisition prior to Secondary Care.