nurse with male patient

Designing a sustainable integrated dermatology service with Somerset ICS

We supported an evolving ICS to develop an integrated dermatology service that is financially and clinically sustainable.


Dermatology services in Somerset are not set up optimally to meet current and future demand. This results in many patients requiring assessment and treatment having to travel outside of the county. The rurality of Somerset and the older demographic, together with pockets of significant deprivation and large health inequalities add further challenges.

SCW was asked to work with the Somerset Dermatology Project Group to conduct a co-created dermatology service review. The following priorities were identified:

  • To provide an equitable, financially and clinically sustainable dermatology service across Somerset
  • Reduce reliance on out-of-county provision and spend
  • Minimise the distance patients travel for Dermatology Services
  • Secure robust support to the GP with Specialist Interest (GPwSI)’s and expansion of community provision
  • Increase utilisation of Advice and Guidance and Teledermatology
  • Improve performance (particularly suspected cancer two-week wait)  


We delivered:

  • Patient pathway mapping and development of re-design options
  • Detailed options appraisal for a new Teledermatology system
  • Dermatology workforce solutions for Triage and Advice & Guidance 
  • Education and training solutions to ensure accreditation and CPD activities can be undertaken
  • Thematic review of patient feedback and an equality impact assessment


There is now a greater understanding of the best ways to deliver dermatology services within Somerset, utilising the existing workforce. We provided innovative ideas for securing additional workforce through training and supervision packages to future-proof sustainable services. This includes plans for completing sufficient activity for CPD and re-accreditation requirements of the current workforce. 

Further, we supplied planning for full-service re-design, including procuring a Teledermatology system for all non-two-week wait patients. This will reduce the geographical variation in terms of travel distances and waiting times for accessing specialist dermatology assessment.

Working with the SCW team was great from start to finish. They integrated with the system project team and carried out discrete pieces of work quickly and to a high standard. SCW also brings the experience of working on similar projects elsewhere and share learning and best practice - Carmen Chadwick-Cox, Deputy Director of Commissioning, Planned Care, Somerset CCG

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