Dermatology Services for Kent and Medway Integrated Care Board

The requirements of the service is a consultant-led (but not exclusively consultant delivered) Levels 1-4 service supported by a multi-disciplinary team which will manage a range of dermatological conditions. The descriptions for Levels 1 – 4 are as follows: Level 1 Self-Care - People with skin conditions who manage their conditions themselves should be supported with high-quality service user information and input from suitably trained nurses, service user support groups and community pharmacists. Ideally service users presenting with conditions that could be managed with self-care should be referred to their local community pharmacy and be supported to self-manage their condition. Community pharmacists are able to advise on a range of common skin conditions, included but not limited to allergic rashes, dry skin conditions such as eczema, minor skin infections, warts and verrucae. The new service will be expected to work with Primary Care and service users to develop a programme of education around low level management of skin conditions which would not be routinely referred to the service. To further support service users, however, the provider will be required to identify a range of voluntary sector organisations who specialise in supporting service users with skin conditions and who offer group support for service users. This educational programme will need to be inclusive of all service user groups and therefore accessibility and representation (of those groups) should be considered throughout the programme. Level 2 Generalist Care - People with skin conditions needing generalist care are managed initially through self-referral to their GP. Ideally these service users should be managed within the GP practice. As noted above, the provider will be required to develop training and management of Level 2 conditions within the practice. Level 3 Intermediate and Specialist Care - Any service user whose skin condition cannot be managed by a generalist will need to be referred for specialist care and will need to be managed by a specialist in the community setting. Level 4 Supra-Specialist Care – the management of complex and/or rare skin disorders including 2 ww pathways. These services were historically delivered from a secondary care setting by a consultant dermatologist.

The service will provide and deliver a consultant led (but not exclusively consultant delivered) Level 1-3 service supported by a multi-disciplinary team which will manage a range of dermatological conditions. The provider will host a consultant-led triage service, using clinical and operating protocols agreed with East Kent Hospitals University Foundation Trust (EKHUFT), ensuring service users are directed to appropriate services. Level 4 services will remain with the incumbent provider East Kent Hospitals University Foundation Trust (EKHUFT) and are therefore not included within the scope of this Lot, however, the community services will be expected to fully integrate with the Level 4 service and ensure referrals seen in the acute setting are those that only really need to be there. The descriptions for Levels 1 – 4 are as follows: Level 1 Self-Care - People with skin conditions who manage their conditions themselves should be supported with high-quality service user information and input from suitably trained nurses, service user support groups and community pharmacists. Ideally, service users presenting with conditions that could be managed with self-care should be referred to their local community pharmacy and be supported to self-manage their condition. Community pharmacists are able to advise on a range of common skin conditions including, but not limited to, allergic rashes, dry skin conditions, such as eczema, minor skin infections, warts and verrucae. The new service will be expected to work with Primary Care and service users to develop a programme of education around low level management of skin conditions which would not be routinely referred to the service. To further support service users, however, the provider will be required to identify a range of voluntary sector organisations who specialise in supporting service users with skin conditions and who offer group support for service users. This educational programme will need to be inclusive of all service user groups and therefore accessibility and representation (of those groups) should be considered throughout the programme. Level 2 Generalist Care - People with skin conditions needing generalist care are managed initially through self-referral to their GP. Ideally, these service users should be managed within the GP practice. As noted above, the provider will be required to develop training and management of Level 2 conditions within the practice. Level 3 Intermediate and Specialist Care - Any service user whose skin condition cannot be managed by a generalist will need to be referred for specialist care and will need to be managed by a specialist in the community setting. Level 4 Supra-Specialist Care – To be provided by EKHUFT - the management of complex and/or rare skin disorders including 2 weeks wait (2ww) pathways and the use of biologic therapies, which is Level 4 only.