"Skin lesion requiring urgent referral."

About: Crosshouse Hospital / Dermatology Crosshouse Hospital Dermatology KA2 0BE Heathfield Suite / Dermatology Heathfield Suite Dermatology KA6 6DX

Posted by All we want is to be seen ASAP (as the patient), 5 years ago

I saw my gp regarding a lesion on my leg in mid July. The GP recommenced I try Fusidic on same to see if it would help. I returned on another occasion and unfortunately the lesion had grew and changed. My GP then made an urgent referral to Dermatology expecting me to have a consultation with in 2-3 weeks.
Having heard nothing in regards to an appointment I decided to phone Dermatology clinic in the Heathfield suite Ayr Hospital. My concerns at this time being the lesion has grown several mm and also is blistering round outside of lesion,and not forgetting a further lesion beginning to grow on the same leg.
Heathfield could tell me I’m on the urgent list and be seen within 2-3 weeks however I was advised to contact Crosshouse appointments to be told that they will not be able to offer me an appointment earlier than 6-8 weeks & could I phone my GP or go to A and E.
Now I find myself in the same position as my daughter was earlier in the year when she got referred urgently for several breast lumps and was told when she phoned it would be 8 weeks + before she would be seen.
Fortunately for us care opinion responded to my pleas and my daughter was given an appointment the next day.
I am worried sick at how quick lesion is growing and the pain I’m suffering in the surrounding area.Its now growing around 2mm a week so another 8 weeks is another 16mm. Not a lot some would say however if lesion requires removal it will be a lengthy scar.
All I ask is that I’m seen sooner rather than later 6-8 weeks is too long to wait knowing if I do or don’t have some form of skin CANCER.

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Responses

Leigh Smith

MASScot- Melanoma Action and Support Scotland

Submitted on 06/08/2019 at 00:14

Published on Care Opinion at 11:08

To All we want is to be seen ASAP.
I so understand your concern as I am sure everyone who reads this will. There is a chronic shortage of dermatologists and those retiring (often due to over work due to staff shortage) are not able to be replaced. We have not as a country been training enough dermatologists for some years. due to a cut back of Scot Gov spending. But that is no help to you just now.
My advice would be to take a photograph of the lesion (with a mobile phone if possible with a good camera) in a good light and with a ruler or measuring tape beside it.
Call the dermatology secretaries at Crosshouse hospital and ask for the email address of one of the Consultant Dermatologists. Email the photograph to him and tell them you will take a cancellation at short notice or be willing to go to another hospital if necessary.
They will not be able to make a firm diagnosis from the photo but it will give them an idea of the urgency or otherwise.
As we get older, especially if you have been sunburned, we do get funny growths on skin that are totally harmless. But it is necessary to have it checked by a dermatologist, failing that a plastic surgeon. If you are concerned they will probably remove it for you and send it to pathology for verification.
If it is any help - pain is not usually a problem with skin cancer. The antibiotic would do no harm and mid July is only 3 weeks ago but you are right if there is a strong suspicion of cancer then 2-3 weeks is the expected waiting time. It does depend on how your GP described and labelled the request.
Please try not to worry too much but do call me and we can have a chat about this and what else you might try to help you cope meantime. My number is 0773 823 1260.
Leigh MASScot

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Update posted by All we want is to be seen ASAP (the patient) 5 years ago

Hi Leigh I didn’t make myself clear, the lesion has been there around 15 weeks now starting as what appeared to be a bite. I didn’t initially think much of it until I noticed it had started growing quite quickly. The lesion itself is around 19mm now however around the lesion the skin is opaque in a wider area of 4cm.
my gp put an urgent referral in as was confirmed by Crosshouse appointments that I was on the list.
I called them today to be told I’m not on the cancellation list now as I have an appointment in 9/2019. That’s another 5 weeks away.
I also was advised to go private however my wages as a nurse within Ayrshire and Arran won’t stop stretch that far.
my coping skills are not what they should be as I can’t help but wonder do I or don’t I have CANCER.
Thank you

Sandra Hanlon

Ward 2E- Dermatology and Dermtology OP, Crosshouse Hospital,

NHS Ayrshire and Arran

Submitted on 07/08/2019 at 15:55

Published on Care Opinion on 08/08/2019 at 10:26

Dear All we want is to be seen ASAP
GP referral letters are vetted as either urgent, soon or routine and we aim to see patients within the national set waiting times and have been working hard in the department doing extra clinics to get waiting times down but understand your frustration and anxiety that whilst you are waiting to be seen you can observe your lesion changing causing you further worry.
Sometimes we do contact patients to offer an appointment at short notice due to cancellations as we do not want any appointment slots going to waste and hopefully you may get that phone call. If you would like to contact me on 01563 827923 I can ensure your contact details are correct on the system.
Kind regards
Sandra Hanlon
Dermatology Senior Charge Nurse
University Hospitals Crosshouse and Ayr

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Eunice Goodwin

Patient Feedback Manager for NHS Ayrshire and Arran, Quality Improvement and Governance Team,

NHS Ayrshire and Arran

I respond initially to most of the posts and ensure they are passed to the appropriate team whether they are compliments, observations or grumbles. It is important to make sure all issues are addressed and I try to encourage that to happen for all the posts as required.

Submitted on 08/08/2019 at 18:25

Published on Care Opinion at 18:25

Dear All we want is to be seen ASAP,
I wonder if it would be helpful to give some clarity on some of the observations made in this post and subsequent responses.
Firstly, Care Opinion in an excellent tool. It is the vehicle for communication and sharing the posts and it brings your stories to our attention, it does not make changes regarding appointments etc. It has many excellent facets, not least that we can share changes and cellebrations widely with other services and we can learn from them.
In your daughter's case, a member of NHS Ayrshire and Arran must have made this possible and I suspect the appointment was available because of a cancellation. Everyone on a waiting list can advise us that they are available for a short notice appointment (if they are of course), ensuring we have up-to-date contact details. This is helpful to us all.
We are always keen to hear when we get things right or when we can improve but I would caution anyone thinking that Care Opinion can be used as a way to skip the queue.
In addition, I would strongly advise against endeavouring to send pictures to a dermatologist. There are some technical reasons why we do not have this facility in NHS Ayrshire and Arran but more importantly perhaps is the governance around this practice for example - Data protection, confidentiality and security.
I hope this is helpful and that you get a seen very soon, with a quick and good result.
Kindest regards,
Eunice

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Update posted by All we want is to be seen ASAP (the patient) 5 years ago

Hi Eunice,
it seems ideal that you can be placed 0n a cancellation list which I ensured I was when I spoke with staff at Heathfield suite Ayr and also Crosshouse appointments however once they generate an appointment you are removed from said list and are responsible for continuous phone calls on a daily basis in the hope a cancellation is available.
I was given an appointment for an URGENT referral for September 2019 this referral from my GP was received and vetoed in July. It’s a long wait and not the 2-3 week wait my GP and the Heathfield suite believed.
I did not contact care opinion on this occasion to queue jump I contacted them because your assistance previously with my daughter helped greatly.
I will be commenting further on my story and have a few people to thank immensely as after speaking with Leigh MASScot late afternoon I received a call from Heathfield suite and attended dermatology at Ayr hospital the following morning where a core biopsy of one lesion and a partial excision on the larger lesion was carried out. I now have 8 weeks to wait for pathology results to come back.
regards

Update posted by All we want is to be seen ASAP (the patient) 5 years ago

Dear Sandra,
im aware of the different lists for referrals. Crosshouse appointments confirmed I was on the urgent list but still stating it would be a 6-8 week wait for appointment.. I also was placed on the cancellation list however once they generate an appointment you are removed from said list and responsible for phoning several times a day every day to see if cancellation is available.Not ideal as I work night shift.
I did receive an appointment for September 2019, not very urgent considering they vetoed my GP referral in July.
as you will see from further responses a very kind lady stepped in and I received treatment the following day. I now need to wait 8 weeks for pathology results.
regards

Update posted by All we want is to be seen ASAP (the patient) 5 years ago

Following on from my original story I have several people I would like to thank immensely.
Leigh Smith you are an inspiration I got lucky when you responded to my story. I can’t thank you enough for responding and the lengthy phone calls we had over 2 days helped me immensely and in honesty made me quite emotional only because I felt someone cared enough. You continue to share your experiences and you have continued to reach out to people educating them on skin damage etc. I will never be able to thank you enough for personally emailing medical staff. This I believe resulted in my phone all to attend dermatology the following morning. I will keep in touch and let you know results.
A big thank you to Dermatology Ayr Hospital from the reception staff to nursing staff and of course Dr Dwyer. From the minute we arrived staff were friendly compassionate and very helpful. Dr Dwyer can only be described as a perfect gentleman informing us as he carried examinations etc what was happening and arranging the biopsy and excision immediately. Thanks to the nursing staff who carried out the procedures, your chat certainly distracted as to what was being done.
Myself and husband both work in health care and know that it’s rare for us to get thanks for doing our jobs therefore albeit “mushy’ I felt compelled to write this story.

Sandra Hanlon

Ward 2E- Dermatology and Dermtology OP, Crosshouse Hospital,

NHS Ayrshire and Arran

Submitted on 20/08/2019 at 13:33

Published on Care Opinion at 13:33

Dear All we want it to be seen ASAP
Many thanks for taking the time to post your message. I will ensure it is shared with all the staff involved in your care including Dr Dwyer as I am sure it will give the team a boost. It is great to hear when we get it right for patients and deliver safe, effective and efficient care and can only apologise for your initial wait between being referred and being seen at clinic.
Kind regards
Sandra
Sandra Hanlon
Dermatology Senior Charge Nurse
University Hospitals Crosshouse and Ayr

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