Referral information for GPs
Criteria for referral:
The patient is suspected as having one or more of the below conditions:
- Basal Cell Carcinoma
- Bowens Disease
- Actinic Keratosis
- Benign symptomatic skin lesions (see below)
Pigmented lesions and squamous cell carcinomas are out of scope and require direct 2 week wait referral to a hospital dermatology department.
BCCs appropriate for treatment under this service are defined as follows:
The patient is not:
- aged 24 years or younger (that is, a child or young adult)
- immunosuppressed or has Gorlin’s syndrome.
- is less than 2 cm in diameter on the body, and less than 1cm on the head and neck, with clearly defined margin
- is not on the nose, ears, lips or eye lids
- is not a recurrent or persistent BCC following previous surgery
- is not morphoeic, infiltrative or basosquamous in appearance
If the BCC does not meet the above criteria, or there is any diagnostic doubt, following discussion with the patient they should be referred to the hospital dermatology department. Incompletely excised BCCs should be discussed with the hospital dermatology department.
Bowens is an increasingly common premalignant skin disease characterised by flat erythematous scaly patches commonly on the lower legs. Treatment options are varied and include efudix, cryotherapy, PDT and shave excision, curettage and cautery. If your patient is suspected of having Bowens disease and has failed topical treatment with efudix for 4-6 weeks then it is appropriate to refer to the Community Dermatology Clinic. We will offer shave excision, curettage and cautery. We do not offer cryotherapy.
Solar keratosis is common and increasing in prevalence due to an ageing population with a history of sun exposure. The condition may be managed in primary care. This service specification will provide an option for treatment when prior appropriate management in primary care has not led to resolution. We are able to offer shave excision, curettage and cautery. We recommend the use of topical treatments according to the Oxfordshire Solar Keratosis Primary Care Treatment Pathway. We do not offer cryotherapy.
Symptomatic Benign Skin Lesions
Lesions which recurrently bleed and are problematic, for example Pyogenic Granulomas, can be treated in the community dermatology service. We do not offer treatment for simple cysts, lipomas, seborrhoeic keratoses or skin tags which may be irritating only.
What to expect at your appointment
Your GP has referred you to the South West Oxfordshire Community Dermatology Service based at Woodlands Medical Centre in Didcot. We will offer you an appointment in the post, but if you do not hear from us or if you have any questions about the appointment booking, you can contact Suzanne Bailey at Woodlands Medical Centre on 01235517765. Due to the nature of the clinic, we are able to offer limited appointment dates, if you are unable to attend on that date or do not attend then you may be discharged back to your referring GP. You can then be referred on to a Hospital Dermatology Department of your choice.
You will be seen by a local GP, Dr Adam Jones or Dr Chris Phillips, who have had specialist training in dermatology and minor skin surgery.
Please leave 1 - 1 ½ hours for your appointment during which time you will be assessed and treated on the same day. The doctor assessing you will assess the skin lesion your GP referred you for and will also offer you a full skin check, to check the rest of your body. This is because we know that when a person has one area of concern (which may be related to long-term sun damage) there may be others. Please wear clothes that are easy to take off and put on. If the doctor offers a minor operation under local anaesthetic to treat your skin problem it will happen on the same day. You may be offered a follow up appointment if further treatment is recommended. If the doctor advises creams to be prescribed, your referring GP will be notified and they will issue a prescription which you can pick up from your surgery 2 weeks after your community dermatology appointment.
Depending on the type of operation undertaken, you may have stitches. These will need to be removed by your practice nurse at your own surgery 7-14 days later and you will need to be available for this time if required. We will of course give you detailed information on wound care at the time of the appointment.
You will be able to drive after the operation, unless the operation is on the face, in which case it is best to make alternative arrangements. There is free parking at Woodlands Medical Centre.
Your wound will need to be kept clean and covered. You will need to keep it dry for 48 hours and avoid bathing or swimming for 2 weeks. If you require stitches, then we recommend no heavy lifting or sports activities for 4-6 weeks.
We will write to your GP once we have seen you in clinic advising on the treatment you have received and if your GP needs to issue a prescription or take further action. If you have a minor surgery procedure, we will write to you with the results of the sample that was sent to the laboratory, and if further action is needed, this should take up to 4 weeks.
How to find us
Woodlands Medical Centre is located next to the Didcot Community Hospital site, off the B4493 (Wantage Road) between Didcot Broadway and Harwell.
32A Didcot, Harwell, Wantage, Abingdon
X32 Wantage Harwell Didcot and Oxford
93 to Didcot Town Centre and station
Didcot Parkway Train Station which is a 15minute walk or bus 93
Meet The Team
Dr Adam Jones MBBS BSc MRCGP DPD DGM DFSRH
Dr Jones is a partner at Woodlands Medical Centre and completed the Cardiff Diploma in Practical Dermatology in 2012 with Distinction. He has been working at the Churchill Hospital Dermatology Department since 2015 in the Skin Tumour Clinic and attends weekly theatre sessions.
Dr Chris Philliips MBBS B.Med SCI MRCP MRCGP
Dr Phillips is a GP who has an interest in dermatology. He works at variosu other practices in the Oxfordshire area. He works at the Churchill Dermatology Deparmtent once a week doing minor surery and skin cancer clinics. He is also a GP tutor for Oxford Medical Students.
Both Adam Jones and Chris Phillips are working closely with the dermatologists at the Churchill Hospital to ensure a high quality service for patients attending the Community Dermatology Clinic.
Suzanne is our excellent service administrator. Suzanne is available for liaison with patients if questions arise and can be contacted on 01235517765. If Suzanne is not available then please leave a message on her answerphone and another member of the team will respond.
Suzanne manages the appointment system once referrals have been triaged by Dr Jones or Dr Phillips. She sends information to patients in the post regarding their clinic appointment date and time. After the appointment Suzanne will send letters to patients the histology results of all surgical procedures undertaken, feedback forms and any necessary additional information. Important and relevant clinical information is sent to the referring GP practices via encrypted email.