The three-year transformation programme is being led by Scottish national dermatology improvement nurses Dianne Ross and Hilary Nicolson, who want to maximise the potential of nurses to make sure patients can get the care they need quickly and without having to travel long distances.
“It really needs to be replicated on a much larger scale and it needs to be more consistent”
Ms Ross told Nursing Times that historically dermatology care across the three areas of the UK included in the programme had been predominately an inpatient-based service.
She said that in some cases patients were being made to travel “huge distances” to see a consultant dermatologist, because of the way services were currently organised.
However, Ms Ross said: “It might be that actually the most appropriate person for them to see is not a consultant.”
With the number of patients being referred into these services rising year-on-year, Ms Ross said there was a need to “transform the service to get a bit more responsible with patients being signposted to see the right clinical, at the right time and in the right place”.
Kicking off in January 2018, the first phase of the initiative has been to complete a “scoping exercise” with every health board in Scotland, the five health trusts in Northern Ireland and the three trusts in Ireland that come under the remit.
This saw the two nurses speak with dermatology consultants, department managers and clinical nurse specialists to find out the current stay of play in terms of service provision and education.
hilary nicolson and dianne ross
As part of this work, they also held focus groups with staff in bands 2 to 5 without department managers present, so they could talk freely about the barriers and facilitators to education.
Ms Ross told Nursing Times that the specialist nursing facilities were there, but they tended to be isolated in the larger teaching hospitals.
“The level of expertise that they are demonstrating and the impact it can have on service delivery – it really needs to be replicated on a much larger scale and it needs to be more consistent,” she said.
In terms of training, she said opportunities were “very much organised locally” and were usually work-based and delivered by colleagues.
Nurses faced barriers attending the “limited” study days that were available including getting time off work and travel, said Ms Ross.
There was no academic education beyond a-level specific to dermatology, she added.
With the information they have gathered through the scoping exercise, Ms Ross and Ms Nicolson are now developing a range of educational tools for the 400 nursing staff already working in dermatology across Scotland and Ireland as well as those who enter the profession in the future.
This will include online training materials, which are set to be rolled out across Scotland, Northern Ireland and parts of the Republic of Ireland next year, followed by an official evaluation.
“This highly innovative project will deliver real efficiencies in vital health and social care services”
Ms Ross and Ms Nicolson have also secured Scotland’s first ever masters-level dermatology training programme that will be delivered from the University of Stirling from September this year.
They are also organising regional and national study days for dermatology registered nurses and healthcare support workers.
While the focus of the programme is on dermatology nurses in secondary care, Ms Ross said they were also looking to introduce some basic dermatology education tools for nurses from other sectors.
The initiative is being funded as part of a multi-million grant through the EU’s INTERREG VA Programme, which is managed by the Special EU Programmes Body and aims to help improve cross-border health challenges between Scotland and Northern Ireland and the Republic of Ireland.
Gina McIntyre, chief executive of the Special EU Programmes Body, said: “This highly innovative EU INTERREG VA funded project will deliver real efficiencies in vital health and social care services for the benefit of thousands of people on a cross-border basis.”