Department of Dermatology, University Hospitals of Leicester NHS Trust, Leicester, UK.
Department of Dermatology, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Clin Exp Dermatol. 2021 Jul;46(5):861-866. doi: 10.1111/ced.14555. Epub 2021 Feb 22.
Little is known about the demand for out-of-hours (OOH) dermatology in the UK, and this can make commissioning of acute services difficult. The East Midlands region has a population of 4.5 million people, with variable access to OOH dermatology services.
We sought to investigate the provision of, and demand for, OOH dermatology services across the region with a view to informing commissioning decisions for the future.
We contacted all dermatology departments in the East Midlands region to establish what level of service was commissioned at evenings and weekends. At the sites providing any form of OOH service, we recorded all requests for advice received after 17.00 h on weekdays, or at any time during weekends and bank holidays over a 3-month period from October to December 2019.
The OOH services provided ranged from 24 h/day cover 7 days/week at one site, to no formal provision across much of the rest of the region. In total, 125 calls were received during the study period, averaging 1 call per day on weekday evenings, and 2 calls per day at weekends and on bank holidays. Of these 125 calls, 11 patients (9%) were prioritized and seen by the on-call dermatologist on the day of referral, and 9 of these had potentially life-threatening skin conditions. A further 39 (31%) were deemed to need review within 24 h and 22 (18%) within 48 h. The remaining 42% were given appointments within 7 days or dealt with by telephone advice.
The demand for OOH dermatology across the East Midlands is low, but access to timely dermatology advice is essential in some situations. Commissioning of a regional dermatology OOH service incorporating digital technology may help to improve the equity of access for all patients across the region.
在英国，人们对非工作时间（OOH）皮肤科服务的需求知之甚少，这使得急性服务的委托变得困难。东米德兰兹地区拥有 450 万人口，其 OOH 皮肤科服务的获取途径各不相同。
我们旨在调查该地区 OOH 皮肤科服务的提供情况和需求，以便为未来的委托决策提供信息。
我们联系了东米德兰兹地区的所有皮肤科部门，以确定在晚上和周末委托的服务水平。在提供任何形式 OOH 服务的地点，我们记录了 2019 年 10 月至 12 月的 3 个月期间，在工作日 17 点以后或周末和银行假日的任何时间收到的所有咨询请求。
OOH 服务的提供范围从一个地点的 24 小时/天覆盖 7 天/周，到该地区大部分地区没有正式的服务。在研究期间共收到 125 个电话，平均每个工作日晚上接到 1 个电话，周末和银行假日每天接到 2 个电话。在这 125 个电话中，有 11 名患者（9%）被分诊并由当天的皮肤科医生接诊，其中 9 名患者患有潜在危及生命的皮肤病。另外 39 名（31%）被认为需要在 24 小时内复查，22 名（18%）需要在 48 小时内复查。其余 42%的患者在 7 天内预约或通过电话咨询进行处理。
东米德兰兹地区对 OOH 皮肤科服务的需求较低，但在某些情况下，及时获得皮肤科咨询至关重要。委托一个包含数字技术的区域皮肤科 OOH 服务可能有助于提高该地区所有患者的公平获取机会。
