Exploring dermatology patients’ expectations and experiences of dermatology

Background: Management of dermatology patients has changed with the introduction of Choose & Book, the Closer to Home agenda and reconfiguration of dermatology services to incorporate General Practitioners with a Special Interest (GPwSI). Objective: To assess whether the current configuration works for dermatology patients and meets their expectations. Method: A survey was conducted among patients who attended general out-patient dermatology clinics in a general district hospital. Results: Response rate for the survey was 54/75 (72%). In 52% of cases a choice of referral for further management was given by their usual GP using Choose & Book. A discrepancy existed between what treatment patients expected and how the skin disorder was actually managed: 40% of the total respondents were treated first by their own GP or a GPwSI, even though 64% of the respondents had anticipated being referred directly to a hospital. In this survey patients feel it is more important to see the most qualified clinician than to be seen nearer their home. 61% of responders would prefer to be treated in a hospital setting, rather than at a GPwSI clinic; the latter is preferred by 15% of the respondents. Conclusions: Patients could possibly be better informed about their treatment options and about the role of a GPwSI in dermatology services, through support by their regular GP. Although the sample is biased, since only secondary care patients were surveyed, dermatology patients express a strong preference for hospital-based care, which contradicts the Closer to Home approach applied by policy makers.