"A minor procedure - could the process be improved?"

About: Gilbert Bain Hospital / Dermatology Lerwick Health Centre

(as the patient),

I attended the GP to have a mole examined. The GP examined my mole and made an urgent referral to out-patients so I could have it removed. When I attended out-patients I was met by a consultant who carried out a very similar assessment to the GP and said I would be re-booked for another appointment to have the mole removed. Prior to this I had another call by a nurse to have a further pre-assessment undertaken. From my initial contact with the GP it took over 4 weeks to have the mole removed.

The treatment I received from the clinical staff was at a standard I would expect and the doctor who removed my mole had a great chair side manner. The problem, I felt, was that it did not seem well organised (there was repetition, poor communication and I wasn't sure if I saw the right clinical staff in parts of the journey).

It is well known that one of the main costs for the NHS is repetition and good management of care pathways would rectify this. The fact that my GP told me I would have my mole removed and when I arrived to see the consultant I was informed they wanted to see it first and then sent me on my way, was quite disappointing. Did I need to see a consultant? Could a photo have been taken as well as the description provided? What was the protocol they have in place to communicate with each other? I saw a GP, consultant, nurse and doctor in my pathway. Was there a more safe, effective and person centred way to deliver this care? If this is what happens for all minor procedures then this is not good value for patients? In my opinion NHS Shetland have excellent clinical staff they just need help managing the patient pathway and using the skills of the right clinician at the right time.

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Response from Carolyn Hand, Corporate Services Manager/Complaints Officer, Chief Executive's Department, NHS Shetland We are preparing to make a change

Thank you for taking the time to provide this feedback. You are quite correct that there appears to have been unnecessary duplication of work. We are trialling using digital photography to see if it makes the referral process more efficient.

Roger Diggle, Medical Director

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