This leaflet answers common questions about the two week wait (2WW) teledermatology service. If you would like further information, or have any worries, please do not hesitate to speak one of our team. 

What is teledermatology?

Teledermatology is the use of a specialist magnifying camera to take photographs of your skin. Your photographs will be reviewed by a consultant dermatologist and a decision made as to whether you will need to be seen in clinic at one of the Royal Free London hospital sites.

The photographs are high quality and taken by professional medical photographers. However, if the consultant has any uncertainty about the diagnosis, they will ask to see you in a face-to-face consultation.

This type of service is provided in many areas of the country and is an excellent way of helping patients be seen more quickly without losing any quality in the care received.

Who can be referred?

Patients who have been seen by their GP where there is a concern about the possibility of skin cancer, and who are considered suitable for the service, can be offered the teledermatology service.

The service aims to provide a prompt diagnosis for patients with a new or changing skin lesion.

Please remember that most skin cancers are not life threatening and can be easily treated, and very few of our referred patients will be diagnosed with cancer.

How do I get an appointment?

Your GP will refer you to the Royal Free London on a 2WW suspected skin cancer pathway. After your referral, a member of the dermatology team will look at the information your GP provided and will decide if this is the best service for you.

You will receive a phone call offering you an appointment. Following the call, you will receive a text message confirming the date, time, and location. Due to the speed of the service, it is not possible to follow up with a letter.

Service benefits

The benefits of the teledermatology service are that you may come to find out the cause of your skin condition sooner than a hospital appointment, as the medical photos are sent directly to your consultant.

This service can also avoid potential delays in your care as your consultant is able to direct you to the most appropriate clinic for a follow-up appointment if necessary, once photos of your skin lesion have been examined.

During your appointment

After booking in at reception, a member of the medical photography team will ask for your consent to take relevant photographs of your skin lesion. You will then be photographed either in a medical photography studio or clinic room. Photographs will be taken using a specialist dermatology camera.

These photographs will be transferred electronically to a consultant dermatologist at the Royal Free Hospital, along with the referral letter from your GP and your signed consent form. This is done through a secure NHS IT network.

After your appointment

The consultant dermatologist will carefully review your photographs and your referral. They will decide on the best treatment plan, in the same way as if you had been seen in a faceto-face hospital clinic, which could involve a follow-up appointment.

The consultant will write to you and your GP with your management plan which will explain what action, if any, you need to take next. You will usually receive this within ten working days of seeing the medical photographer.

It could be that there is no further action needed, in which case you only need to go back and see your GP if you are worried about your skin condition.

For some patients, the consultant will be able to diagnose your problem, provide reassurance and discharge you back to your GP with a plan for looking after your condition.

If stated in your letter, it is very important that you call your GP practice and make an appointment that your treatment, if any, can be started.

The consultant may decide that your skin lesion should be looked at in-person or that you need a biopsy (this is where a small piece of skin is taken and sent to a laboratory for diagnosis). You will then be offered an in-person appointment.

They may also decide you need treatment for a potential skin cancer. If this is the case, you will be offered a fast-track, in-person appointment.

Who provides the service?

This service is delivered by the Royal Free London dermatology department, which is part of The Royal Free London skin unit.