1. Skin Cancer Nursing A Nursing Perspective from a Specialist Skin Centre
Karen Pocock
Skin Cancer Clinical Nurse Specialist
St.Helens & Knowsley Hospital Trust

2. Content Dispel myths Role of Skin CNS Geographical boundaries
Patient Journey
Which patients should be referred?
Referral process in to SSMDT
MDT Link – value of
Who are the SSMDT?
The future
Summary

3. Dispel Myths - Macmillan
Macmillan does not mean end of life!!!!
Macmillan
is a source of information for patients/families dealing with cancer.
is a source of information for health professionals working in the cancer field.
aims to improve the lives of people affected by cancer.

4. Role of the Skin Cancer CNS within the specialist Centre
Diagnosis – End of Life
Link to all hospitals/teams/other skin CNS
Clinical expert
A resource
An educator
Change Agent
Researcher
Advocate

5. Geographical Boundaries
Glan Clwyd
Nobles IOM
Chester
Bangor
Broad Green
STHK
Wigan
Halton
CCO
Southport
Aintree
Warrington
Ormskirk

6. Patient Journey Diagnosis (dermatology, plastics, GP)
Referred to Specialist Skin Centre
Surgery (plastics)
Waiting for results
Possible further surgery
Scans, further investigations
Possible referral to CCO - radiotherapy
Possible referral to oncology - clinical trials, chemo
Possible referral to other specialist centres i.e. Christies, Glasgow.
Living with cancer
End of life

7. CASE STUDY

8. So how do we help? Smooth patient Journey
Act as a link between all teams
Communicate to other Skin CNS
Relieve patient/family anxieties
Point of contact / key worker
Refer on to other teams throughout the network
Lymphoedema nurses
Counselling/clinical psychology
Prosthetics, Physiotherapy
Palliative care
Holistic therapies

9. Which patients should be referred to the SSMDT?
Any complex skin cancer requiring wider excision
Wider excision & SLNB
Local recurrence
Lymph node Dissections
Head & neck melanoma
MOHS
Oncology
Discussion only for expert advice
See Network Guidelines

11. SSMDT Referral Form All patients need to be referred via form
Clinical information
Send relevant investigations with form
Fax to Barbara Marsh
Listed for SSMDT
Deadline Thursdays 12 noon for MDT discussion
Appointments generated via Barbara ASAP

12. Barbara Marsh 01744 646776 MDT Link – HUB of team Role
Receives all initial referrals via fax
Constructs MDT list
Meets deadlines for cancer targets
Makes referral appointments
Chases investigations i.e. scans, histology
Uploads data to somerset
Contacts patients
Acts as a link to other trusts

13. The Team at STHK 2 MDT co-ordinators
3 Core Plastic surgeons - specialists in skin cancer surgery
6 Dermatologists
1 Medical oncologist
1 Clinical Oncologist
2 Histopathologist
2 Radiologists
2 CNS’s
1 Research Nurse
Variety of associate specialist surgeons/nursing/clerical staff

14. The Future Continue to develop the service
Nurse Led Clinics / clinical diagnostics in melanoma
Electro chemotherapy
Increased clinical trials portfolio
Patient led support groups

15. Summary
The Skin Cancer CNS is here as a result of the national cancer agenda, as with all other tumour sites.
The role of the CNS can enhance the quality of care delivered to each individual patient with skin cancer by being their key worker.
The patient journey is complex, given the geographical boundaries of where they come from.
MDT co-ordinator is a main link to SSMDT
See Melanoma network guidelines for referral criteria to SSMDT
We want to work together with all members of the team putting the patients needs first.
The patient is the most important person of all our work.

16. Thank you