HNY Policy and Pathway Repository - York

Create and submit referral request to the RSS

Suspected diagnosis – please tick on referral form

• Pigmented lesion with a weighted 7-point checklist of 3 or more
• Pigmented/non-pigmented lesion that suggests nodular melanoma
• Nail changes e.g. pigmented line or new pigmentation under nail
• Biopsy confirmed diagnosis of melanoma (send histology report)
• Suspected SCC
• Another form of skin cancer (but not a BCC)
• Weighted 7 Point Check List for assessment of pigmented lesions
• Suspicion is greater if 3 or more but strong concerns about any feature should prompt referral

Major features of the lesion (2 points each):

• Change in size
• Irregular shape or border
• Irregular colour

Minor features of the lesion (1 point each):

• Largest diameter 7mm or more
• Inflammation
• Oozing or crusting of the lesion
• Change in sensation (including itch)

If your patient does not meet any of the NICE defined USC criteria please liaise (by phone or Advice and Guidance) with a specialist or send them in as an urgent referral. Please do not annotate USC forms with your own criteria.

Patient awareness

• Confirm that your patient understands that they have been referred onto a “suspected cancer pathway”
• Confirm that your patient has received the information leaflet
• Confirm that your patient is available to attend an appointment within 2 weeks of this referral
   

This referral pathway / form should not be used for BCCs or for lesions on the following special sites: on the vermillion, anus, penis and vulva.

Photo of lesion

To include: 

• Overview
• Close up image
• Dermatoscopic image

Exceptions

• An area the patient deems too sensitive to photograph (e.g. genitalia, breasts)
• Dermatoscopic equipment is broken (normal overview and close up photos should still be sent)
• Dermatoscopic equipment is unavailable for other reason (normal photos should still be sent)
• Patient declines to have photographs taken even when referrer has explained the benefits to them and other patients of doing so. A patient leaflet on medical photography
• Any exceptions and the reason for them must be included in the referral.

• Skin cancer criteria form
• Patient leaflet

 

Referral forms

• EMIS
• SystmOne

GIRFT Best Practice Timed Diagnostic Cancer Pathways
 

Faster diagnostic pathways

Implementing a timed skin cancer diagnostic pathway