NCL 2WW Teledermatology Service

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The North Central London Suspected Skin Cancer (2WW Teledermatology) pathway has been designed to allow patients with suspected skin cancer to receive a diagnosis of their skin condition without having to attend a face-to-face 2WW appointment in secondary care, thus ensuring that such face-to-face appointments only occur where absolutely required during the Covid-19 outbreak.

The pathway allows GPs to refer patients via e-RS with a digital image/s of the suspicious skin lesion taken with a dermatoscope or a smartphone or other camera if dermoscopy is not available

Appropriate suspected skin cancers are:

  • suspected melanomas
  • squamous cell carcinomas
  • high-risk basal cell carcinomas
  • any other suspicious rapidly enlarging lesions 

A dermatologist from the Royal Free London or Whittington Health will triage the referral using the information received on e-RS.  The dermatologist may contact the patient via a telephone consultation (RF and Whittington) or video consultation (RF only) to help make this decision. The triage outcome record will detail the dermatologist’s discussion with the patient.

The dermatologist will then either

  • send a management plan back to the referring GP, to be delivered in primary care
  • or arrange to see the patient at a face to face appointment.

For more detail see the GP communication letter, and to support GPs with initial triage of patients, see the pathway/cribsheet, both available as downloads. There is also a five section NCL 2WW teledermatology how-to guide for GPs.

Eligibility criteria


  • People registered with an Islington GP


The following patients should NOT be referred via this pathway, but should be referred via the usual route, either 2WW or routine referral:

  • paediatric patients (15 years old and under)
  • patients without capacity to 
    • make informed decisions
    • consent to photography
    • understand the English language
  • patients with anogenital skin lesions
  • patients with >3 lesions for review (as these warrant a full body check)

How to refer

EMIS form

Referral methods: e-Referral

A referral form can be found in ISL EMIS under
ISL global documents > 2WW Cancer Refreral Forms  > NCL COVID Suspected Skin Cancer Referral

Please send form via e-Referrals using the following steps:

Speciality: 2WW
Clinic Type: 2WW skin
Click ‘search primary care’