Customer story | Game-changing skin cancer pathway

The Chorley and South Ribble Healthcare Network (PCN) have been working in partnership with the Lancashire and South Cumbria Cancer Alliance to reimagine the way in which patients are triaged. The result has saved in excess of 20,000 GP appointments in just 24 months.

The senior management team at Chorley and South Ribble Healthcare Network, led by business and operations director Brian Hann, used key features within the PCN Hub functionality in EMIS Web® to build a new kind of digital care pathway.

Faced with growing demand for dermatology referrals, increasing skin cancer rates, and long wait times, they had a clear goal in mind: faster access to specialist care for those who need it most, while reducing the burden on GPs and dermatology services.

Focusing on skin cancer

Skin cancer is one of the most common and fastest-growing cancers in the UK. Early diagnosis increases the chance of successful treatment and can prevent the spread, yet GPs often lack the time and tools to distinguish between benign and malignant lesions during short consultations.

“Most GPs may not confidently determine the possible outcome of a potentially cancerous lesion,” said one clinician involved in the project. “So, patients often end up on the two-week cancer referral pathway, even when it’s not necessary.”

This creates bottlenecks in dermatology services and delays for patients who require treatment, which can lead to poorer experience and outcomes. Brian’s desired outcome is that the patient gets seen by the right person at the right time.

Innovating with existing technology

In 2022, Brian’s aim was to pilot a pre-referral process that allowed patients with suspicious lesions to be screened and imaged before being seen by a clinician. The breakthrough came when he realised, they could use one of the many useful features within EMIS Web PCN Hub as the foundation for his new digital triage system.

“It dawned on us that we could use EMIS Web as a front-end tool for a process that sits slightly outside traditional primary care,” Brian said. “We already know that it has many wonderful rich functions such as protocols, concepts and population reporting; and I suspected that I could dig a little deeper and push the capabilities a further to design a pathway that worked for this particular scenario.”

The process starts at the point of initial contact, whether that’s in person, over the phone, or online. Non-clinical staff use a scripted interaction embedded in the system to ask a set of structured questions, designed by dermatologists.

Brian said: “The beauty of this is that the questions are very clinical, but it doesn’t take a clinician to ask them. There’s no decision-making pressure on individuals; the system handles it for them.”

If risk factors are identified, patients are routed through a second stage of clinical screening and referred for imaging. A central virtual triage team then reviews the case and either discharges the patient, refers them for treatment, or escalates them to urgent dermatology care.

The pathway is powered by auto-populated templates, and intelligent branching logic — reducing the cognitive load for staff while ensuring consistency and safety at every step. This also means that patients get the treatment they need more quickly whilst freeing up GP time so that they can deliver more clinically complex care.

This has completely transformed our referral process, patients in critical need are getting seen a whole 14 weeks faster."

Brian Hann
Business and Operations Director, Chorley and South Ribble Healthcare Network

The results

In just 24 months, the impact has been remarkable:

20,000 patients have been screened

16,000 have been imaged and reviewed by dermatology teams

70% of those were discharged without needing specialist care

30% were fast-tracked into cancer pathways

Referral times have dropped from 14 weeks to under 2 weeks

Brian explained that many patients have described the service as feeling “like private healthcare.” The team now hopes to expand the model to other clinical areas, including respiratory and diabetes, using the same digital principles.

This project is a shining example of how innovation, collaboration, and better use of digital tools can drive real change — prioritising patient care while easing the pressure on the NHS.