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This guidance covers the referral of a patient presenting with skin lesions suggestive of skin cancer or in whom a biopsy has confirmed skin cancer to a team specialising in skin cancer.
Refer patients with persistent or slowly evolving unresponsive skin conditions with uncertain diagnosis to a dermatologist.
If you perform minor surgery you should have received appropriate accredited training in relevant aspects of skin surgery including cryotherapy, curettage, and incisional and excisional biopsy techniques, and should undertake appropriate continuing professional development.
GPs can refer a patient they suspect of having cancer to be seen within 14 days by a specialist. GPs must send the referral within 24 hours of the decision to refer.
Please use the referral forms listed on this page to ensure appropriateness. They have been agreed by the Peninsula Cancer Network.
All pigmented lesions that are not viewed as suspicious of melanoma but are excised should have a lateral excision margin of 2mm of clinically normal skin and cut to include subcutaneous fat in depth.
Send all excised skin specimens for pathological examination.
When referring a patient in whom an excised lesion has been diagnosed as malignant, send a copy of the pathology report with the referral correspondence.
Malignant melanoma
NICE Referral Guidelines on lesions suspicious of malignant melanoma. Patients with a score of 3 or more as follows:
Squamous cell carcinoma
Basal cell carcinoma
The GP should use e-Referral Service to book an appointment or send the referral.
Please ensure you include:
e-Referral selection:
Please ensure that referrals are booked via NHS e-Referral Service. If no slots are available please defer to provider and the RDE will book the appointment and contact the patient. Please also ensure that referral letters are attached to the system within 24 hours to enable us to book pre appointment tests and scans timely.
For any patients that you are unable to process through NHS e-Referral please contact the drss.helpdesk@nhs.net
Suspected Skin cancer referral form - No merge field
Suspected Skin cancer referral form - EMIS
NICE referral guidelines for suspected cancer
Suspected Cancer Guidelines A-Z
NICE referral guidelines for suspected cancer
bmj - New NICE guidance on referral for cancer
bmj - Assessing and referring adult cancers infographic
New Leaflet available for patients who are referred to exclude a diagnosis of cancer
New Leaflet available for patients who are referred to exclude a diagnosis of cancer
This guideline has been signed off by NHS Devon.
Publication date: November 2016