O224: Patient Services Not Fit for Purpose: Analysis of Skin Cancer Pathway

Abstract Background NHS public satisfaction fell to 29% in 2022; a record low in NatCen’s British Social Attitudes report since its debut in 1983. Exacerbated by COVID-19, services have redesigned to having an almost 3-fold increase in percentage of telehealth appointments. Now >40% of initial skin cancer appointments in our service are delivered remotely, an approach prioritising efficiency over patient-centred care. This study attempts to gain a comprehensive understanding of patient perceptions and attitudes in our skin cancer pathway. Method A snapshot survey of 103 consecutive patients, aged 22-96, 58% female, was conducted over one year at the Royal Free Hospital's skin cancer service. Data was analysed using thematic analysis, allowing for identification of recurring themes and patterns, following the American Association for Public Opinion Research’s guidelines for population analysis. Statistical analysis of frequency data was also applied. Results Key findings include a clear preference towards face-to-face as opposed to tele-dermatology in 62% of patients. Tele-dermatology’s primary drawback is only allowing for the assessment of one lesion in a clinic appointment, leaving 54% of patients with multiple unassessed lesions. Patients expressed satisfaction (72%) with waiting times for their initial appointment, however, 68% of patients were dissatisfied with the waiting time for their biopsy results. Conclusions The present configuration of services is not fit for patient needs. This study identifies key themes addressing appointment scheduling, telehealth limitations and communication preferences, offering guidance to healthcare providers to improve the quality of care for skin cancer patients, enhancing patient satisfaction and overall healthcare quality.