A NEW way of supporting patients in Somerset with skin conditions which can lead to mental health issues has proven a success in its first 18 months.

It came about when Somerset NHS Foundation Trust’s dermatology service linked up with Dr Janet Angus, a consultant dermatologist at North Bristol NHS Trust and leading figure in the specialty, to set up a virtual forum for dermatology and mental health clinicians to come together to plan treatment for individual patients.

Dr Angus runs a complex clinic which integrates physical and mental health.

It is a tertiary service open to patients across the Westcountry, from Truro to Gloucester, and involves travelling to Bristol.

However, the service in Somerset has for the first time made this type of care available virtually, meaning patients can receive support closer to home without the need to travel.

Somerset’s dermatology service is made up of an extended team of about 30 colleagues, including 22 GPs with an extended role in dermatology.

It is well-known that people with dermatological conditions can develop mental health issues, so the trust’s consultant dermatologist, Dr Alex Anstey, contacted Dr Angus to look at if it was possible to bring a variation of her successful complex service to Somerset.

Dr Anstey said: “When we were developing our new dermatology service for Somerset, I got in touch with Janet, as an expert in the field, to see whether she had any advice on how we could care for those patients with mental health conditions, too.

“These are patients who would have previously waited a long time for mental health treatment following a separate referral from their GP, but this makes it so much easier for their physical and mental health needs to be treated by the same team.

“Our patients often have complex problems, so it is really beneficial that we can immediately set them off down the right path, where their care is discussed by a group of experts.

“Collectively, we develop a management plan for each patient, with a colleague in the team taking a lead for their care.

“That may be the dermatologist, one of the psychiatrists, somebody from talking therapies, or even Janet.

“Together, we developed the concept of a monthly multidisciplinary team meeting, which includes a consultant psychiatrist, a colleague from our talking therapies service, our lead dermatology clinical practitioner Ivona Ramoiu, who has a BA science degree in psychology and a Master’s degree in clinical psychology, myself as a consultant dermatologist, and Janet.

“Janet’s idea was that we prepare each patient’s case notes in advance for a discussion and decision on the most appropriate care and treatment for them.

“As it is run online, anybody from the team can attend, so it also serves as a really useful educational resource for our resident doctors who are training in dermatology, too.

“We have seen nine patients so far, and we believe we are the only NHS trust in the country with this type of hub and spoke virtual clinic.”