1.71 Consultees proposed several mitigations that could strengthen any chosen model:
- expand community-based screening, including mobile screening.
- reinstate local phototherapy and dermatology clinics, especially for those living in north Ceredigion and beyond.
- strengthen cross-border collaboration with Betsi Cadwaladr University Health Board to address shared workforce and service resilience challenges.
- more triaging of referrals, with only urgent cases sent to a centralised service.
- invest further in telemedicine and make better use of medical photography and video links.
1.72 Consultees proposed other potential alternatives and suggestions, including the following:
- consider the viability of dermatology being delivered in Hywel Dda and explore options to support out of area treatment in, for example, Swansea and Shrewsbury.
- provide a rotational service, with consultants or nurses travelling between hospitals, GP surgeries, health centres, and other sites to provide clinics on a weekly or fortnightly basis.
- consultant-led clinics at community sites (in Amman Valley and Llandovery Hospitals for example), rather than fixed in any particular general hospital, to save patients travelling large distances.
- create an Integrated Care Centre in Aberystwyth for minor operations (including dermatology).
- include the GP provision element in all four options due to the likeliness of it being implemented.
1.73 For further details, see the dermatology sections in the individual consultation method chapters.