Improving outcomes for people with skin tumours including melanoma

A function of the LSMDT is to audit management and in particular to
ensure that wider/re-excisions have been adequately performed. As
with BCC/SCC audits, this should be presented quarterly to the MDT.
The LSMDT should also receive quarterly audit data from any
clinicians working in the community (Table 3).
Improving Outcomes for
People with Skin Tumours
including Melanoma
Organisation of skin
cancer services
Core membership of the LSMDT
The LSMDT should include the following.
• Designated lead clinician. A designated lead clinician (normally
a consultant dermatologist) who will take overall responsibility
for the service.
• Dermatologists. There should be a designated lead and ideally a
deputy lead, both with a special interest in skin cancer, and any
dermatologist involved in skin cancer care should attend the
MDT meeting.
• Skin cancer clinical nurse specialists (CNS) (as defined by the
Manual of Cancer Services 23 ). Patient advocacy and provision of
information and support for patients and carers are crucial
aspects of this role. The CNS will play a key role in
communication between the patients and the different
specialties involved in management and must have a high level
of communication skills. She or he should be able to provide
practical support such as advice postoperatively. The CNS will
also have an important role in the identification of patients’
psychosocial needs and will advise on appropriate referral. The
CNS may, if suitably trained, carry out a range of related service
activities such as minor surgery, skin cancer surveillance and
follow-up clinics in parallel with an appropriately trained doctor.
3
• Histopathologists. Histopathologists should take a lead role in
skin cancer. Pathology reports should include all the information
required by the current Royal College of Pathologists minimum
dataset for the relevant cancer. 24 The histopathologists engaged
in skin cancer diagnosis should participate in an appropriate
external quality assessment (EQA) scheme and demonstrate
evidence of continuing professional development (CPD) relevant
to skin cancer. The lead histopathologist should attend over 50%
of MDT meetings. Other histopathologists reporting skin cancer
should be able to demonstrate some MDT activity.
23 Department of Health (2004) Manual for cancer services. Available from: www.dh.gov.uk
24 Royal College of Pathologists. Standards and datasets for reporting cancers. Available
from: www.rcpath.org
Guidance on cancer services: skin tumours including melanoma
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