Skin Lesion Service
Skin Lesion Service – Minor Surgery
Key Purpose/Benefit
The WBOP PHO has an agreement with the BOP DHB to deliver the Skin Lesion Service in primary care. Credentialed General Practitioners with a Special Interest (GPSIs) are funded for removal of skin lesions that have been prioritised for surgery through a triage process.
Eligibility Criteria
An eligible patient must:
o Be Enrolled with a WBOPPHO Practice or
o Reside permanently in the Bay of Plenty; and
o Be a New Zealand citizen or have New Zealand residency status and
o Have one of the identified, entitled skin lesions listed below.
Entitled Skin Lesions
Pigmented when histology or provisional diagnosis indicates the following types:
o Melanoma
o Melanoma in situ
o Dysplastic naevus
o Other pigmented cutaneous malignancy
Non-Pigmented when biopsy testing indicates the following types:
o Basal cell carcinoma
o Squamous cell carcinoma including in situ
o Other non-pigmented cutaneous malignancies including keratoacanthoma
Exclusions
The following lesions are NOT entitled under the Skin Surgery Service:
o Seborrhoeic Keratoses
o Lipomas
o Sebaceous cysts
o Warts
o Solar Keratoses
o All other non-malignant lesion not listed above
Referral Process
The Skin Lesion Service has an independent triage clinician to assist in the processing of referrals. At frequent intervals, referrals are considered using the Priority Schedule to assess their criticality and the general scoring criteria. Lesions will be placed in descending order of priority. Funds will be assigned going down the schedule until the funds are fully assigned. See page 5 for priority schedule.
All referrals are sent to the WBOP PHO through Halcyon. It is important to attach supporting documentation with referrals for fair and accurate triage.
See Page 6: for the service Process flowchart. & Page 5: for the Priority schedule
Photos are Mandatory for both Pigmented and Non-Pigmented Lesions
o All referrals must have at least one clear clinical photo to indicate lesion location. A photo showing a scale/ ruler beside the lesion is preferred
o Where lesions have been biopsied, a clear clinical photo is still essential for fair triaging - please attach along with the histology
o For lesions that are not biopsied, clear clinical and dermoscopic photos are required for the triage process.
o Referrals for Non-Pigmented Lesions must include the histology.
All PMS’s
Referral to this service is accessed through Halcyon
1. When Halcyon opens – click on the “Other Options” tab (Top Right)
2. Then Select Skin Lesion – New referral.
3. When submitting from a PMS the Patient and Referrer tabs will auto populate. You will need to check the contact details tab for patient preferred method of notification.
4. Work your way through each tab within the referral – any mandatory fields will stop the form from submitting and show in pink.
4. Referral Details
5. Lesion 1
• Please include as much detail as possible as referrals will continue to be triaged remotely by a clinician and the information is handed on to GPSIs on approval.
• Photos are compulsory – the referral will not submit without photos attached.
• There is an additional guideline on saving photos to your desktop or PMS in the WBOPPHO Patient Services Guide (Portal)
• Second Opinions are only funded for probable Melanoma
Certain field selections will trigger other Fields.
Where a lesion is a Proven Melanoma is selected (provisional/Reported Histology Diagnosis)
Breslow will be required
If Breslow is >0.9mm then
o A checkbox :SLN Biopsy discussion has been had with the patient
Where a lesion is a proven or possible BCCN on the Head/Neck
Is the lesion over the embryonic plates (Y/N)
Where a lesion is a Proven SCCO on the Trunk/Limb
Differentiation will be requested
6: Finally, submit the referral – if any compulsory fields are omitted, you will get a pink alert with specific fields to complete
Payment
No Charges or payments are associated with referring to this service.
Resources
WBOPPHO Patient Services Guide (Portal)
https://portal.wboppho.org.nz/funded-clinical-programmes/%0d
Contact Details
For service Claims, Queries and Programme Support Requests
Please contact the Skin Lesion Service Administrator
Email: skinlesion@wboppho.org.nz
Phone: 07 571 2150
For Halcyon issues
Please contact the Programme facilitator
practiceClaims@wboppho.org.nz
Priority
Embryonic
