8 in 10 skin cases managed without a face-to-face GP appointment
How structured remote triage can free clinical time and get patients answers faster.
This is the full web adaptation of RADAR Skin Health's community pharmacy edition of its eight-week tele-dermatology pilot case study, labelled Q4 2026. The source headline describes cases as “resolved without an appointment”. Here, that means the recorded care route did not require a face-to-face GP appointment; it does not establish that the underlying condition had resolved.
Putting the evidence into practice. Pressure on UK skin care is about both specialist capacity and how quickly each case reaches the right clinician with enough information to decide. The case study asks whether structured remote triage can support everyday general practice. In one UK GP practice over eight weeks, more than eight in ten cases were managed without a face-to-face GP appointment, and the median clinician review took under four minutes. This community pharmacy edition uses the same GP-practice dataset; it is not a separate pharmacy trial. Its applications to that setting are proposals for further evaluation.
- Managed without a face-to-face GP appointment
- 83.6%
- 488 of 584 unique cases
- Median clinician review time
- 3.6 min
- From opening the case to a decision; 444 timed review sessions
- Clinical answer within 24 hours
- 73.5%
- Submission to decision, including time in the queue
Reported findings from one UK GP practice over eight weeks. Diagnostic accuracy and patient outcomes were not measured.
Why this pilot matters
The case study cites more than 423,000 dermatology waiting pathways in England in August 2026, with 69% waiting less than 18 weeks. [1] The original PDF calls these “people”; waiting-list statistics count pathways, which are not necessarily unique patients. It also cites a British Association of Dermatologists statement that urgent skin assessment referrals rose by 170% over ten years, while only 6% of urgent suspected skin cancer referrals were confirmed as cancer. [2] These are the source's dated context figures, not findings from the RADAR pilot.
The skin pathway bulletin and full white paper argue that adding appointments alone will not close the gap. They propose a faster route to the appropriate clinical decision, built on a structured history and clinically usable images, with specialist time reserved for cases where it changes care. The pilot explores that idea at the GP's front door.
About the pilot
Over eight weeks, one UK GP practice routed its skin presentations through RADAR Skin Health. The publisher describes RADAR as a certified remote dermatology assessment platform, developed by clinicians for clinicians, for community pharmacies, GP practices and dermatology clinics. Patients submitted a structured history and clinical images; cases were routed to a clinician, and the outcome was returned to the patient record.
Outcomes cover 584 unique cases. Review-time results cover 444 review sessions with complete timestamps. [6] The case count and the timed-session count have different denominators.
How the hybrid model works
RADAR describes a hybrid diagnostic support model: digital tools prepare and route the information, while a qualified clinician makes the clinical decision.
1. Patient submits the case
A structured history and photographs are submitted from home, at any time.
2. Platform prepares and routes
The platform checks completeness, standardises the case and routes it to the appropriate clinician.
3. Clinician reviews the case
The clinician assesses the history and images and can request more information at any point.
4. Clinician decides the route
Options include discharge with advice, monitoring, face-to-face assessment or referral, including urgent escalation.
5. Platform records the outcome
The determination is filed to the patient record. The source names EMIS, SystmOne and WriteUpp as direct integrations.
Patient capture → digital preparation → human review and decision → recorded outcome. Product workflow and integration descriptions are the publisher’s statements.
The clinician decides
Diagnostic judgement stays with a qualified clinician, who determines every case and retains full responsibility for the outcome.
The platform supports
The intended reduction in rework comes from complete, consistent cases, routing to the appropriate clinician and filing the outcome without re-keying.
Urgent escalation is part of the pathway
The source states that suspected skin cancer is escalated on the urgent pathway. Three cases in the pilot were referred urgently.
Results: the recorded outcomes
488 of 584 cases (83.6%) did not need a face-to-face GP appointment. 480 cases (82.2%) were managed without either a face-to-face GP appointment or an onward referral.
Source: RADAR Skin Health pilot outcome data; 584 unique cases. Percentages are rounded.
- Managed without a face-to-face GP appointment83.6% · 488 cases
- Face-to-face GP appointment16.4% · 96 cases
The 488 cases include eight onward referrals. “Without a face-to-face GP appointment” does not mean no further care was needed.
Decisions were fast
- Median clinician review time
- 3.6 min
- Mean 4.7 minutes
- Reviews completed in under ten minutes
- 90.1%
- Among recorded timed reviews
- Median submission-to-decision time
- 18.1 hrs
- Includes the queue for review
- Cases determined within five days
- 96.1%
- Reported pilot turnaround
Review duration is the clinician’s time on a case. Submission-to-decision time also includes the patient’s wait for review.
Two-thirds of recorded reviews (67.6%) took under five minutes. Median review time fell from 4.4 minutes in the first half of the pilot to 2.9 minutes in the second, a reported 34% reduction.
Including queueing, 73.5% of cases were determined within 24 hours. The source contrasts this with a typical wait of up to two weeks for a routine GP appointment, citing NHS England Digital's Appointments in General Practice. [5] That is the report's contextual comparison, rather than a matched control group or a universal NHS waiting time.
How this compares with other services
The source places its findings alongside a Royal Cornwall Hospitals tele-triage pathway, which reported 49.8% of referrals managed without a face-to-face assessment and consultant time reduced from about 20 minutes to three minutes per patient. [3] It also cites an Eastern AHSN evaluation in Norfolk and Waveney in which 0.45% of patients discharged through advice and guidance re-presented within six months. [4]
RADAR's proposed application brings a similar remote-review approach earlier in the pathway, at the GP's front door. These are separate service evaluations with their own populations and workflows. They are not direct comparisons with this pilot, and the Norfolk and Waveney re-presentation figure is not a measured RADAR outcome.
The economic case: resources saved and capacity gained
The report proposes that cases arriving complete, ready for review around scheduled clinics, could allow the same clinical time to support more assessments. Using the pilot's figures, it presents the following estimates. [6]
- Estimated clinician time released
- 76 hrs
- Across the eight-week pilot
- Estimated reduction in clinician time
- 52%
- Across all 584 cases
- Assessments per clinical hour
- 3–4×
- Reported remote-review capacity comparison
- Appointment-equivalent slots per year
- ~2,000
- One practice, if the eight-week pattern were sustained
Modelled estimates, not a controlled comparison or observed annual savings.
The source presents 12–16 remote assessments per hour versus four 15-minute appointments. This illustrates review capacity and is not total episode throughput.
For community pharmacies and the GPs and dermatologists who support them, the proposed benefit is to preserve face-to-face sessions for procedures, complex conditions and suspected malignancy. These are estimates from a GP practice, not measured pharmacy staffing savings, consultation volumes or income.
Model assumptions. Each of the 584 cases is assumed otherwise to require one 15-minute appointment. The calculation uses the observed 4.7-minute mean remote review time, and includes additional face-to-face appointments for the 96 cases that still needed them. Annual figures extrapolate the eight-week rate. Around 2,000 slots represents the appointment-equivalent value of saved clinician time; it is not a count of appointments observed to be released over a year. Local case mix, administration, follow-up, staffing and service arrangements will affect actual capacity.
What this means for community pharmacies
The pharmacy edition describes community pharmacy as an increasingly important front door for skin care. Citing NHSBSA data, it reports that, since January 2024, pharmacies in England had completed more than 1.1 million consultations under Pharmacy First's three skin pathways. These accounted for one in six Pharmacy First consultations, with skin activity growing by 40% in the preceding year. [7] The PDF does not specify the extraction date for those activity totals.
The source notes that these pathways cover impetigo, infected insect bites and shingles. Many other concerns seen in pharmacies, including eczema flares and changing moles, fall outside those clinical pathways or do not meet a gateway criterion.
- Skin pathway consultations
- 1.1m+
- England, since January 2024; source snapshot
- Pharmacy First consultations
- 1 in 6
- Attributed to the three skin pathways in the report
- Growth in skin activity
- 40%
- The report’s comparison with the preceding year
Activity figures reproduced from the pharmacy edition, labelled Q4 2026, citing NHSBSA. The PDF does not state an extraction date.
Pharmacy First at a glance: the report's 2026/27 snapshot
The following preserves the policy and funding information supplied in the original pharmacy edition. It is a dated account of what that report says, not current eligibility, payment or prescribing guidance. Local commissioning arrangements and the applicable service specification determine what a pharmacy can provide and claim.
| Topic | Source snapshot |
|---|---|
| Three skin pathways | Impetigo: age one and over. Infected insect bites: age one and over. Shingles: age 18 and over. Each has gateway criteria that must be met before treatment can be supplied. |
| Consultation fee | The report states £17 per completed clinical pathway consultation. |
| Monthly payments | The report states £500 for 20–29 consultations, or £1,000 for 30 or more consultations. |
| Independent prescribing | The report says that independent prescribing extends Pharmacy First from autumn 2026, with new prescribing-only pathways under consideration, including skin infections. |
The funding and development statements cite The Pharmacist, “What does the 2026/27 contract mean for pharmacies?”, dated 1 June 2026 in the PDF. [8] They are preserved as attributed source statements, not independently verified announcements or payment entitlements.
Where skin consultations get difficult
- Outside the pathway: presentations such as eczema flares or a changing mole may fall outside the three pathways or fail a gateway point, requiring a GP assessment and another wait.
- Incomplete onward referrals: without images or a structured history, the GP may need to repeat the assessment.
- Limited specialist support: an uncertain rash or lesion may require a second opinion without a quick, agreed route to obtain it.
- Time pressure: a busy pharmacy can make comprehensive documentation difficult.
How RADAR proposes to support Pharmacy First
The following are the pharmacy applications set out in the source. The measured evidence remains the single GP-practice pilot, and these pharmacy effects were not tested in that study.
| Benefit | What it means for a pharmacy |
|---|---|
| Structured, consistent consultations | A guided history and clear clinical images would give each skin case a complete, consistent record. |
| A second opinion when needed | Cases outside the pathways or failing a gateway point could be shared for remote review by a GP or dermatologist. The 3.6-minute median review was measured in the GP pilot, not a pharmacy review service. |
| Better onward referrals | When a patient needs GP or urgent care, sending the history and images with the referral aims to avoid repeating the assessment. |
| Urgent cases escalated | The proposed workflow identifies suspected skin cancer and other red-flag presentations at clinician review and routes them to the appropriate pathway. |
| Confidence to complete more consultations | Clear documentation and access to advice could help pharmacists manage eligible skin cases within the pathways. The source links completed eligible consultations to its stated £17 fee and monthly thresholds; actual claims remain subject to the applicable service rules. |
| Ready for independent prescribing | A full clinical record, including images, could support prescribing decisions and audit as the service develops. |
Pharmacy implementation would need an agreed reviewer, clinical responsibility, outcome communication, follow-up and routes for in-person or urgent care. The GP pilot does not establish pharmacy safety, effectiveness or financial returns.
What this means for patients
| Benefit | What it means for patients |
|---|---|
| Faster answers | Most patients in the pilot received a clinical decision within 24 hours, compared in the report with waiting weeks for a routine appointment. |
| Reduced anxiety | A prompt, clinician-led assessment aims to reduce prolonged uncertainty about whether a skin change is serious. |
| Urgent cases prioritised | The workflow is designed to identify higher-risk presentations, including suspected skin cancer, and escalate them on the appropriate pathway. |
| Appointments for those most in need | Remote management of suitable routine cases could preserve face-to-face appointments for patients needing in-person assessment. |
| Convenience | Patients can submit a case from home at any time, potentially avoiding travel and time off work when an in-person appointment is unnecessary. |
| Privacy and security | RADAR states that data is encrypted, hosted inside the NHS firewall and never shared for commercial purposes. |
Patient benefits described in the case study; patient outcomes and experience were not measured.
What this case study tells us
The skin pathway bulletin argues for earlier, better-informed decisions alongside capacity expansion. This pilot offers early practical evidence about that approach at the GP's front door, using a model in which technology prepares a case and a clinician determines the next step.
| Conclusion | Evidence and interpretation |
|---|---|
| Many presentations can receive a decision without an in-person GP appointment | 83.6% of 584 cases were managed without a face-to-face GP appointment; 82.2% needed neither that appointment nor an onward referral. These are care-route outcomes. |
| Information quality may support capacity | Median clinician review was 3.6 minutes. The report models 76 clinician hours released over eight weeks and three to four times as many assessments per review hour. |
| Specialist capacity can be focused through triage | Eight of 584 cases (1.4%) were referred onwards, three urgently. This illustrates selective referral in the cohort; referral counts alone do not establish whether all patients needing referral were identified. |
| Patients can receive an answer promptly | 73.5% of cases received a clinical decision within 24 hours and 96.1% within five days, compared in the report with waiting up to two weeks for a routine GP appointment. |
Appendix: about RADAR Skin Health
The source describes RADAR as moving the first skin consultation online, designed with UK dermatologists and GPs, by clinicians for clinicians, for use in community pharmacies, GP practices and dermatology clinics. The following reproduces its product, integration and assurance information as statements made by RADAR in the supplied case study. These were not independently verified as part of the pilot and are not clinical study findings.
A fluid workflow
Patients submit a structured history and photographs through an app, at any time. The intended workflow produces complete, standardised cases, routes them to a suitable clinician and allows review around the clinician's workload. RADAR describes this as requiring no appointment booking, avoiding missed appointments for the remote review and eliminating re-keying of the determination.
Integrated with clinical records
RADAR states that it connects securely with existing clinical systems so that each determination is filed directly to the patient record without manual transcription. The report names direct integration with EMIS, SystmOne and WriteUpp.
Certified and secure
The source states that RADAR is certified to ISO 9001 and ISO 27001, has NHS DSPT and Cyber Essentials Plus accreditation, and is aligned to the NHS SCAL. It also states that data is encrypted, hosted inside the NHS firewall and never shared for commercial purposes. These are the publisher's assurance statements, retained from the source appendix.
Clinical safety and governance
RADAR describes its role as supporting clinical decisions. Every case is reviewed and determined by a qualified clinician, who can request more information, arrange a face-to-face appointment or refer at any point.
- Clinician-led decisions: no case is closed without clinical review; the reviewing clinician retains full responsibility for the outcome.
- Urgent cases escalated: suspected skin cancer and other higher-risk presentations are reviewed and referred on the appropriate pathway. Three cases in the pilot were referred urgently.
- Regulated and assured: the source identifies RADAR as a UK MDR Class I medical device, with clinical safety managed under DCB0129 and alignment to the NHS Digital Technology Assessment Criteria (DTAC).
Join us in shaping the future of skin care
RADAR is inviting a small number of community pharmacies delivering Pharmacy First to help shape its next phase. Complete the two-minute UK Skin Pathway Benchmark Questionnaire on how your pharmacy manages skin cases. The source offers a findings report showing how your approach compares with other UK pharmacies and practices.
Take the UK Skin Pathway Benchmark Questionnaire.
Read the wider evidence
- The UK skin pathway is under critical pressure: the bulletin's figures on rising demand, constrained specialist capacity and four points where the pathway could improve.
- The UK skin assessment pathway: the full analysis of demand, capacity and the route to clinical decisions, with the updated paper's 20 referenced sources.
Get in touch or request a demonstration
Explore how the workflow could fit your pharmacy. A demonstration covers the patient journey, clinician review, how outcomes reach the clinical record, and questions about governance and integration.
Request a RADAR demonstration.
Sources and study context
Adapted from RADAR Skin Health Clinical trial – Pharmacies, published by RADAR Skin Health and labelled Q4 2026. The references below retain every source listed in that edition; they are the source document’s bibliography.
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NHS Wait Helper. Dermatology waiting times, England, August 2026. The source for the case study’s waiting-list context.
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British Association of Dermatologists. AI roadmap press release, 2 July 2025. The source cited for the ten-year urgent referral increase and cancer confirmation proportion.
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Royal Cornwall Hospitals NHS Trust. Tele-triage service report, February 2025. The source cited for 49.8% avoiding face-to-face assessment and approximately three-minute clinician review.
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Eastern AHSN. Norfolk and Waveney dermatology advice and guidance evaluation. The source cited for 0.45% re-presentation within six months following discharge.
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NHS England Digital. Appointments in General Practice. The source cited for the routine appointment waiting-time comparison.
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RADAR Skin Health. Pilot outcome data: 584 unique cases from one UK GP practice over eight weeks; review times from 444 sessions with complete timestamps.
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NHS Business Services Authority (NHSBSA). NHS Pharmacy First clinical pathways data. The source cited for skin pathway consultation activity; the PDF does not identify an extraction date.
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The Pharmacist. What does the 2026/27 contract mean for pharmacies?, 1 June 2026, as cited in the supplied PDF. The source cited for its funding and independent prescribing snapshot.