Background: Aotearoa New Zealand has one of the highest burdens of skin cancer in the world(1). National expenditure in 2021 was estimated at $180.5m and due to the increasing burden of this disease has been projected to reach $295m in 2025. Healthcare services providing diagnosis and management of skin cancer in this country must be prepared for increasing demand among our population. Introduced to this hospital 6 years ago, the See and Treat (S&T) model provides specialist assessment and surgery in a single outpatient visit and has been shown to improve patient wait times for skin cancer treatment(2).
Methods: This retrospective audit of a single-centre S&T skin cancer care model assesses the performance against ministry of health (MOH) 62 day cancer treatment guidelines(3) and identifies opportunities to improve efficiency in our strained healthcare system. All patients reviewed in our S&T specialist outpatient clinic were identified from virtual clinical records. Demographic data, management trends and referral/treatment wait times formed the basis of this dataset.
Results: A total of 6087 patients with a mean age of 67.8 years underwent specialist assessment in our S&T outpatient clinic from August 2018 to March 2024 (five years and seven months). Referrals originated largely from general practice (95%) and the mean wait time from referral to specialist appointment was 87 days. Only 36% of patients were seen within the 31-day MOH target for cancer treatment. Of the patients who had surgical management, 70% underwent same-day surgery compared to 2% of patients in the pre-S&T era.
Conclusions: Introduction of the S&T model of care has greatly improved surgical waitlist times in this unit. Despite this, compliance with MOH targets is poor. A further prospective audit is currently underway to identify barriers to same-day-surgery and implement change.