Faster decisions for urgent suspected skin cancer referral at Homerton

Dermatology consultants at Homerton Healthcare NHS Foundation Trust are now reviewing twice as many referrals per clinic, thanks to a new digital pathway for urgent suspected skin cancer.

Developed in partnership with City and Hackney GPs, the North East London Cancer Alliance, and Isla Health, the pathway is already helping teams manage rising referrals faster and more safely.

A smarter way to manage growing NHS referrals

Urgent suspected skin cancer referrals in North East London have been increasing by 10–15% year on year since 2020. To meet that rising demand, Homerton and its partners have redesigned the way these referrals are managed. They are now using Isla’s digital pathway platform to support more responsive, tech-enabled care delivery.

The new approach supports faster and more confident decision-making by allowing GPs to capture high-quality images and clinical information from patients. Those images and forms are sent securely to Homerton for review through the NHS e-Referral Service (e-RS), with digital consent replacing paper-based processes and everything saved directly into the patient’s record.

The pathway went live across several City and Hackney GP practices in April 2025. It’s part of a wider effort to improve both urgent and routine dermatology care by using technology in smarter ways, while reducing unnecessary delays for patients.

Angela Wong, Chief Medical Officer at the North East London Cancer Alliance, said: “Our top priorities as a cancer alliance are to deliver faster diagnostic results, detect cancer at an earlier and more treatable stage, and tackle health inequalities across our communities.

“By adopting ISLA’s digital platform for suspected skin cancer, we’re taking a significant step forward in achieving these goals. This innovation will help strengthen our position as one of the leading cancer alliances in the country.”

Integrated with NHS e-RS with no extra steps

The new pathway is fully integrated with e-RS, which is already used for over 380,000 referrals a week across England. That means it fits easily into existing clinical workflows, without needing to switch between systems or download attachments manually.

How does the pathway work in practice?

GPs capture a photo and clinical information via a structured form in Isla. When a referral is sent through e-RS, Isla then pulls it directly into the platform, along with any documents or images. Patient details are automatically imported, creating a structured view of the referral in the patient’s digital record. There’s no need to switch systems or re-enter information. 

From there, clinical teams can zoom in on images and compare them side-by-side, and triage and record decisions directly in Isla. Everything is saved in one place, with reporting and data exports available to help operational teams track activity and manage demand.

For patients, it means quicker responses and fewer delays. For clinicians, it means less admin, fewer duplications, and a clearer picture at the point of triage.

Faster and safer care

The new pathway has already doubled the number of referrals being reviewed per clinic at Homerton. 

That means patients are more likely to get timely answers and treatment or reassurance sooner.

The pathway also improves safety, quality and governance:

• Secure image capture and storage – Consent is recorded digitally via Isla using a tickbox, and no images are stored on local devices. Everything is saved securely in the patient’s record.
• Enhanced image quality – Isla maintains high-resolution images and uses built-in blur detection to prompt images to be retaken if they aren’t clear enough for clinical review.
• Support for USSC teledermatology – The improved triage and image quality is already supporting the launch of a more efficient urgent suspected skin cancer (USSC) teledermatology model.
• Population-level insights – GP practices can access a data dashboard in Isla, giving them a broader view of referral activity and image quality across their population.

Together, these features support safer decisions, more efficient reviews, and a better experience for both patients and clinicians.

 Peter Hansell, CEO and Co-founder of Isla Health said: “Another great example of how digital pathways step us towards a better model of care. By doubling referral capacity and speeding up decision-making, the teams at Homerton are making a real difference for patients every day. It’s a strong example of effective digital transformation in the NHS and is exactly the sort of pathway that should be deployed for all relevant centres through a nationally led programme. Huge well done to the whole Homerton team who have driven this forward!”

Rosie O'Dea, Project Manager, North East London Cancer Alliance, added: "Working with Isla to introduce this new digital tool means a faster, more effective and safer service for our local patients who are worried about changes to their skin.

"This is a fantastic example of how the Cancer Alliance is supporting residents by working with trusted partners and introducing innovative solutions. These improvements in local cancer care will help save lives.”

A suspected skin cancer referral model for today

For teams exploring how to improve dermatology pathways, this collaboration shows what’s already possible using existing systems and infrastructure.

It’s delivering faster triage decisions, better image quality, and reducing the time it takes for patients to get answers and treatment where necessary. And because it’s integrated with e-RS, it doesn’t ask you to change how you’re working or add new steps. It enhances what’s already there.

You can also read about Royal Cornwall Hospitals NHS Trust’s work with Isla to see how a similar model is reducing the patient waiting time for urgent two-week wait (2WW) skin cancer referral by 79% (from 57 to 12 days of waiting).

Working together across North East London

This work brings together organisations who know the local health system and the latest technology to make care better for patients:

Homerton Healthcare NHS Foundation Trust is an integrated care trust providing hospital and community health services for Hackney, the City, and surrounding areas. Hospital services are delivered from the Homerton site, alongside a full range of community care in people’s homes and local settings.

The North East London Cancer Alliance is one of 21 alliances across England, set up following the Independent Cancer Taskforce strategy. The Alliance brings together patients, clinicians, and partners across the region to improve the diagnosis, treatment, and care of people living with cancer.

City and Hackney Place Partnership brings together the NHS, local government, Voluntary, Community and Social Enterprise (VCSE) organisations, and residents to shape services around what works for the local community.

Isla Health is a digital pathway platform for healthcare providers to support patients throughout their care journey. The platform is used by over 30+ NHS trusts and international healthcare organisations across more than 40 clinical specialties. Healthcare providers manage over 2 million patient  submissions per year through Isla.