Virtual remote occupational skin health clinics for Cardiff and Vale UHB staff: 2 year experience and lessons learnt

Cardiff and Vale University Health Board

From the start of the COVID-19 pandemic, large numbers of health care staff rapidly developed skin problems directly related to COVID-19 personal protective measures, such as hand eczema from frequent hand washing, facial skin problems from mask wearing and exacerbations of pre-existing skin disease. It was recognised, in early April 2020, that if these staff with urgent skin issues were not managed quickly, staff rota gaps would have been likely, impacting on the ability to manage the first COVID-19 wave of hospitalisations.

Traditionally, a letter referral system for health care staff was in place between occupational health departments and dermatology, with clinic bookings within a few weeks to months, depending on the urgency of the clinical problem. In light of the expected demand, a mechanism was needed for rapid referrals with direct access to dermatology and then a mechanism for urgent safe consultation with a dermatology expert within 1-2 days of referral to prevent sickness and work absences.

By mid-April 2020, a rapid access remote telephone clinic was established for staff experiencing urgent skin problems with personal protective equipment. Liaising directly with UHB Employee Health and Wellbeing Lead and Occupational Health Lead Nurses, a strategy was put in place to implement and advertise this clinic widely, with Executive Board support and the assistance of central communications.

A new service pathway was developed, with direct referrals securely emailed from occupational health to dermatology. Staff were then telephoned personally within 1-2 days for diagnosis and management.

Between April 2020 and January 2022, occupational health nurses screened over 300 staff and over 250 staff attended the Occupational Dermatology Clinic. It is estimated that sick leave time of staff members using this novel service has reduced by about 50% (an average 7-10 sick days prevented per affected staff member).

Mabs Chowdhury

mmu.chowdhury@wales.nhs.uk