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Dermatology Step-Up Clinic

Dermatology services receive more urgent referrals for suspected cancer than any other specialty. About half of the one million dermatology referrals per year are suspected skin cancer two-week wait referrals. It is recognised that a significant proportion of patients referred have non-relevant skin lesions. An ageing population is expected to put further pressure on the specialty, as skin cancer is much more common in the elderly and can be more difficult to treat in the presence of age-associated co-morbidities.

Dermatology clinics in the primary care setting enhances the quality of referrals to consultants, can reduce local waiting lists and can also ensure faster and more convenient access to high quality care close to the community.

GP Health Partners Ltd (GPHP), also known to some as the ‘GP Hub’ is a local GP federation serving 18 practices in and around Epsom, Banstead and Leatherhead. Through partnership and collaboration, we deliver a range of services for our local population to improve access to healthcare. One of these services is our Dermatology Step-Up Clinic that means patients can be seen locally, potentially reducing unnecessary referrals and improving patient satisfaction.

Clinic Criteria & Booking

The expected pathway would begin via a patient’s registered GP; if the GP believes further treatment of the patient should be continued at the step-up clinic, they can book directly into the Dermatology Step-up Clinic Service for consultation by a GP with a specialist interest in Dermatology. GP’s and patients should be aware that we cannot see any of the following:


  • Lesions that require a two-week rule referral for example malignant melanoma, squamous cell carcinoma, high risk/above the neck suspected basal cell carcinoma (BCC)
  • confidently identified low risk BCC (if unsure please refer to Step-up clinic or consider two-week rule referral if appropriate)
  • Photodynamic/Light therapy
  • Immunosuppressant prescriptions
  • Children under the age of 12 years old
  • Severe and scarring acne that may require oral retinoids (e.g. Roaccutane) prescribed by secondary care Consultant Dermatologists
  • Rash in an unwell patient
  • Clinically benign conditions that require removal for cosmetic purposes
  • Treatment that commissioners will not routinely fund – e.g. Botox, cosmetic fillers, scar refashioning
  • Patch Testing

Who we can see


  • Lesions suitable for dermoscopy where cancer is not thought to be the diagnosis
  • Low risk BCC on the body that can be treated topically
  • Diagnosis, investigation and management of chronic rashes in adults and children aged over 12
  • Step up care for eczema and psoriasis
  • Acne treatment – mild to moderate non scarring
  • Conditions of the hair, scalp and nails
  • Pre-Malignant condition e.g. solar keratosis and Bowen’s disease
  • Children aged 12+ years

For more information please see our Dermatology Step-Up Clinic Patient Information Leaflet

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