Skin Cancer  Referral  Sentinel

This short survey should be completed in relation to any suspected / proven skin cancer referral you make to Secondary Care , particularly if there is significant delay in instances of urgent referral. The purpose of the survey is to enable identification of local referral pathways where there may be unsafe levels of delay. It is important to the PCSA, the ICGP and the NCCP that such instances are accurately and consistently highlighted, and reported appropriately. The survey takes 2-3 minutes.
THANK YOU FOR YOUR  HELP  
Dr Niall Maguire MICGP FRCGP 
niallpmaguire@yahoo.com  +353 879728793

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* 1. What did you refer?

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* 2. approx age of patient

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* 3. Where was the lesion

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* 4. Approximate size  of lesion

small mm large
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 5. How sure is the diagnosis at time of referral?

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* 6. To whom or to which Team did you refer your patient ?

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* 7. Where did you  refer?

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* 8. Where did you  refer?

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* 9. What date did you refer?

Date

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* 10. What date did the patient see the Hospital Specialist?

Date

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* 11. What date did the patient have surgery?

Date

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* 12. Were there any deferrals/cancellations?

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* 13. Final Diagnosis?

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* 14. Extreme delay: If you have made a referral and have received a refusal to see or a very long rage appointment, please tell us about it here.

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