BH04 Review of a dermatology nurse-led hair service

Abstract

Abstract In 2017, our department was faced with a significant delay in new patient waiting times for the tertiary hair and nails clinic. A nurse-led service was developed to relieve this pressure. Within 18 months, the waiting list was much more manageable at less than 12 weeks, an improvement that has been maintained. The nurse-led service was designed predominantly to see and treat patients with alopecia areata. We present details of the nurse training and clinic setup. Three years after the setup of the nurse-led hair clinic, we reviewed this service. The aims of this review were to assess the capacity of the nurse-led hair clinic, the clinical outcome and the psychological impact. A review of all patients seen between November 2021 and October 2022 is presented. The total number of patients seen was 130. The majority had focal alopecia areata (90%). Clinical outcome measures were recorded using the Severity of Alopecia Tool score and Alopecia Areata Investigator Global Assessment. Psychological outcome measures were assessed using the Dermatology Life Quality Index and a patient questionnaire. The majority (72%) were treated with intralesional triamcinolone; 5% received a wig. The aim is to treat and discharge, while enabling easy access back into the service. It was hoped that this pathway would alleviate patient anxiety on discharge. All patients reported that they found it easy/very easy to be referred correctly by their general practitioner. The majority of returning patients had been given a clear explanation of the rereferral process on discharge. All reported an excellent or good service. More than 90% answered positively when asked whether the nurse listened, addressed fears/concerns and provided adequate verbal and written information. Sixty-two per cent remember being signposted to a relevant support group and all were satisfied with their treatment. We will present written information provided by the patients on what they found most useful about the clinic and how the clinic could be improved. We show the success of a nurse-led service that has addressed capacity issues and clinical management and provides emotional support. The detail presented will be sufficient to guide other departments on training and clinic setup when developing such a service.