P170 Red rash, green outcomes: working towards a greener, sustainable dermatology service

Abstract There is a growing awareness among UK dermatology professionals to evaluate their practice from a sustainability viewpoint. The publication of the British Society for Dermatological Surgery guidance for skin surgery (2022) and The Journal of Sustainable Dermatology in Practice are positive steps. Our study highlights the hitherto overlooked role of teledermatology in promoting sustainable practices and environmental efficiencies. We are an independent teledermatology service provider across six commissioning zones. We cover 165 National Health Service practices with 1565 registered users. Our consultant-led, ‘first-line’ service uses the principle of Getting It Right First Time to redesign and comprehensively manage the clinical pathway for all dermatology referrals between primary and secondary care for commissioners. Combining proprietary software with rapid access to personalized specialist opinion in a cost-effective, timely manner, we achieved the following demonstrable efficiencies. Between January 2020 and January 2025 we prevented 98 684 patients (77% of 128 419 referrals received) from being referred to secondary care. This resulted in direct cost savings of £8 404 735. We saved 37 538 specialist healthcare hours, equating to 20 years’ full-term appointment, creating a significant and sustainable impact when services are grappling with staff shortages. The most positive outcome was the ‘green impact’ of our service. Our patients saved 115 630 h of travel time, and saved 2 582 066 km in travel distance. Assuming the split between patients taking public and private transport is 50 : 50, the total carbon savings were 344 708 kg of CO2 equivalent (CO2e) (Table). In Britain 88% of passenger kilometres are by cars, vans and taxis. Assuming this split, the true total carbon savings were 416 335 kg of CO2e. Each patient saved between £3.10 (public) and £4.38 (private) in transport costs. A split of 88 : 12 between public and private transport gives total transport cost savings of £417 078. We are honoured to have our environmental and efficiency impact recognized by being awarded the Sustainability Partnership awards 2024 for the Supplier of the Year and Software of the Year. We have also been shortlisted for the HSJ Partnership Award 2025. Our report demonstrates that dermatologists can harness technology and innovation to achieve sustainability impact across the wider patient journey. It also shows that green practices can be assimilated seamlessly within the current scope of work.TableTravel statistics assumptionsAverage distance to hospital7.96 miles or 12.81 km one wayAverage emission per car0.17 kg CO2 equivalent per kmAverage emission for public transport (bus)0.097 kg CO2 equivalent per kmAverage travel time to hospital36.25 minAverage petrol cost151 pence per litreAverage fuel cost per appointment (by car)£1.38