P005 The creation of a countywide skin cancer prevention strategy informed by public health and national guidance: from aspiration to reality

Abstract UK and local population data show high absolute rates for skin cancer, a disease that utilizes huge dermatology service capacity despite being almost entirely preventable. However, only one National Health Service (NHS) trust to date has published and reported a local skin cancer prevention strategy. Our aim was to create a countywide skin cancer prevention strategy following consultation with multiple stakeholders. The 6-month secondment of a public health registrar to the NHS trust’s dermatology service created the opportunity to write a local skin cancer prevention strategy. The strategy, which sits within the trust’s broader dermatology strategy and clinical model, was developed utilizing national and regional guidance and legislation. This included National Institute for Health and Care Excellence (NICE) guideline NG34 on sunlight exposure, NICE public health guideline PH32 on skin cancer prevention, examples of relevant work from elsewhere in the UK and abroad, stakeholder consultation, and patient and public engagement. The resulting strategy has two overarching aims: to reduce the incidence of skin cancer in the county, and to increase the proportion of skin cancers diagnosed at an early stage (therefore reducing morbidity and mortality) through early presentation. It aims to achieve this via two broad objectives: changing knowledge, attitudes and behaviours; and facilitation of sun safe behaviours. The strategy proposes universal actions focused on communications, workforce education, shade provision and sunbeds, in addition to targeted measures for high-risk groups including those who work outdoors, children and young people, and transplant patients. Strategy implementation will require effective partnership working and commitment from all partners including the NHS trust, local council and other organizations brought onboard to support implementation. Broad targets for the strategy include countywide reduction in the incidence of skin cancer (long term), countywide reduction in mortality from skin cancer (medium term) and countywide reduction in the proportion of melanoma diagnosed at late stages (medium term). Shorter-term evaluation plans will also be developed focusing on changes in public knowledge, attitudes and behaviours. Disease prevention is a stated health priority within the UK and in the local integrated care system. Skin cancer prevention at a local level requires a pragmatic strategy based on partnerships between public health and the NHS, close working with local stakeholders including patients and the public, and use of national guidelines and examples of good practice.