CD15: The development of a semi-virtual patch testing service at a university hospital during the COVID-19 pandemic

Rebecca McCarthy, Livia Soriano, Michelle Oakford, Birgit Pees and Alice Sinclair

University Hospital Southampton NHS Trust, Southampton, UK

The COVID-19 pandemic saw an increase in the use of virtual consultations across the National Health Service (NHS) to reduce the number of in-person reviews in line with public health guidance. The implementation of virtual consultations posed logistical difficulties for patch testing. We developed a new semi-virtual patch testing service to overcome these difficulties. Prior to the COVID-19 pandemic, the patch testing service was run over 1 week. On Monday, patients attended for consultation and patch application; on Wednesday patients attended for removal of patches and clinical review; and on Friday patients attended in person for final reading. The patch testing service was redesigned to enable testing to continue safely while minimizing footfall in our department. The new semi-virtual patch test service is performed as follows. (1) Pretesting consultation occurs via video link (NHS Attend Anywhere) with a consultant and registrar. Patients are booked for patch testing 6–8 weeks later (conducted as below). (2) On Monday, patients attend for patch application. (3) On Wednesday patches are removed by patients themselves at home. Patients take photographs at this time. If it is not possible for patients to remove patches, they attend the clinic. (4) On Friday patients attend for review. There are many benefits of integrating virtual and face-to-face consultations for patch testing. If active treatment is required prior to testing (e.g. for active eczema on the back), this can be arranged following the video consultation, avoiding short-notice cancellations. Training has been maintained and, in fact, it has been easier for trainees to be part of the online consultation online. We continue to accept direct referrals from general practitioners without the need for general clinic review first, which has significantly reduced waiting times for this group of patients. Shorter face-to-face clinics on Mondays has resulted in a more efficient service, freeing up nursing staff and room space in the department. Patients attend the clinic better prepared for the week as the relevant information has been provided in advance. There are fewer in-person visits to hospital and this allows patients to fit patch testing into their weekly schedule with less interruption to activities of daily living. The integration of virtual consultations poses many challenges for dermatologists. The implementation of this patch testing service at our university hospital has demonstrated the positive impact of the integration of virtual and in-person cutaneous allergy testing. A similar process could be adopted by other centres to improve the efficiency of patch testing for patients and healthcare professionals.