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Richard Alun Jones from Stourbridge had recently retired from Jaguar Land Rover when his partner noticed changes to a mole on his back. He had the operation to remove it as part of a new nurse-led pathway at Dudley's Russells Hall Hospital on his 61st birthday last August and was later told it was melanoma. "It was the best birthday present.
Just get rid of it," he said. "Thankfully they captured it. They got it." The Dudley Group NHS Foundation Trust's direct-to-surgery pathway aims to take patients from a telephone consultation with a nurse to surgery within the same week, removing the need for a face-to-face consultant appointment.
This was developed by lead cancer nurse Lucy Smith to ensure those with suspected cancer could be assessed, biopsied, and treated sooner. All patients went through the trust's well-established teledermatology triage system, with consultant dermatologists assessing their images online. "We can then streamline patients into the best pathway for them," she said, adding patient choice was "paramount." While some patients still need to see a consultant, the nurse-led route is designed for simpler excisions where time is critical.
A four-month pilot from June to October 2022 treated 80 patients, with 70% diagnosed with skin cancer, pre-cancerous changes, or abnormal moles. The service now sees about 40 to 50 patients a month. Jones initially worried about not seeing a consultant face-to-face but later said, "I was just informed all the way.
I knew exactly what was going on." After surgery under local anaesthetic, he was told the mole had been melanoma. He was booked for a second operation in October to ensure no recurrence. Jones would recommend the nurse-led pathway, calling it "the best thing ever." He also encouraged vigilance about skin checks, noting that skin cancer referrals to the trust have risen sharply from 4,985 in 2023 to 7,793 in 2025.
Smith expressed satisfaction with the service, saying it improved patient satisfaction and streamlined care. Jones’ experience led him to focus on living life more intentionally, emphasizing the importance of acting quickly when health concerns arise. "Life is short," he said, highlighting the urgency of early detection and treatment.
Source: BBC
