Does dermatology have a place in secondary care?

These are challenging times in the NHS – structurally and financially. The reforms outlined in the Health and Social Care Act 2012 are being implemented rapidly. This is at a time when cost savings are high on the agenda of commissioners and providers of care, despite the emphasis placed on delivering high-quality, patient-centred care. The changes will see more competition in the NHS marketplace, so clarity of which services sit best where, and for what reasons, would be helpful to inform the new clinical commissioning groups. This article considers the specific issues relating to the configuration of dermatology services and, in particular, the question of whether dermatology has a place in secondary care. Before answering this question, consideration will be given to the meaning of ‘secondary care’ and ‘dermatology’.