The use of technology to support dermatology referrals could help reduce waiting lists for the service but there is an “urgent need” to recruit additional consultants, according to the health and safety watchdog.
The HSE requested the Health Information and Quality Authority (Hiqa) to complete an assessment on the proposed implementation of teledermatology to support the management of primary-care referrals.
This would involve a dermatologist using photos, videos or live interactive video as well as the clinical information provided by the GP to decide whether to refer them for in-person care, refer back to their GP, book the patient in for a procedure or redirect the patient to another specialty.
According to the health technology assessment, published on Thursday, Irish dermatology services are “under significant pressure”, with more than 60,000 patients waiting for an appointment as of June 2025. Some people are waiting up to three years for a routine appointment.
“This delay is in the context of 100,000 new referrals from primary care and approximately 150,000 completed outpatient appointments each year – two-thirds of which relate to return patients. Long delays in receiving specialist care place a significant burden on patients and can worsen health outcomes,” the assessment said.
The watchdog said if referral rates continued to grow in line with population growth and demographic changes, and the current system remained unchanged, there could be more than 370,000 people on waiting lists within 10 years.
The authority warned about the potential health risks to delays in accessing specialist dermatology services, such as “reduced survival for cancers diagnosed at later stages and increased physical and psychological burden for patients with chronic inflammatory conditions”.
A health technology assessment found teledermatology is a safe and effective way to help manage referrals when it is used as part of a complete clinical pathway.
Hiqa estimated that a teledermatology-supported referral pathway would cost an additional €2.7 million over 10 years, but would enable an additional 270,000 patients to be managed compared with the current referral system.
In its advice to the HSE and the Minister for Health, Hiqa said it could be “implemented in the short term to help reduce the substantial unmet need in Irish dermatology services and to support the management of primary-care referrals … and support the timely delivery of safe and effective care”.
“However, in addition to these efficiency gains, other actions are required to fully address the significant and growing demand-capacity gap in this area,” its advice said.
“These include recruitment of more clinical staff, and potentially insourcing and outsourcing initiatives. More consultant dermatologists are required, although recruiting and retaining suitably qualified doctors is a persistent challenge across the healthcare system.”
Dr Conor Teljeur, Hiqa’s chief scientist, said teledermatology was widely used internationally and there was a “large body of evidence to support its use”.
“However, teledermatology can only do so much to bridge the gap between demand and capacity. There remains an urgent need to recruit more consultant dermatologists,” he added.