The British Journal of Dermatological Nursing has given Alex Anstey’s book about his career as a NHS dermatologist a five star review. The book emphasises the key role nurses play in healthcare. To create successful teams for delivery of dermatology NHS care, Anstey says, requires nurses in key roles alongside the dermatologists in the front line.
Here is the full text of the review by Bev Gambles:
“I found ‘Under The Skin’, by Alex
Anstey, delightful. The book is without
the jargon. It is easy to read, appealing
to the general public, service providers
and healthcare professionals alike.
I have had the privilege of working
with Alex for many years, and have
witnessed the drive and ambition that
he possesses first-hand. The patient is
always at the forefront of his attempts
to challenge the current state of
healthcare provision.
“One would think that the complex
challenges facing the NHS, with its
paucity of funds, are insurmountable.
Not so with Alex. He has an insight
into the way in which small changes can
make a huge impact on patient care
without the need to spend huge sums
of money. Involving others in problem
sharing through quality research and
teaching can (and does) lead to an
improvement in service.
“Alex considers the contributions
made by historical figures from the
last 200 years and the barriers and
pitfalls they faced when trying to
achieve their goals – which are always
ultimately about the better provision of
healthcare. The dedication of nurses
like Betsi Cadwaladr, whose ‘creativity in
finding solutions with limited resources’
meant that soldiers who would
otherwise have died of infection and
starvation lived to tell the tale. Equally,
without Edward Jenner’s dedication to
researching smallpox, the disease would
not have been eradicated. Nye Bevan,
inspired by the success
of the Tredegar Hospital, established
the National Health Service. Bevan had
a vision of healthcare provision for all
through national taxation.
Alex is committed to the core
principles of the NHS – quality
healthcare for all and challenging the
way in which this is delivered. Home
treatments, where the patient does
not have to travel to a secondary care
setting is not a new concept; renal
patients have been self-dialysing for
years, but within dermatology, the
provision of a home phototherapy
service is a new approach to providing
treatment within the community.
“Setting up such a service in North
Wales has improved the patient
experience considerably. This means
less travel to the secondary care
facility for treatment, and less time
away from work for patients and
their families. Alex involves PhD
students (mathematicians) to create
mathematical models of how the
service will function and benefit both
the patient and secondary care sector.
“As Alex said in the book, patients
just want to be listened to and have
good quality care delivered in a timely
manner. In many ways, we are failing our
patients by not delivering this. There
are only a handful of clinicians that have
medical knowledge and skills, a research
background and teaching experience
who can see the broader picture and
identify solutions to these problems.
“Alex questions our reasoning for
conducting procedures in a traditional
way just because it has always been
done in this fashion.
“Alex notes that GPs have the
enthusiasm but not the knowledge to
deliver dermatology care. This leads
to inappropriate referrals, generating
a backlog of care. The creation of a
collaboration of care in North Wales
undoubtedly addressed some of these
knowledge gaps. Robust teaching,
support and guidance from dermatology
specialists, timely responses to
referrals via tele-dermatology and
regular meetings between GPs and
dermatologists led to a new model of
‘Dermatology Integrated Care’.
“The book is honest. Alex
acknowledges his failings and
shortcomings, his lack of experience
as a junior doctor and the journey
towards his incredible achievements.
But throughout, he’s passionate
about delivering a better quality
healthcare service and his anecdotes
and patient stories reveal a caring
committed doctor.”
Bev Gambles is a Clinical Nurse Specialist at
Cardiff and Vale NHS Trust
Dermatological Nursing, 2022, Vol 21, No 2
http://www.bdng.org.uk
Alex Anstey 