An overview of current guidance published by national bodies designed to support NHS organisations to implement Skin Analytics DERM into NHS skin cancer pathways in line with national guidance.
DERM is a Class III AI as a Medical Device authorised to independently make clinical decisions on skin cancer without oversight.
On May 1st 2025, the National Institute for Health and Care Excellence (NICE) published its Early Value Assessment (EVA) of ‘Artificial intelligence (AI) technologies for assessing and triaging skin lesions within the urgent suspected skin cancer pathway‘.
For the autonomous use of DERM, NICE specifically stated:
‘Comparative evidence suggests that DERM may be able to identify a cancer lesion with similar accuracy to teledermatology or face-to-face dermatology assessment, with further evidence suggesting it could halve the number of referrals to dermatologists within the urgent skin cancer pathway while maintaining patient safety.‘
This decision provides a clear and long-awaited signal for NHS organisations already deploying DERM, and a confident path forward for those looking to adopt it. This recognition further validates years of clinical work, real-world evidence, and regulatory approval.
The evidence generation requirements referred to in the NICE EVA is an obligation on Skin Analytics only and individual sites are not required to take part in additional evidence generation unless agreed with Skin Analytics (NICE clarified this here).
We are working with NICE to discuss the evidence generation plan and aim to comply with that plan
These are NICE’s recommendations to mitigate risk. As with all NICE guidance, this is guidance only and can be considered at a local level.
While there is no evidence to suggest DERM underperforms in assessing people with black or brown skin, there is less data as only 0.5% of Skin Cancer in the UK is diagnosed in Black and Asian patients. NICE’s position is therefore cautious but understandable. More info can be found here.
Our teledermatology platform allows for the automatic routing of Fitzpatrick 5 and 6 patients who would otherwise be discharged by DERM to a clinician (NHS or Skin Analytics) to comply with this guidance. This is typically around 2-4% of patients, meaning this doesn’t significantly impact overall performance.
The NICE EVA confirms NHS organisations can use core funds to use DERM in an autonomous pathway in secondary care. While the EVA was specifically scoped to focus on secondary care, there is no regulatory or other barrier to using DERM in primary care, and we operate primary care pathways today.
NICE granted Skin Analytics conditional approval under the early value assessment (EVA) for a period of three years, while further evidence is gathered.
This recommendation is the best possible outcome from an EVA process.
In its response to the NICE EVA, NHS England welcomed NICE’s conditional recommendation on the autonomous use of DERM in the review and assessment of skin lesions.
Read the full NHS England response and guidance around autonomous use in NHS England’s response to the NICE EVA.
"When DERM is first introduced at a site, the site should consider using it initially with a second clinical read.
Once there is local confidence in implementation practices for DERM, the site can move to autonomous use."
NHS England’s position recognises that DERM’s performance is not in question, with the Class III regulatory approval meaning that there is an independent body (our notified body) that reviews our safety update reports as part of post-marketing surveillance requirements.
However, NHS England has now released a toolkit to support sites with implementation of DERM, which recommends that:
“When DERM is first introduced at a site, the site should consider using it initially with a second clinical read. Once there is local confidence in implementation practices for DERM, the site can move to autonomous use.”
This approach is entirely sensible and we have an established and tested approach which helps your teams to:
When the team is ready to move to fully autonomous use (usually once comfort and confidence with implementation practices has been developed) our transformation team will be able to support you in launching an autonomous DERM pathway.
Evidence on the use of DERM with second read suggests additional demand on specialist capacity is significant:
For an NHS Trust receiving 10,000 urgent suspected skin cancer referrals and with a goal of objective of reducing the number of patients on waiting lists to zero, using DERM autonomously (compared to using it with second read) would:
This capacity release can support efforts to reduce urgent suspected skin cancer waiting lists and support Trust’s in improving performance against the Faster Diagnosis Standard.
NHSE published their “Implementing Artificial Intelligence in skin lesion pathways: a toolkit” on the Digital Innovation Team’s FutureNHS site on 9th December 2025.
This toolkit – developed based on good practice and lessons learned at existing DERM implementation sites – provides a comprehensive outline of the process new partners should expect to follow to ensure the most effective rollout of AI triage. With these templates and support from our Transformation team, rollout can be completed in a few weeks.
Skin Analytics welcomes the publication of the toolkit as further support for Trust adoption and NHS England’s confidence in DERM skin cancer pathways, as well as showing NHS England’s commitment to taking a leading position globally in the use and adoption of innovative AI technologies in healthcare.
The toolkit reflects learnings from more than five years of DERM’s use by NHS partners.
Publication of the toolkit follows other recent guidance and documents from NHS England which indicate the value of AI triage in skin cancer pathways:
The guide summarises the benefits together with the key steps to implementation, including specific guidance in the following areas:
