P091 Has dermatology service demand outpaced population growth? A population-adjusted national analysis of dermatology activity in England (2005–2025)

Abstract

Dermatology services in England have experienced sustained growth in clinical activity over recent decades, particularly within outpatient care and urgent suspected skin cancer pathways. While increasing workload pressures are widely recognized, it remains unclear whether this growth reflects population expansion alone or represents a true increase in per capita dermatology service demand. The aim of this study was to determine whether dermatology service demand in England has outpaced population growth between 2005 and 2025 using population-adjusted national activity data. A retrospective population-adjusted analysis was conducted using publicly available national datasets from 2005 to 2025. Data sources included Office for National Statistics midyear population estimates, NHS outpatient dermatology activity statistics and national urgent suspected skin cancer referral data. Annual dermatology activity rates were standardized per population to assess trends in per capita service demand over time. Temporal divergence between population growth and dermatology activity was examined longitudinally. Over the study period, England’s population increased steadily, while dermatology outpatient activity and urgent suspected skin cancer referrals rose at a substantially faster rate. Population-adjusted analyses demonstrated a sustained increase in dermatology activity per 100 000 population, indicating that service demand growth exceeded that expected from demographic change alone. The divergence between population growth and service activity widened progressively, with the steepest increases observed in urgent suspected skin cancer referrals. Rising dermatology workload in England cannot be explained solely by population growth. Persistent increases in per capita demand highlight the need for population-adjusted service planning, workforce modelling and performance benchmarking to ensure sustainable and equitable dermatology care.