Staff at London's University Hospital Lewisham hospital have slashed the average wait for a dermatology appointment from 48 to 13 weeks. They compared the number of routine and urgent slots with numbers and types of referrals - and found there were too few routine appointments available.

But Amanda Millard, deputy director of support services, fears the two-week waiting guarantee for suspected tumours may affect the scheme: 'The GPs, not the hospital, will control referral rates'. Modernisation action teams will only work if they 'translate ideas into a language everyone understands at grass roots level', she adds.