Patient guide
Private dermatology or the NHS urgent skin cancer pathway: how to choose
If a mole worries you, there are two ways to be seen quickly: your GP can refer you on the NHS urgent suspected cancer pathway, or you can book privately. Both can be appropriate. This guide explains how each works, what to consider and why the urgent pathway is not something to bypass.
Last checked: 2026-10-03
Key facts
At a glance.
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Urgent pathway
If a GP suspects skin cancer, they can refer on a pathway intended to get specialist assessment quickly.
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Free at the point of use
NHS assessment, biopsy and treatment for suspected skin cancer are free for eligible patients.
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Private option
Private dermatology offers faster routine access and longer appointments, at your own cost.
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Do not delay
A lesion that is changing, bleeding or growing should be assessed promptly by whichever route is fastest and safest.
The NHS urgent pathway
The pathway is designed for people whose GP suspects cancer according to NICE guidance (NG12). For pigmented lesions, clinicians use a weighted checklist of features, such as change in size, shape or colour, and refer if the score is high or if melanoma is suspected. Non-pigmented lesions, such as a rapidly growing nodule suspected to be squamous cell carcinoma, are also referred urgently. Historically called the two-week wait, the pathway sets targets for how quickly patients are seen, though real waits vary by area and over time.
What a GP does
A GP will examine the lesion, often with a dermatoscope, and may take or send images for review by a specialist. They decide whether to refer urgently, arrange routine review, advise monitoring or reassure you. If you are worried, say so clearly and mention changes, family history and previous skin cancers. If you are not satisfied, you can ask to discuss it further or request a second opinion within the practice.
What private dermatology offers
Private dermatologists, who should be on the General Medical Council specialist register for dermatology, can examine and, if appropriate, biopsy or remove a lesion quickly. Appointments tend to be longer, and results are often faster. Costs vary widely and may include separate fees for consultation, procedures and histology, so ask for an itemised quote. If cancer is diagnosed, you can usually choose to continue privately or transfer to the NHS.
Points to compare
| Point | NHS urgent pathway | Private dermatology |
|---|---|---|
| Cost to you | None at the point of use | You pay for consultation, procedure and tests |
| Access | Via GP referral | Direct booking, though some insurers want a GP referral |
| Speed | Prioritised for suspected cancer; waits vary | Often quicker for first appointment |
| Continuity | Integrated skin cancer teams and multidisciplinary meetings | Depends on provider; teams may be linked to hospitals |
| Ongoing care | Follow-up on NHS pathways | You may need to arrange follow-up and pay for it |
A sensible approach
If you are worried about a specific lesion, see your GP promptly, because they can trigger the pathway and examine you at no cost. If you prefer or need quicker access, a private dermatologist is a legitimate choice, but make sure they will arrange histology of anything removed and clear follow-up. Do not rely on a cosmetic clinic or non-specialist to assess a suspicious lesion.
If cancer is found
Melanoma and other skin cancers are managed by specialist teams, with surgery as the main treatment for most. Treatment pathways are well established on the NHS and in the private sector. If you started privately, ask whether the treating team follows national guidelines and whether the case will be discussed at a multidisciplinary meeting.
Frequently asked
Questions people ask.
Quick, plain-English answers to the questions we hear most.
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Does a private mole check replace seeing my GP?
It can complement it, but a worrying lesion should be assessed promptly by whichever route is quickest and appropriately qualified.
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Will the NHS see me if a private clinic referred me?
Usually via your GP, who can refer on the appropriate pathway.
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How fast is the NHS urgent pathway?
It aims for rapid assessment. Actual waits vary, so ask when you are referred.
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Can I self-refer to an NHS dermatologist?
Generally no. A GP referral is needed.
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What if my GP does not think it is serious?
Ask about monitoring or a second opinion, and return if the lesion changes.
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Do insurers cover private dermatology?
Many require GP referral and cover assessment for suspected cancer, but check your policy.
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Is private histology as reliable?
Yes, if processed by an accredited laboratory with a consultant pathologist. Ask who reports it.
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Can I get a second opinion on histology?
Yes. Ask your clinician about a review by a specialist skin pathologist.
Where this comes from
Sources and checking.
This guide is for information, not medical advice.
Your GP or consultant knows your history and can tell you which parts apply to you. If your symptoms are severe, rapidly worsening, or come with red-flag features, seek urgent medical care. Figures and availability change, so treat them as a guide and confirm with the provider.
Published 2026-10-03, next review 2027-10-03.
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NICE guideline NG12, Suspected cancer: recognition and referral (nice.org.uk)
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NHS website, Skin cancer (melanoma and non-melanoma) pages (nhs.uk)
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British Association of Dermatologists, patient information leaflets (bad.org.uk)
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General Medical Council, Good practice in prescribing and managing medicines and devices (gmc-uk.org)