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Background/Aims Melanoma is the most aggressive skin malignancy with an ever-increasing caseload, especially in the western world. Recently developed immunotherapeutic modalities have substantially improved the prognosis of advanced melanoma. The association between serum levels of vitamin D and prognosis of melanoma has been a focus of ongoing research, with some evidence of vitamin D's potential as an adjunctive modality to immunotherapy. The National Institute for Health and Care Excellence guidelines clearly recommend that assessment of vitamin D levels and relevant advice should be an inherent aspect of the management of patients with melanoma at the secondary care level. Method A service improvement project was conducted to ensure full compliance of practice in the authors' skin unit with the current National Institute for Health and Care Excellence guidelines on the management of vitamin D status in patients with melanoma. Results After two reaudits the unit's practice complied with National Institute for Health and Care Excellence guidelines by using a multidisciplinary team approach. Conclusions The authors propose that the simple and reliable pathway used to achieve and sustain the results could be easily adopted to ensure universal adherence to these guidelines.

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<p class="abstract"><strong>Background: </strong>Coronavirus disease 2019 (COVID 19) has created an immense strain on the NHS. During the height of the pandemic, trauma services were affected by redeployment, reduced theatre capacity and staff illness, and COVID BOAST guidelines were introduced.</p><p class="abstract"><strong>Methods: </strong>This retrospective study aimed to evaluate the standards of management of open fractures of the lower limb at a Major Trauma Centre in the United Kingdom during the COVID-19 pandemic and compare the same with the pre-pandemic period. Patient demographics, mechanism of injury, timing and mechanism of initial debridement and definitive soft tissue and skeletal fixation were noted. Outcomes including duration of hospital stay, 30 day and 1 year mortality were also assessed.</p><p class="abstract"><strong>Results: </strong>There was an overall 21% reduction in admissions with open lower limb fractures during the pandemic period with a 48% reduction during the first lockdown. There was a significant reduction in time taken from Emergency Department presentation to first debridement as well as a notable increase in operating outside of regular theatre hours. There was little difference in operative technique used for skeletal or soft tissue management at initial and definitive surgery, though fewer cases were performed as a two stage procedure. There was no difference in amputation rate in the two years. Length of stay was reduced from 21 days to 17, and 30 day mortality remained the same.</p><p class="abstract"><strong>Conclusions:</strong> Our study shows this Major Trauma Centre was able to provide a trauma service in accordance to the BOAST4 guidelines despite the increased pressures of the COVID-19 pandemic.</p>

Background/Aim Multidisciplinary team meetings have been an integral part of comprehensive cancer services in the UK for over 20 years. The COVID-19 pandemic led to the adoption of virtual platforms to allow these meetings to continue with minimal in-person contact. This study assessed multidisciplinary team members’ perspectives regarding the efficacy of the virtual platform, with the view of continuing this mode of delivery in the post-pandemic world. Methods A two-phased survey study was conducted among all members of the cancer multidisciplinary team in one UK hospital. Respondents completed a four-part questionnaire 6 months (n=108) and 1 year (n=120) after the implementation of the virtual platform in March 2020 to determine their perceptions of its effectiveness and safety. Results There was a statistically significant (P<0.05) improvement between the 6-month and 1-year survey responses in terms of overall satisfaction with the virtual platform, ease of use and efficiency of collective decision making using the virtual format. After 1 year, 80.5% of respondents preferred either continuing to use the virtual platform exclusively or switching to a hybrid model. Conclusions Staff experiences of using a virtual platform for cancer multidisciplinary team meetings may improve over time, with many respondents preferring this mode of delivery. Virtual meetings can provide greater flexibility and allow wider participation, potentially including specialists from across the globe.