The NHS Plan 2000 proposed the development of specialist GPs to take referrals from other GPs in specialities including dermatology. The NHS Modernisation Agency Action on Dermatology (AoD) programmefunded pilot site studies of dermatology GPwSI, services and preliminary results were encouraging. Guidelines for the development of GPwSI services were developed within the framework of the AoD programme, which includes representation from all stakeholders including the British Association of Dermatologists, Royal College of General Practitioners and the Primary Care Dermatology Society. The Department of Health (DH) published these guidelines in April 2003 (Department of Health. Guidelines for the Appointment of General Practitioners with Special Interests in the Delivery of Clinical services: Dermatology. London: DH, 2003). The aim of this study was to audit dermatology GPwSI services against the DH framework with particular regard to accreditation, experience and links with secondary care.