 The President of the British Association of Dermatologists said this was "just one example of the many fires we are fighting across the UK to try to keep dermatology services open in the face of poorly thought-out commissioning decisions and the Government’s lack of understanding of the implications of pushing NHS services into unsustainable models provided by commercially driven private providers or enterprises,”  The exodus of doctors left a department with too few staff to function, and put Circle under "financial pressure" because they had to pay nearly £300,000 per year each for six locum doctors, some insufficiently qualified to be on the specialist register.A report, by Dr Chris Clough of Kings College Hospital, London, called for the trust, Circle and Rushcliffe Clinical Commissioning Group to work together to solve the problem.The handling of these changes by both commissioners and providers was described as an ‘unmitigated disaster'.