Ooh, interesting. It depends who thinks you need an annual screening. Usually, unless there is a particular problem or risk of problem that means the NHS guidelines agree you need an annual check, then no. Say you had a Weird Mole, and your GP agreed you should be referred, and the dermatologist guy was like “I’m fine with how this mole is but I’d like to see you again in 6 months to see if it’s changed”, then his secretary would book you in for 6 months. If there was felt to be an ongoing need, then that might keep happening. If, however, he said “yeah, that IS a weird mole”, you’d have the appointments relevant to that, as an outpatient in his clinic (his “clinic” being the days of the week in which he sees Weird Mole patients in the relevant department of the hospital, not like his own clinic unless he’s private), eg consultation, whipping it off, and follow up. And if he’s satisfied that eg the mole is off and it’s fine, you’d be discharged from his clinic and if you then felt - perfectly reasonably - that you’d like all your moles looked at by him annually, you’d still need to go back through your GP (who would need to think they looked sufficiently weird for a specialist to look at them). You could pay out of pocket to see him whenever you liked, if he also did private work.

Equally, tbh, this would be true of my health insurance. I need a GP’s referral usually to indicate that something is necessary and then the insurance will pay up. I THINK. But I’m an insurance novice.