Minor Surgery

Primary Care minor surgery remains at a cross-road. The development of predominantly consultant based treatment pathways are threatening to sideline this popular and cost-effective specialty. GPs may be forced down the road of ever less essential procedures. Alternatively, GPs can choose the route of improved standards, training and accountability and from there work as GPs with Extended Roles (GPwER, formerly known as GPwSI) or, if working under Acute Trust governance as Model 2 Practitioners. 

 

There is published guidance for the management of skin cancer and for the different levels of skills and governance required to provide community based minor surgery: 

 

Guidelines

Evidence

In May 2016 the BJGP (Br J Gen Pract. 2016 May;66(646)) published the outcome of the Community-Based Surgery Audit (CBSA) "Safety of community-based minor surgery performed by GPs: an audit in different settings (Botting JCorrea ADuffy JJones Sde Lusignan S).   This UK wide audit concluded that GP minor surgery is safe and prompt. GPs working within a managed framework (GPwER) performed better. 

Developments

 

Working with the British Association of Dermatologists the RCGP is exploring a centralised system to ensure GPs with Extended Roles have access to a standardised methodology for accreditation and re-accreditation.  This enhanced process would mirror similar credentialling pathways for medical specialties.

 

Resources

  • Association of Surgeons in Primary Care  A UK based organisation that acts as a meeting place for GPs with similar interests.  It helps GPs develop a wide range of surgical skills along with mentoring and business development.
  • Primary Care Dermatolgy Society  A UK based organisation that brings dermatology and skin surgery enthusiasts together.  The PCDS provides regular dermatology and skin surgery training to its members.

 

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