Editorial: Minor surgery ripe for growth in primary care

Would your practice like to earn an extra £32,000 a year?

This is the type of sum GPs offering regular minor skin surgery sessions could pocket if work is transferred out of hospitals and into primary care.

This week GP reveals exclusively that the NHS is wasting millions of pounds on minor surgery in secondary care that could be commissioned from GP practices, because of unnecessary restrictions on GPs, according to the RCGP.

Estimates suggest at least £57m a year could be saved from NHS budgets if primary care was given greater responsibilities for excising melanomas and some non-melanoma skin cancers alone.

We take an in-depth look at the issue and the RCGP's bold attempt to reverse the decline in primary care minor surgery and convince commissioners in the new-look NHS that primary care really can deliver.

So why isn't this already happening now?

PCTs often placed caps on such work in the past and clinical commissioning groups (CCGs) will need convincing that there is evidence that the expansion of GP minor surgery actually works.

The RCGP should be applauded therefore for its three-year project with the NHS Information Centre to audit the performance of GPs practising minor surgery.

Feedback from patients is also vital. Would they rather be seen in their practice or at hospital and is it safe to transfer such work into primary care? Is there a case for more consultants working out of hospitals and in primary care?

At a time when the Nicholson challenge to save £20bn is at the forefront of everyone's mind, big ideas such as these, which build on the successes of general practice, are welcome.

But if such a switch is to be successful, CCGs must also ensure that the funding for such workload shifts is taken from hospitals to pay for the training, expertise and premises that will be needed in primary care.

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