Funding cuts threaten groundbreaking GP minor surgery audit

A groundbreaking audit that proved the safety of minor surgery in general practice faces being wound up in a move that GPs fear could undermine the evidence base for transferring work out of hospitals.

Basal cell carcinoma (Photo: iStock)
Basal cell carcinoma (Photo: iStock)

The Community-Based Surgery Audit (CBSA), which began as a joint project run by the RCGP and the Health and Social Care Information Centre (HSCIC), has gathered more than 8,000 submissions of data on minor surgical procedures in community settings from 160 volunteer GPs since 2013.

But the CBSA now faces being wound up after the HSCIC and RCGP warned they had been unable to secure funding to maintain it.

Findings from the audit show that GPs carried out skin procedures with high success rates - with complete excision of malignancies in 93% of cases, 95% accurate diagnoses for basal cell carcinomas and just a 2% rate of complications.

RCGP experts have said that evidence gathered through the audit could help extend the range of skin cancers that GPs offering minor surgery can treat.

The profession has faced a battle to be allowed to treat skin cancers, with NICE guidance in 2006 ruling GPs out of treating malignant skin lesions. GP minor surgeons have been able to operate on 'low risk' basal cell carcinomas since 2010 after lobbying from the RCGP.

GP minor surgery

Dr Jonathan Botting, RCGP clinical lead for minor surgery, said of the CBSA: 'This is a unique audit tool that provides confidence for patients that their surgeon is safe and effective, provides commissioners the evidence for high-quality commissioning and gives individual GPs evidence they need for appraisal, revalidation and accreditation. We are pursuing every avenue in a last-minute attempt to avoid losing this priceless resource.'

The CBSA has received praise from across the health sector, with the CQC highlighting it as an example of outstanding practice, and personal support from health secretary Jeremy Hunt. The CBSA is also being considered for use by NICE in the development of its new quality standards for skin cancer care.

GPs with additional training, such as those with special interest and those working under their local acute trusts, were shown by the CBSA to have comparable level of diagnostic and surgical skill to their secondary care colleagues. Complete excisions of all skin cancers exceeded 97% in these GPs.

However, an HSCIC spokeswoman said: ‘The HSCIC and the RCGP have worked together to maintain the audit and seek funding for over a year now. Unfortunately neither we nor the RCGP have been able to find another source of funding which is why it is coming to an end.’

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

Flexibility over PCN recruitment cash extended in bid to boost staff this year

Flexibility over PCN recruitment cash extended in bid to boost staff this year

NHS chiefs have added 'nurse associates' to the list of roles PCNs can hire this...

Fellowship scheme offers £10,000 a year to support every new GP

Fellowship scheme offers £10,000 a year to support every new GP

A two-year GP fellowship scheme promised in the 2020/21 GP contract deal will offer...

NHS chiefs warned not to underestimate pressure on GPs as figures show sharp rise in workload

NHS chiefs warned not to underestimate pressure on GPs as figures show sharp rise in workload

GP workload has surged sharply in recent months, official data show, underscoring...

Call for 'decisive action' to halt decline in GP continuity of care

Call for 'decisive action' to halt decline in GP continuity of care

Researchers have called for 'decisive action' to reverse declining continuity of...

Salaried roles now the most attractive career option for GPs, poll reveals

Salaried roles now the most attractive career option for GPs, poll reveals

Salaried jobs are now the most attractive career option for GPs, according to a GPonline...

PCN funding worth millions at risk as rising GP workload hits recruitment

PCN funding worth millions at risk as rising GP workload hits recruitment

GPs fear millions of pounds in primary care funding could be lost because rising...