NICE guidance allows GPs to provide more minor surgery

Updated skin cancer guidance from NICE will increase the number of minor surgical procedures in primary care.

GPs and GPSIs will now be allowed to diagnose, manage and excise low-risk BCCs (Photograph: SPL)
GPs and GPSIs will now be allowed to diagnose, manage and excise low-risk BCCs (Photograph: SPL)

NICE's recommendations, issued today, will allow GPs and GPSIs with the appropriate skill base to treat low risk basal cell carcinomas (BCCs) without the need for referral to specialists.

Meanwhile, the RCGP revealed plans to develop an online database for minor surgery GPs to enable them to compare performance nationally.

NICE's original skin cancer guideline from 2006 came under fire for its restrictive definition of ‘low risk' BCC and how skin cancer services were commissioned.

LMCs had complained that the guidance forced GPs in England and Wales to refer patients unnecessarily on to secondary care. Mounting criticism forced NICE to review its recommendations.

Under the updated guideline GPs and GPSIs will now be allowed to diagnose, manage and excise low-risk BCCs, providing PCTs or local health boards ensure they are fully accredited to do so and they undergo continuous professional development to maintain accreditation.

RCGP chairman Professor Steve Field said the updated guidance was a 'major step forward', adding that many patients would prefer to have minor surgery at their GP practice rather than going to hospital.

GPC chairman Dr Laurence Buckman said: ‘We are pleased NICE has listened to our concerns and that this guidance acknowledges the important role family doctors have to play in treating patients with low risk skin lesions or tumours.'

The RCGP said that its database, currently in development, will help minor surgery GPs track their performance against peers. This will help improve the fragmented nationwide picture of minor surgery in primary care, said the college's clinical champion for minor surgery Dr Jona­than Botting.

The online tool may also contain an interactive learning programme, enabling GPs to develop evidence of audit, continuing professional development and peer review towards revalidation.

Stephen Robinson

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