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Safety of community-based minor surgery performed by GPs: an audit in different settings.

Botting, J, Correa, A, Duffy, J, Jones, S and de Lusignan, S (2016) Safety of community-based minor surgery performed by GPs: an audit in different settings. The British journal of general practice : the journal of the Royal College of General Practitioners, 66 (646). e323-e328.

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Abstract

Minor surgery is a well-established part of family practice, but its safety and cost-effectiveness have been called into question.To audit the performance of GP minor surgeons in three different settings.A community-based surgery audit of GP minor surgery cases and outcomes from three settings: GPs who carried out minor surgery in their practice funded as enhanced (primary care) services (ESGPs); GPs with a special interest (GPwSIs) who worked independently within a healthcare organisation; and GPs working under acute trust governance (Model 2 GPs).An audit form was completed by volunteer GP minor surgeons. Data were collected about areas of interest and aggregated data tables produced. Percentages were calculated with 95% confidence intervals (CIs) and significant differences across the three groups of GPs tested using the χ(2) test.A total of 6138 procedures were conducted, with 41% (2498; 95% CI = 39.5 to 41.9) of GP minor surgery procedures being on the head/face. Nearly all of the samples from a procedure that were expected to be sent to histology were sent (5344; 88.8%; 95% CI = 88.0 to 89.6). Malignant diagnosis was correct in 69% (33; 95% CI = 54.2 to 79.2) of cases for ESGPs, 93% (293; 95% CI = 90.1 to 95.5) for GPwSIs, and 91% (282; 95% CI = 87.2 to 93.6) for Model 2 GPs. Incomplete excision was significantly more frequent for ESGPs (17%; 9; 95% CI = 7.5 to 28.3, P<0.001). Complication rates were very low across all practitioners.GP minor surgery is safe and prompt. GPs working within a managed framework performed better. Consideration needs to be given on how better to support less well-supervised GPs.

Item Type: Article
Subjects : Health Care Management
Divisions : Faculty of Arts and Social Sciences > Surrey Business School
Authors :
AuthorsEmailORCID
Botting, JUNSPECIFIEDUNSPECIFIED
Correa, AUNSPECIFIEDUNSPECIFIED
Duffy, JUNSPECIFIEDUNSPECIFIED
Jones, SUNSPECIFIEDUNSPECIFIED
de Lusignan, SUNSPECIFIEDUNSPECIFIED
Date : May 2016
Identification Number : 10.3399/bjgp16X684397
Copyright Disclaimer : ©British Journal of General Practice
Uncontrolled Keywords : clinical audit; dermatology; general practice; minor surgical procedures; quality improvement; skin neoplasm.
Additional Information : Full text not available from this repository.
Depositing User : Symplectic Elements
Date Deposited : 08 Jun 2016 16:49
Last Modified : 26 Jul 2016 10:09
URI: http://epubs.surrey.ac.uk/id/eprint/810985

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