Safety of community-based minor surgery performed by GPs: an audit in different settings
<p><strong>Background</strong> Minor surgery is a well-established part of family practice, but its safety and cost-effectiveness have been called into question.</p> <p><strong>Aim</strong> To audit the performance of GP minor surgeons in three different se...
| Main Authors: | , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Royal College of General Practitioners
2016
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| _version_ | 1817931367609008128 |
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| author | Botting, J Correa, A Duffy, J Jones, S de Lusignan, S |
| author_facet | Botting, J Correa, A Duffy, J Jones, S de Lusignan, S |
| author_sort | Botting, J |
| collection | OXFORD |
| description | <p><strong>Background</strong> Minor surgery is a well-established part of family practice, but its safety and cost-effectiveness have been called into question.</p>
<p><strong>Aim</strong> To audit the performance of GP minor surgeons in three different settings.</p>
<p><strong>Design and setting</strong> 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).</p>
<p><strong>Method</strong> 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 χ2 test.</p>
<p><strong>Results</strong> 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.</p>
<p><strong>Conclusion</strong> 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.</p> |
| first_indexed | 2024-12-09T03:20:54Z |
| format | Journal article |
| id | oxford-uuid:ebc921d2-84f1-4e2e-a2fe-a0a4b8a1fb9b |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-12-09T03:20:54Z |
| publishDate | 2016 |
| publisher | Royal College of General Practitioners |
| record_format | dspace |
| spelling | oxford-uuid:ebc921d2-84f1-4e2e-a2fe-a0a4b8a1fb9b2024-11-07T10:03:47ZSafety of community-based minor surgery performed by GPs: an audit in different settingsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:ebc921d2-84f1-4e2e-a2fe-a0a4b8a1fb9bEnglishSymplectic ElementsRoyal College of General Practitioners2016Botting, JCorrea, ADuffy, JJones, Sde Lusignan, S<p><strong>Background</strong> Minor surgery is a well-established part of family practice, but its safety and cost-effectiveness have been called into question.</p> <p><strong>Aim</strong> To audit the performance of GP minor surgeons in three different settings.</p> <p><strong>Design and setting</strong> 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).</p> <p><strong>Method</strong> 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 χ2 test.</p> <p><strong>Results</strong> 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.</p> <p><strong>Conclusion</strong> 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.</p> |
| spellingShingle | Botting, J Correa, A Duffy, J Jones, S de Lusignan, S Safety of community-based minor surgery performed by GPs: an audit in different settings |
| title | Safety of community-based minor surgery performed by GPs: an audit in different settings |
| title_full | Safety of community-based minor surgery performed by GPs: an audit in different settings |
| title_fullStr | Safety of community-based minor surgery performed by GPs: an audit in different settings |
| title_full_unstemmed | Safety of community-based minor surgery performed by GPs: an audit in different settings |
| title_short | Safety of community-based minor surgery performed by GPs: an audit in different settings |
| title_sort | safety of community based minor surgery performed by gps an audit in different settings |
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