Financial implications and adherence to 2 week wait referral times from minor surgical lists in primary care with regards to malignant skin lesions
Aims & Objectives
Minor operative lists in general practice shoulder a significant proportion of dermatological diagnostics work from secondary care, saving the NHS money. Majority of skin incision biopsies from primary care are benign however suspicious lesions require efficient referral under 2 week wait (2WW). In this regard it reduces the burden of minor surgery cases on secondary services. We set out to:
Tanworth-in-Arden represents an affluent Caucasian community with a stable patient base with significant number spending many months a year abroad in temperate climates. We retrospectively analysed the data of 317 patients in the area that attended a minor operative list for excision of a skin lesion and had a biopsy between 2014 and 2016. Cases were analysed for formal histological biopsy diagnosis as well as GP impression of lesions were noted for low risk lesions from the notes.
Malignant or suspicious lesions meeting 2WW criteria were assessed for timing: from diagnosis to referral and referral to outpatient appointment. We also made an assessment on the financial saving of these patients being managed in primary care vs. secondary care.
Primary care is invaluable for minor operative diagnostics work for benign conditions. It has the potential to deliver a high standard of care for concerning pathology. As treatment in secondary care requires a GP appointment first anyway, excision in primary care is overall more cost-effective whilst saving time. In this regard we should explore and remain open to strategies of safely mobilising further surgical work to primary care in future.